Observational study of informative value of routine EEG and nocturnal EEG-video monitoring in adult patients with epilepsy in the real-life setting
Abstract
The aim was to study the informative value of routine EEG and nocturnal EEG-video monitoring in adult patients with epilepsy.
Materials and methods. We examined 1217 patients who were referred to a specialized epilepsy clinic; of those, 589 (48.4%) men and 628 (51.6%) women aged from 22 to 83 years. In these patients, the age of seizure onset varied from I month to 72 years. The inclusion criteria in this study were: an age over 18 years and two or more epileptic seizures in the medical history. The exclusion criteria: a history of non-epileptic seizures of any etiology and/or the inability to perform regular EEG or EEG video monitoring. The examination included medical history records, clinical and neurological examinations, routine EEG and EEG video monitoring, brain MRI, and laboratory tests. In total, 915 routine EEG and 302 nocturnal EEG video monitoring were performed.
Results. During the routine EEG procedure, no epileptiform activity was detected in 379 (41.42%) patients. Among other patients, non-epileptic changes were found in 163 (17.81%), focal epileptiform activities - in 203 (22.19%), and generalized epileptiform activities - in 170 (18.58%) patients. During the nocturnal EEG-video monitoring, no epileptiform activity was detected in 34 (11.26%) patients; among other patients, non-epileptic changes were found in 11 (3.64%), focal epileptiform activities - in 167 (55.3%), and generalized epileptiform activities - in 90 (29.8%) patients.
Conclusion. Routine EEG and nighttime EEG video monitoring do not always reveal an epileptiform activity. The probability of detecting an epileptiform activity is higher with nocturnal EEG video monitoring due to its longer record duration and an increased epileptiform activity in sleep. The probability of detecting an epileptiform activity also depends on the form of epilepsy. It is advisable to gradually replace a routine EEG procedure with a nocturnal EEG-video monitoring.
About the Authors
K. V. Firsov
Moscow Regional Research and Clinical Institute (MONIKI)
Russian Federation
Russian Federation
Konstantin V. Firsov- MD, PhD, Neurologist, State Budgetary Healthcare Institution.
61/2 Shchepkina Str., Moscow 129110
A. S. Kotov
Moscow Regional Research and Clinical Institute (MONIKI)
Russian Federation
Russian Federation
Aleksei S. Kotov - MD, PhD, Doctor of Medical Sciences, Head of the Department of Pediatric Neurology, Professor at the Department of Neurology, State Budgetary Healthcare Institution.
61/2 Shchepkina Str., Moscow 129110
References
1. Speranskij A.D. Epileptic seizure. Moscow. 1932; 60 s. (in Russ.).
2. Sundaram M., Sadler R.M., Young G.B., Pillay N. EEG in epilepsy: current perspectives. Can J Neurol Sci. 1999 Nov; 26 (4): 255-62. Review. PubMed PMID: 10563209.
3. Avakyan G.N. Modern epileptology. Problems and solutions. Epilepsia i paroksizmal’nye sostoania / Epilepsy and Paroxysmal Conditions. (In Russ.) 2014; 6 (4): 46-49.
4. Benbadis S.R. What type of EEG (or EEG-video) does your patient need? Expert Rev Neurother. 2015 May; 15 (5): 461-4. DOI: 10.1586/14737175.2015.1029918. Epub 2015 Mar 25. PubMed PMID: 25804449.
5. Belova Yu.A., Rudakova I.G., Kotov A.S., Kotov S.V. The effectiveness of the treatment of focal epilepsy in stroke patients. Klinicheskaya gerontologiya. 2014; 20 (7-8): 6-8.
6. Kotov A.S. Epilepsy in patients with alcohol and drug abuse. Zhurnalnevrologiiipsixiatriiim. S.S. Korsakova. (in Russ.) 2015; 115 (10): 85-88.
7. Rudakova I.G., Belova Yu.A., Kotov A.S. Pharmacoresistant epilepsy is treatable. Vestnikehpileptologii. (in Russ.) 2013; 1: 3-7.
8. Fisher R.S., Cross J.H., French J.A., Higurashi N., Hirsch E., Jansen F.E., Lagae L., Moshe S.L., Peltola J., Roulet Perez E., Scheffer I.E., Zuberi, S.M. Operational classification of seizure types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017; doi:10.1111/epi.13670.
9. Scheffer I.E., Berkovic S., Capovilla G., Connolly M.B., French J., Guilhoto L., Hirsch E., Jain S., Mathern G.W., Moshe S.L., Nordli D.R., Perucca E., Tomson T., Wiebe S., Zhang Y.-H., Zuberi S.M. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017; doi:10.1111/epi.137091-3.
