Adding video recording increases the diagnostic yield of routine electroencephalograms in children with frequent paroxysmal events.
OBJECTIVE
To report on the usefulness of adding video recording to routine EEG studies of infants and children with frequent paroxysmal events.


METHODS
We analyzed the efficacy of this diagnostic means during a 4-year period. The decision whether to add video recording was made by the pediatric EEG interpreter at the time of the study. Studies were planned to last between 20 and 30 min, and, if needed, were extended by the EEG interpreter. For most studies, video recording was added from the beginning of EEG recording. In a minority of cases, the addition of video was implemented during the first part of the EEG test, as clinical events became obvious. In these cases, a new study (file) was begun. The success rate was analyzed according to the indications for the EEG study: paroxysmal eye movements, tremor, suspected seizures, myoclonus, staring episodes, suspected stereotypias and tics, absence epilepsy follow-up, cyanotic episodes, and suspected psychogenic nonepileptic events.


RESULTS
Video recording was added to 137 of 666 routine studies. Mean patient age was 4.8 years. The nature of the event was determined in 61 (45%) of the EEG studies. Twenty-eight percent were hospitalized patients. The average study duration was 26 min. This diagnostic means was particularly useful for paroxysmal eye movements, staring spells, myoclonic jerks, stereotypias, and psychogenic nonepileptic events. About 46% of 116 patients for whom cognitive data were available were mentally retarded. EEG with added video recording was successfully performed in all 116 cases and provided useful information in 29 (55%) of these 53 patients.


CONCLUSIONS
Adding video recording to routine EEG was helpful in 45% of cases referred for frequent paroxysmal events. This technique proved useful for hospitalized children as well as for outpatients. Moreover, it was successfully applied in cognitively impaired patients. Infants and children with paroxysmal eye movements, staring spells, myoclonic jerks, stereotypias, and pseudoseizures especially benefited from this diagnostic means. Because of its low cost and the little discomfort imposed on the patient and his or her family, this technique should be considered as a first diagnostic step in children with frequent paroxysmal events.
Watemberg
Nathan
N
Pediatric Neurology Unit, Wolfson Medical Center, Sackler School of Medicine, Tel-Aviv University, Holon, Israel. nwatemberg@pol.net
Tziperman
Barak
B
Dabby
Ron
R
Hasan
Mariana
M
Zehavi
Liora
L
Lerman-Sagie
Tally
T
D000367:Age Factors; D000553:Ambulatory Care; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000379:methods* / Q000706:statistics & numerical data; D004827:Epilepsy / Q000175:diagnosis; D005069:Evaluation Studies as Topic; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D009069:Movement Disorders / Q000175:diagnosis*; D015835:Ocular Motility Disorders / Q000175:diagnosis; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis*; D012815:Signal Processing, Computer-Assisted; D014743:Videotape Recording / Q000379:methods* / Q000706:statistics & numerical data