title: Impact of video-ambulatory electroencephalography on the medical management of epilepsy.
abstract: Video-ambulatory electroencephalography (video-AEEG) is increasingly being used in secondary care centres for the diagnostic work-up of new cases with suspected epilepsy and for the review of known cases with active seizures despite medical treatment. We reviewed how the outcome of video-AEEG influenced the medical management of patients who underwent this investigation at a neurophysiology department within a secondary care centre. Out of a total of 171 consecutive video-AEEG studies performed over a period of two years, 111 could be included in our retrospective analysis, based on availability and completeness of relevant clinical information pre- and post-investigation. In our sample, 55.9% of patients had typical clinical events captured on video-AEEG and diagnostic yield was higher in patients with a previously established diagnosis of epilepsy (n=62; diagnostic yield 62.9%). A total of 27 patients (24.3%) had changes in medical treatment following video-AEEG, most frequently antiepileptic drug introduction/increase when epileptic seizures were captured. This proportion was similar between patients with or without a previously established diagnosis of epilepsy. Our findings in a real-life setting confirm the usefulness of video-AEEG in influencing the clinical attitude towards complex patients with suspected or longstanding history of epilepsy.
authors.affiliation: Department of Neurology, Royal Wolverhampton NHS Trust, Wolverhampton, UK. Electronic address: francesco.manfredonia@nhs.net.
authors.forename: Francesco
authors.initials: F
authors.lastname: Manfredonia
authors.affiliation: Department of Neurology, Royal Wolverhampton NHS Trust, Wolverhampton, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Lawley
authors.affiliation: Department of Neuropsychiatry, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK; School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, UK; Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology and UCL, London, UK.
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Cavanna
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000927:Anticonvulsants / Q000627:therapeutic use*; D058256:Brain Waves / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004827:Epilepsy / Q000188:drug therapy* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014741:Video Recording; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Antiepileptic drugs; Epileptic seizures; Non-epileptic attacks; Psychogenic non-epileptic seizures; Video-ambulatory electroencephalography