10. Editorial A. Guidelines for carrying out of routine EEG of neurophysiology expert board of Russian League Against Epilepsy. Epilepsia i paroksizmal’nye sostoania / Epilepsy and Paroxysmal Conditions. (in Russ.) 2016; 8 (4): 99-108.
11. Brodie M., Schachter S. Fast Facts - Epilepsy. Oxford: Health Press Limited 2001; 82.
12. Petruxin A.S., Muxin K.Yu., Blagosklonova N.K., Alixanov A.A. Epileptology of childhood. Moscow. (In Russ.) 2000; 623 s.
13. Kotov A.S. The course and prognosis of symptomatic and cryptogenic partial epilepsy in adults. MD diss. (In Russ.) 2010; 192 s.
14. Groppa S.A., Kiosa V.A., Hanganu A.T. Particulars of clinical polymorphism of acute epileptic seizures. Clinical telemetric video-eeg examination. Epilepsia i paroksizmal’nye sostoania / Epilepsy and Paroxysmal Conditions. (In Russ.) 2010; 2 (2): 6-9.
15. Hui A.C., Kwan P., Leung T.W., Soo Y., Mok V.C., Wong L.K. Diagnostic value and safety of long-term video-EEG monitoring. Hong Kong Med J. 2007 Jun; 13 (3): 228-30. PubMed PMID: 17548912.
16. Erlichman M. Electroencephalographic (EEG) video monitoring. Health Technol Assess Rep. 1990; (4): 1-14. Review. PubMed PMID: 2104066.
17. Lancman M.E., Asconape J. Clinical value of electroencephalographic monitoring in closed-circuit television (EEG-video). Analysis of 44 studies. Medicina (B Aires). 1990; 50 (4): 315-8. Spanish. PubMed PMID: 2130225.
18. Benbadis S.R. What can EEG-video monitoring do for you and your patients? J Fla Med Assoc. 1997 Jun-Jul; 84 (5): 320-2. Review. PubMed PMID: 9260437.
19. Remi J., Noachtar S. Differential diagnosis of epileptic seizures. Nervenarzt. 2012 Feb; 83 (2): 162-6. DOI: 10.1007/s00115-011 -3427-z. German. PubMed PMID: 22237650.
20. Mironov M.B., Mukhin K.Yu., Abramov M.O., Bobylova M.Yu., Krasilschikova T.M., Petrukhin A.S. Video-EEG-monitoring in diagnosis of myoclonic absences. Epilepsia iparoksizmal’nye sostoania / Epilepsy and Paroxysmal Conditions. (in Russ.) 2016; 1: 66-74. https://doi.org/10.17749/2077-8333.2016.8.1.066-074.
21. Kotov A.S. Epilepsy and sleep. Zhurnal nevrologii i psixiatrii. (In Russ.) 2013; 7: 4-10.
22. Khachatryan S.G., Tunyan Y.S. Differential diagnosis of nocturnal epileptic and nonepileptic paroxysmal phenomena of sleep in adults. Epilepsia i paroksizmal’nye sostoania / Epilepsy and Paroxysmal Conditions. (In Russ.) 2013; 5 (3): 59-64.
23. Benbadis S.R. The EEG in nonepileptic seizures. J Clin Neurophysiol. 2006 Aug; 23 (4): 340-52. Review. PubMed PMID: 16885708.
24. Morris H.H., Klem G., Gilmore-Pollak W. Hair loss after prolonged EEG/ video monitoring. Neurology. 1992 Jul; 42 (7): 1401-2. PubMed PMID: 1620354.
25. Pillai J.A., Haut S. R. Patients with epilepsy and psychogenic non-epileptic seizures: an inpatient video-EEG monitoring study. Seizure. 2012 Jan; 21 (1): 24-7.
26. Muxin K. Yu., Petruxin A. S., Gluxova L. Yu. Epilepsy: Atlas of electro-clinical diagnosis. Moscow. (In Russ.) 2004; 389-406.
27. Billiard M., Echenne B., Besset A. et al. All-night polygraphic recordings in the child with suspected epileptic seizures, in spite of normal routine and post-sleep deprivation EEGs. Electroencephalogr Clin Neurophysiol. 1981; 11: 450-460.
28. Gnezditskiy V.V., Korepina O.S., Karlov V.A., Novoselova G.B. Pathological signs of epileptic and non-epileptic origin detected in awake/sleep EEG patterns during outpatient and inpatient monitoring: problems of interpretation. Epilepsia iparoksizmal’nye sostoania / Epilepsy and Paroxysmal Conditions. (In Russ.) 2017; 9 (2): 30-40. https://doi.org/10.17749/2077-8333.2017.9.2.030-040.
