Outpatient video EEG recording in the diagnosis of non-epileptic seizures: a randomised controlled trial of simple suggestion techniques.
OBJECTIVE
To assess the yield of recorded habitual non-epileptic seizures during outpatient video EEG, using simple suggestion techniques based on hyperventilation and photic stimulation.


METHODS
Randomised controlled trial of "suggestion" v "no suggestion" during outpatient video EEG recording.


METHODS
Regional epilepsy service (tertiary care; single centre).


METHODS
30 patients (22 female, 8 male), aged over 16 years, with a probable clinical diagnosis of non-epileptic seizures; 15 were randomised to each group.


METHODS
Yield of habitual non-epileptic seizures recorded, and requirement for additional inpatient video EEG.


RESULTS
10/15 patients had habitual non-epileptic seizures with suggestion; 5/15 had non-epileptic seizures with no suggestion (p = 0.058; NS); 8/9 patients with a history of previous events in medical settings had non-epileptic seizures recorded during study. Logistic regression analysis with an interaction clause showed a significant effect of suggestion in patients with a history of previous events in medical settings (p = 0.003). An additional inpatient video-EEG was avoided in 14 of the 30 patients (47%).


CONCLUSIONS
Habitual non-epileptic seizures can be recorded reliably during short outpatient video EEG in selected patients. Simple (non-invasive) suggestion techniques increase the yield at least in the subgroup with a history of previous events in medical settings. Inpatient video EEG can be avoided in some patients.
McGonigal
A
A
Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow, UK. aileenmcg@hotmail.com
Oto
M
M
Russell
A J C
AJ
Greene
J
J
Duncan
R
R
D000328:Adult; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D018670:Monitoring, Ambulatory; D010045:Outpatients; D012640:Seizures / Q000209:etiology*; D012680:Sensitivity and Specificity; D013404:Suggestion; D014741:Video Recording