TP3-6 Preliminary evaluation of diagnostic home video telemetry (HVT)

2019 ◽  
Vol 90 (3) ◽  
pp. e19.2-e20
Author(s):  
W Stern ◽  
G Leschziner ◽  
R Howard ◽  
M Koutroumanidis
Keyword(s):  
Clinical Information ◽  
Epileptic Seizures ◽  
Preliminary Evaluation ◽  
Clinical Question ◽  
Home Video ◽  
Clinical Events ◽  
Idiopathic Hypersomnia ◽  
Diagnostic Hypothesis ◽  
Generalized Epilepsy ◽  
Video Eeg

ObjectivesTo assess the clinical usefulness of HVT over the first 2 years.DesignCohort observational.Subjects60 patients (49 F) with epilepsies or non-epileptic paroxysmal clinical events.Methods48–72 hour continuous video EEG at patients’ own environment.ResultsHVT answered the primary clinical question in 45/60 patients (75%), and provided additional clinical information in 5 patients [2 with unsuspected coexistent psychogenic non-epileptic seizures (PNES) and 3 with unsuspected sleep disorders (SD)]. Of the 12 patients with Idiopathic Generalized Epilepsy, absences had been overestimated in 6 and underestimated in 4, while absence status was recorded in 1 of the 2 patients in whom it had been suspected. Valproate was possible to drastically reduce or stop in 3/6 women. Focal seizures were recorded in 19 of 28 patients with focal epilepsies, PNES were the habitual seizures in further 2 patients, while syndrome classification changed in one. In all 4 patients referred for differentiation between SD and epilepsy, HVT confirmed parasomnias in 2, daytime naps in 1 and idiopathic hypersomnia in 1. The diagnosis of PNES was confirmed in 8 of 13 suspected patients. HVT was unhelpful in the 3 patients referred for not witnessed, poorly understood episodes of loss of consciousness. Three patients switched off the video and 2 failed to change battery on day 2.ConclusionsHVT is a useful diagnostic test provided that diagnostic hypothesis and clinical question are appropriate.

Home video EEG telemetry

2021 ◽  
pp. practneurol-2020-002910
Author(s):  
Amardeep Kaundal ◽  
V Hegde ◽  
H Khan ◽  
Holger Allroggen
Keyword(s):  
Gold Standard ◽  
Epileptic Seizures ◽  
Home Video ◽  
Recent Developments ◽  
Video Eeg

Long-term electroencephalogram monitoring is often used to help distinguish epileptic from dissociative (non-epileptic) seizures. Home video telemetry now offers many of the benefits in diagnosis previously available only with inpatient video telemetry, which is usually regarded as the ‘gold standard’. Here, we describe recent developments in home video telemetry and how we undertake this procedure in our unit.

Long-term Home Video EEG for Recording Clinical Events

2020 ◽  
Vol 38 (2) ◽  
pp. 92-100
Author(s):  
Shirin Jamal Omidi ◽  
Johnson P. Hampson ◽  
Samden D. Lhatoo
Keyword(s):  
Home Video ◽  
Clinical Events ◽  
Video Eeg

Computer-Assisted Ambulatory Electroencephalography

2016 ◽  
pp. 167-175
Author(s):  
Jerry J. Shih ◽  
William O. Tatum
Keyword(s):  
Patient Management ◽  
Clinical Information ◽  
Epileptic Seizures ◽  
Clinical History ◽  
Computer Assisted ◽  
Age Group ◽  
Pediatric Age Group ◽  
Epileptiform Discharges ◽  
Interictal Epileptiform Discharges ◽  
Video Eeg

Computer-assisted ambulatory electroencephalography (CAAEEG) is a useful tool when a diagnosis of paroxysmal events cannot be made on the basis of the clinical history, neurological examination, and routine outpatient awake and asleep EEG studies. CAEEG is uniquely able to monitor EEG and electrocardiography (ECG) in an outpatient environment over one to three days. Its most common use is to support a clinical diagnosis of epileptic seizures by identifying interictal epileptiform discharges. Studies indicate ambulatory EEG provides useful clinical information for patient management in over 70% of recordings. CAAEEG may be particularly useful in the pediatric age group, as well as in diagnosing psychogenic events. CAAEEG can assist in the quantification of seizures or determining seizure frequency. A few centers have used CAAEEG to assist in the presurgical evaluation of epilepsy patients. Its niche involves lower cost and less resource utilization compared with in-patient video-EEG monitoring and is more sensitive than routine outpatient EEG in detecting interictal epileptiform discharges.