29. Goodwin E., Kandler R.H., Alix J.J. The value of home video with ambulatory EEG: a prospective service review. Seizure. 2014 Jun; 23 (6): 480-2. DOI: 10.1016/j.seizure.2014.02.008. Epub 2014 Feb 27. PubMed PMID: 24631016.
30. Gnezdickij V.V., Zaxarov S.M., Korepina O.S., Koshurnikova E.E. Modern technologies of long-term monitoring of EEG and polygraphic indicators in neurological practice. Annaly klinicheskoj i ehksperimental’nojnevrologii. (In Russ.) 2009; 3 (1): 25-34.
31. Kotov A.S, Tolstova N.V. Towards the question of idiopathic generalized and cryptogenic focal epilepsies in adolescences and young adults. Nevrologicheskijzhurnal. (In Russ.) 2012; 1: 21-25.
32. Kitaeva V.E., Kotov A.S. Treatment of patients with prolonged course of medial temporal epilepsy. Epilepsia i paroksizmal’nye sostoania/ Epilepsy and Paroxysmal Conditions. (In Russ.) 2018;10 (3): 31-37. https://doi.org/10.17749/2077-8333.2018.10.3.031-037.
33. van Griethuysen R., Hofstra W.A., van der Salm S.M.A., Bourez-Swart M.D., de Weerd A.W. Safety and efficiency of medication withdrawal at home prior to long-term EEG video-monitoring. Seizure. 2018 Mar; 56: 9-13. DOI: 10.1016/j.seizure.2018.01.016. Epub 2018 Jan 31. PubMed PMID: 29414595.
34. Kotov A.S. Antiepileptic drugs and seizure aggravation. Zhurnal nevrologiii psixiatrii im. S.S. Korsakova. (In Russ.) 2014; 114 (11-2): 32-36.
35. Sanders P.T., Cysyk B.J., Bare M.A. Safety in long-term EEG/video monitoring. J Neurosci Nurs. 1996 Oct; 28 (5): 305-13. Review. PubMed PMID: 8950695.
36. Trevathan E. Ellen R. Grass Lecture: Rapid EEG analysis for intensive care decisions in status epilepticus. Am J Electroneurodiagnostic Technol. 2006 Mar; 46 (1): 4-17. PubMed PMID: 16605169.
37. Noachtar S., Guldiken B. Diagnosis of non-epileptic paroxysmal disorders and epileptic seizures. Nervenarzt. 2017 Oct; 88 (10): 1109-1118. DOI: 10.1007/s00115-017-0397-9. Review. German. PubMed PMID: 28842725.
38. Burgess R.C. Design and evolution of a system for long-term electroencephalographic and video monitoring of epilepsy patients. Methods. 2001 Oct; 25 (2): 231-48. Review. PubMed PMID: 11812208.
39. Kalitzin S.N., Bauer P.R., Lamberts R.J., Velis D.N., Thijs R.D., Lopes Da Silva F.H. Automated Video Detection of Epileptic Convulsion Slowing as a Precursor for Post-Seizure Neuronal Collapse. Int J Neural Syst. 2016 Dec; 26 (8): 1650027. Epub 2016 Apr 4. PubMed PMID: 27357326.
40. Avakyan G.N., Badalyan O.L., Burd S.G., Rider F.K., Voronina T.A., Nerobkova L.N. Spectral and coherent analysis of the spatial organization of the bioelectrical activity of the brain in patients with epilepsy before and after treatment. Nejrodiagnostika i vysokie biomedicinskie texnologii. (In Russ.) 2006; 2: 91-96.
41. Pauri F., Pierelli F., Chatrian G.E., Erdly W.W. Long-term EEG-video-audio monitoring: computer detection of focal EEG seizure patterns. Electroencephalogr Clin Neurophysiol. 1992 Jan; 82 (1): 1-9. PubMed PMID: 1370137.
42. Rommens N., Geertsema E., Jansen Holleboom L., Cox F., Visser G. Improving staff response to seizures on the epilepsy monitoring unit with online EEG seizure detection algorithms. Epilepsy Behav. 2018 Jul; 84: 99-104. DOI: 10.1016/j.yebeh.2018.04.026. Epub 2018 May 11. PubMed PMID: 29758446.
For citation:
Firsov K.V., Kotov A.S. Observational study of informative value of routine EEG and nocturnal EEG-video monitoring in adult patients with epilepsy in the real-life setting. Epilepsy and paroxysmal conditions. 2019;11(2):153-163. (In Russ.) https://doi.org/10.17749/2077-8333.2019.11.2.153-163
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