Diagnostic outcome of video EEG monitoring in a referral epilepsy unit

Abstract Background Epilepsy is a serious common neurological disorder. Accurate well-timed diagnosis improves the outcome and saves costs. Video electroencephalography monitoring (VEM) is an important diagnostic tool to confirm the diagnosis of a seizure disorder and classify seizure type. In our work we aimed to audit the electroencephalography (EEG) referrals and Video EEG (VEEG) recording parameters to improve the EEG service in the epilepsy unit at Kasr Alainy hospital. This is a retrospective observational study on all VEM referrals received in a Cairo University epilepsy unit; excluding patients referred for presurgical assessment during the period from January 2019 to December 2019. All the data mentioned in the referrals were noted. VEM records and reports were reviewed and analyzed. Subjects were divided into groups according to the findings of VEM records. Results A total of one hundred and twenty-one VEM referrals were reviewed including the corresponding records and reports. In sixty-six subjects (54.5%) the records showed no abnormality. There was a statistically significant difference between event semiology (in referral) and VEM records; ( P < 0.001). The median latency to first recorded epileptic discharge was 7 min, the majority of the discharges (78.8%) occurred during the first 30 min of the record. After 2 h duration, no new interictal discharges were captured. Conclusion The criteria of selecting candidates for VEM need to be better defined. Detailed accurate history taking must be done by specialized epileptologist. The VEM duration must be tailored for every case according to the recorded findings in the first hour as well as the subjects’ history.