scholarly journals Movement-induced heart rate changes in epileptic and non-epileptic seizures

2009 ◽  
Vol 67 (3b) ◽  
pp. 789-791 ◽  
Author(s):  
Gisele R. de Oliveira ◽  
Francisco de A.A. Gondim ◽  
Edward R. Hogan ◽  
Francisco H. Rola
Keyword(s):  
Heart Rate ◽  
Motor Activity ◽  
Rate Increase ◽  
Epileptic Seizures ◽  
Baseline Heart Rate ◽  
Heart Rate Increase ◽  
Event Duration ◽  
Rate Analysis ◽  
Heart Rate Analysis ◽  
Video Eeg

Heart rate changes are common in epileptic and non-epileptic seizures. Previous studies have not adequately assessed the contribution of motor activity on these changes nor have evaluated them during prolonged monitoring. We retrospectively evaluated 143 seizures and auras from 76 patients admitted for video EEG monitoring. The events were classified according to the degree of ictal motor activity (severe, moderate and mild/absent) in: severe epileptic (SE, N=17), severe non-epileptic (SNE, N=6), moderate epileptic (ME, N=28), moderate non-epileptic (MNE, N=11), mild epileptic (mE, N=35), mild non-epileptic (mNE, N=33) and mild aura (aura, N=13). Heart rate increased in the ictal period in severe epileptic, severe non-epileptic, moderate epileptic and mild epileptic events (p<0.05). Heart rate returned to baseline levels during the post ictal phase in severe non-epileptic seizures but not in severe epileptic patients. Aura events had a higher baseline heart rate. A cut-off of 20% heart rate increase may distinguish moderate epileptic and mild epileptic events lasting more than 30 seconds. In epileptic seizures with mild/absent motor activity, the magnitude of heart rate increase is proportional to the event duration. Heart rate analysis in seizures with different degrees of movement during the ictal phase can help to distinguish epileptic from non-epileptic events.

scholarly journals Ictal ECG changes in temporal lobe epilepsy

1995 ◽  
Vol 53 (3b) ◽  
pp. 619-624 ◽  
Author(s):  
L.M. Li ◽  
J. Roche ◽  
J.W.A.S. Sander
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Sinus Bradycardia ◽  
Cardiac Pacemaker ◽  
Epileptic Seizures ◽  
Ecg Changes ◽  
Unexpected Death ◽  
Complex Partial Seizures ◽  
The Mean ◽  
Video Eeg

Changes in cardiac rhythm may occur during epileptic seizures and this has been suggested as a possible mechanism for sudden unexpected death amongst patients with chronic epilepsy (SUDEP). We have studied ECG changes during 61 complex partial seizures of temporal lobe origin in 20 patients. Tachycardia was observed in 24/61 (39%) and bradycardia in 3/61 (5%). The mean and median tachycardia rate was 139 and 140 beats/min (range 120-180). The longest R-R interval observed was 9 seconds. No difference was found in regard to the lateralisation of seizures and cardiac arrhytmia. One of the patients with bradycardia was fitted with a demand cardiac pacemaker, which appeared to decrease the number of his falls. In conclusion, ictal cardiac changes which may be seen in temporal lobe epilepsy (TLE) are sinus tachycardia and occasionally sinus bradycardia. Patients presenting vague complains suggestive of either TLE or cardiac dysrhythmia, simultaneous monitoring with EEG/ECG is required, and if the episodes are frequent, video-EEG should be considered. Further studies on this subject are warranted as this may shed some light on possible mechanisms for SUDEP.

scholarly journals Juvenile myoclonic epilepsy: current state of the problem

2021 ◽  
Vol 1 (2) ◽  
pp. 2-20
Author(s):  
N. A. Shnayder ◽  
K. V. Petrov
Keyword(s):  
Primary Care Physicians ◽  
Epileptic Seizures ◽  
Juvenile Myoclonic Epilepsy ◽  
Historical Significance ◽  
Current State ◽  
High Prevalence ◽  
Clonic Seizures ◽  
Generalized Epilepsy ◽  
Genetically Determined ◽  
Selection Of

