title: Neurophysiological investigations for the diagnosis of non-epileptic attack disorder in neuropsychiatry services: from safety standards to improved effectiveness.
abstract: OBJECTIVE
  The discipline of clinical neuropsychiatry currently provides specialised services for a number of conditions that cross the traditional boundaries of neurology and psychiatry, including non-epileptic attack disorder. Neurophysiological investigations have an important role within neuropsychiatry services, with video-electroencephalography (EEG) telemetry being the gold standard investigation for the differential diagnosis between epileptic seizures and non-epileptic attacks. This article reviews existing evidence on best practices for neurophysiology investigations, with focus on safety measures for video-EEG telemetry.
  
  
  METHODS
  We conducted a systematic literature review using the PubMed database in order to identify the scientific literature on the best practices when using neurophysiological investigations in patients with suspected epileptic seizures or non-epileptic attacks.
  
  
  RESULTS
  Specific measures need to be implemented for video-EEG telemetry to be safely and effectively carried out by neuropsychiatry services. A confirmed diagnosis of non-epileptic attack disorder following video-EEG telemetry carried out within neuropsychiatry units has the inherent advantage of allowing diagnosis communication and implementation of treatment strategies in a timely fashion, potentially improving clinical outcomes and cost-effectiveness significantly.
  
  
  CONCLUSIONS
  The identified recommendations set the stage for the development of standardised guidelines to enable neuropsychiatry services to implement streamlined and evidence-based care pathways.
authors.affiliation: 1School of Life and Health Sciences,Aston Brain Centre,Wellcome Trust Laboratory for MEG Studies,Aston University,Birmingham,UK.
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Cavanna
authors.affiliation: 1School of Life and Health Sciences,Aston Brain Centre,Wellcome Trust Laboratory for MEG Studies,Aston University,Birmingham,UK.
authors.forename: Stefano
authors.initials: S
authors.lastname: Seri
mesh_terms: D003937:Diagnosis, Differential; D004568:Electrodiagnosis / Q000379:methods; D004569:Electroencephalography / Q000379:methods*; D004827:Epilepsy / Q000175:diagnosis*; D006801:Humans; D064926:Neurophysiological Monitoring / Q000379:methods; D017410:Practice Guidelines as Topic; D012640:Seizures / Q000175:diagnosis*; D013686:Telemetry / Q000379:methods; D014741:Video Recording / Q000379:methods
keywords: epilepsy; neuropsychiatry; non-epileptic attack disorder; safety; video-EEG telemetry