48-hour video-EEG monitoring for epilepsy presurgical evaluation is cost-effective and safe in resource-limited setting

Lim, Kheng Seang and Fong, Si Lei and Le, Minh-An Thuy and Bazir, Sherrini Ahmad and Narayanan, Vairavan and Ismail, Noraini and Loo, Shweh-Fern and Krishnan, Kohila and Tan, Chong-Tin (2020) 48-hour video-EEG monitoring for epilepsy presurgical evaluation is cost-effective and safe in resource-limited setting. Epilepsy Research, 162. ISSN 0920-1211, DOI https://doi.org/10.1016/j.eplepsyres.2020.106298.

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Introduction: Video-EEG monitoring is one of the key investigations in epilepsy pre-surgical evaluation but limited by cost. This study aimed to determine the efficacy and safety of a 48-hour (3-day) video EEG monitoring, with rapid pre-monitoring antiepileptic drugs withdrawal. Material and methods: This is a retrospective study of epilepsy cases with VEM performed in University Malaya Medical Center (UMMC), Kuala Lumpur, from January 2012 till August 2016. Results: A total of 137 cases were included. The mean age was 34.5 years old (range 15-62) and 76 (55.8 %) were male. On the first 24-h of recording (D1), 81 cases (59.1 %) had seizure occurrence, and 109 (79.6 %) by day 2 (D2). One-hundred and nine VEMs (79.6 %) were diagnostic, in guiding surgical decision or further investigations. Of these, 21 had less than 2 seizures recorded in the first 48 h but were considered as diagnostic because of concordant interictal +/- ictal activities, or a diagnosis such as psychogenic non-epileptic seizure was made. Twenty-eight patients had extension of VEM for another 24-48 h, and 11 developed seizures during the extension period. Extra-temporal lobe epilepsy and seizure frequency were significant predictors for diagnostic 48 -h VEM. Three patients developed complications, including status epilepticus required anaesthetic agents (1), seizure clusters (2) with postictal psychosis or dysphasia, and all recovered subsequently. Conclusions: 48-h video EEG monitoring is cost-effective in resource limited setting.

Item Type: Article
Uncontrolled Keywords: Epilepsy surgery; Video-EEG monitoring; Refractory epilepsy
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine > Medicine Department
Depositing User: Ms Zaharah Ramly
Date Deposited: 08 Mar 2023 03:55
Last Modified: 08 Mar 2023 03:55
URI: http://eprints.um.edu.my/id/eprint/37731

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