Due to the high prevalence of the disease, its genetic and clinical heterogeneity, the need for lifelong therapy and the emergence of new views on the pathogenesis and course of JME, it is necessary to provide primary care physicians (general practitioners, district therapists, neurologists) with up-to-date systematized information about the most common form of genetic generalized epilepsy (Herpin-Janz syndrome). JME is a genetically determined disease of the brain, accompanied by a triad of seizures (absences, myoclonia, generalized tonic-clonic seizures), and developing mainly in adolescence and young age. In recent years, monogenic and multifactorial forms of JME have been identified, but questions about the genetics of JME are far from being resolved. JME is characterized by the preservation of intelligence, life expectancy with adequate therapy does not differ from the average population, but the frequency of failures of pharmaco-induced remission is high when taking anticonvulsants is canceled. This explains the need for lifelong pharmacotherapy, individual selection of anticonvulsants. About 30% of patients with JME have non-psychotic mental disorders, disorders of the sleep and wake cycle, which in turn leads to an aggravation of epileptic seizures mainly in the first half of the day. This review presents an analysis of full-text publications in Russian and English over the past five years in the databases eLibrary, PubMed, Web of Science, OxfordPress, Springer, and Clinicalkeys. In addition, the review includes earlier publications of historical significance.

Cardiogenic syncope diagnosed as epileptic seizures: the importance of ECG during video-EEG recording

2015 ◽  
Vol 17 (2) ◽  
pp. 198-203 ◽  
Author(s):  
Luis C Mayor ◽  
Hernan N Lemus ◽  
Jorge Burneo ◽  
Ana Cristina Palacio ◽  
Sergio Linares
Keyword(s):  
Epileptic Seizures ◽  
Cardiogenic Syncope ◽  
Video Eeg

Neurologist, 13 years’ experience, Australia

2020 ◽  
pp. 204-206
Author(s):  
Markus Reuber ◽  
Gregg H. Rawlings ◽  
Steven C. Schachter
Keyword(s):  
Emergency Department ◽  
Behavioral Therapy ◽  
Epileptic Seizures ◽  
Clinical Psychologist ◽  
Eeg Monitoring ◽  
Patient Reported ◽  
History Of ◽  
Convulsive Seizures ◽  
One Year ◽  
Video Eeg

This chapter discusses the experience of a Neurologist with a patient who presented with a history of three bilateral convulsive seizures over a period of several months. The Neurologist started him on an adjunct antiepileptic therapy and he became seizure free. However, the situation changed dramatically after a stable period of twelve months. He started having seizures again and his mother was able to recognize that these seizures were different from those he had had one year earlier. Prolonged video-EEG monitoring confirmed the diagnosis of Non-Epileptic Seizures (NES). The Neurologist then referred the patient to a Clinical Psychologist, who used Cognitive Behavioral Therapy and taught him some techniques to cope with the condition. Eventually, the patient and his family were able to manage the NES better with the help of the psychologist. The patient reported a significant improvement clinically with less frequent NES and they learned how to manage the situation without visiting the Emergency Department.

Psychologist, 2 years’ experience, USA; Psychologist, 5 years’ experience, USA

2020 ◽  
pp. 122-125
Author(s):  
Markus Reuber ◽  
Gregg H. Rawlings ◽  
Steven C. Schachter
Keyword(s):  
Epileptic Seizures ◽  
Holistic Approach ◽  
Well Being ◽  
Definitive Diagnosis ◽  
Adolescent And Young Adult ◽  
Frontal Lobe Epilepsy ◽  
Compelling Evidence ◽  
Caucasian Female ◽  
Video Eeg

This chapter presents a case with compelling evidence for frontal lobe epilepsy (FLE) and Psychogenic Non-Epileptic Seizures (PNES) to address the difficulties providers encounter in helping families receive a definitive diagnosis and eventual path forward. The patient in question was a teenage Caucasian female seeking a third opinion for paroxysmal events. Her father had requested an evaluation to rule out epilepsy after having been told twice before that his daughter’s episodes were likely to be psychogenic in nature. Evidence subsequently obtained over the course of her three-day video-EEG hospitalization provided support for both epilepsy and PNES. The chapter then argues that every adolescent and young adult with epilepsy would benefit from a holistic approach to seizure management, one that takes into account the patient’s quality of life, psychosocial well-being, and relationship with school, family, and friends.

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