Role of short-term video electroencephalogram in monitoring seizure diagnosis

Introduction Epilepsy is known to have a major effect on quality of life of the individuals. More than 50 million people around the world suffer from epilepsy [1]. Given the diverse clinical picture and manifestations of epilepsy, the differential diagnosis is wide, suggesting that a precise diagnosis is often difficult to achieve for physicians creating a practice gap making an accurate and early diagnosis of epilepsy not fulfilled [2]. EEG recordings have been frequently modified for the benefit of proper evaluation of epilepsy. Advances in video EEG monitoring suggested a large spectrum in clinical applications [3]. Determination of the ictal symptomatology differentiates between types of epileptic seizures and also differentiates epileptic from non-epileptic seizures [4]. Inspection of seizure semiology is the first step in evaluation of patients with seizure disorders and is an important tool to predict the symptomatic cause [5]. The most frequently used is outpatient “routine” EEG, lasting 20–30min, to diagnose individuals with suspected seizure disorders [6]. Long-term video EEG monitoring (LVEM), carried out over days to weeks, is mostly performed for inpatients in the presurgical assessment of epilepsy to characterize complex epileptic syndromes and to record seizure frequency [7]. Short-term video EEG monitoring (STVEEG) is lasting for less than 24 h. It takes advantage over long-term video EEG monitoring that it is less resourceand costintensive than long-term video EEG monitoring [8]. The present study aimed to assess the benefit of Short-term video EEG monitoring in the diagnosis of patients with seizure disorders. Subjects and methods This is a cohort study carried out on 80 patients complaining from seizure disorders. The study was carried out at Cairo University Hospitals, the period from November 2016 to January 2018. The experimental method was approved by the ethical committee of the national research center 20 December 2016, under registration number 16465. The study included 80 patients complaining from seizures, of both sexes. The pseudoepileptic group was further subdivided of numbers of males and females following the new diagnosis after STVEEG. The age of the studied patients ranged from 8 to 59 years, which were subdivided into 3 groups according to the onset into childhood-onset including 60 patients, juvenileonset (11 patients) and adulthood-onset epilepsy (9 patients). Patients were recruited from epilepsy clinic at Cairo University Hospital with the following inclusion criteria: epileptic patients (regardless of whether symptomatic, idiopathic, focal, or generalized), available routine EEG with previously positive findings. The following were excluded from the study: patients with age less than 8 years or more than 59 years and associated chronic medical condition (heart diseases, metabolic diseases). All participants were submitted to thorough clinical assessment including careful general medical assessment and detailed medical history of the seizure (including the full description of the seizure), in addition to the results of any previous brain imaging if present (CT or MRI brain). Neurophysiological tests including digital short-term video EEG examination. The brand of the used machine was EBNeuro Galileo/ EBNeur via P.Fanfani 97/A Firenze, Italy. The highfrequency filter was 70 Hz and the time constant 0.3. The paper speed was 30mm/sec and the sampling rate