How Long Does It Take to Make an Accurate Diagnosis in an Epilepsy Monitoring Unit?

被引:53
作者
Friedman, David E. [1 ]
Hirsch, Lawrence J. [1 ]
机构
[1] Columbia Univ, Neurol Inst, Comprehens Epilepsy Ctr, Med Ctr, New York, NY USA
关键词
Video-EEG monitoring; Epileptic seizures; Nonepileptic seizures; Epileptiform discharges; Length of stay; Cost; Insurance; PSYCHOGENIC NONEPILEPTIC SEIZURES; OCCIPITAL LOBE EPILEPSY; VIDEO-EEG; SURGERY; MANIFESTATIONS; LEVETIRACETAM; FREQUENCY; CHILDREN; UTILITY; EVENTS;
D O I
10.1097/WNP.0b013e3181b2f2da
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
This study reports the existence of patients requiring prolonged monitoring with video-electroencephalography to make an accurate diagnosis and to quantify how often this occurs. The authors performed a retrospective review of 248 Consecutive adult patients admitted to the epilepsy Monitoring unit during 12 months for event characterization or presurgical evaluation. For the diagnosis of definite epilepsy, at least one epileptic seizure must have been recorded with video-electroencephalography. The median time to first diagnostic event, whether epileptic seizure or nonepileptic event, was 2 days 35% required 3 or more days and 7% > 1 week. Twelve percent of those with definite epilepsy never had interictal epileptiform discharges and 17% of those with nonepileptic events had interictal epileptiform discharges. Six percent of patients with definite epilepsy had neither epileptic Seizures nor interictal epileptiform discharges until clay 3 or after. Based on our results, it is common to require 3 or more days in an epilepsy monitoring unit to record and diagnose the nature of paroxysmal episodes and not rare to require more than a week. Interictal electroencephalography alone cannot reliably distinguish between those with epileptic seizures and nonepileptic events.
引用
收藏
页码:213 / 217
页数:5
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