Yield of Monitoring in an Adult Epilepsy Monitoring Unit (P2.097)

Objective- Look at diagnostic yield of long term video EEG monitoring (vEEG). Background: vEEG is a standard of practice in epilepsy centers for characterization of paroxysmal spells and surgical work up in cases of intractable epilepsy. Cost of a single study is about $35,000- 40,000. Method: This is a retrospective chart review of the last 200 patients admitted to our Epilepsy Monitoring Unit (EMU). After excluding patients who did not complete the study, 174 were found eligible. We looked at patient demographics, time to first event, number of events recorded and the final diagnosis. Results: 174 studies were reviewed. There were 56[percnt] females and 44[percnt] males ranging from 15 to 76 years. Recording time ranged from one to six days. The study was diagnostic in 130 cases (74.7[percnt]). 42[percnt] had only non-epileptic events (NEE) and 26[percnt] had only epileptic seizures (ES). 4.6[percnt] had both ES and NEE. Four patients had interictal discharges diagnostic of generalized epilepsy though no events were recorded. Median of 3 events was recorded per study. Time to first event ranged from 0.5 to 90 hours. In 64 (41[percnt]) patients, events occurred within 24 hours while in 12 (8[percnt]) the first event was recorded after 72 hrs. Mean time for ES was 33.7 hours while for NEE was 23.2 hours. No interictal epileptiform discharge (IED) was noted in 21[percnt] patients diagnosed with epilepsy. Conclusions: The yield of video-EEG monitoring in an adult EMU was found to be 74.7[percnt]. The average time to first event was 28.3 hours. However, in 8[percnt] cases, more than 3 days of monitoring was needed to obtain an accurate diagnosis. Interictal epileptiform discharges alone cannot reliably distinguish ES and NEE in all cases. Video-EEG monitoring has a high diagnostic yield and is an essential test in the appropriate patient population. Disclosure: Dr. Agrawal has nothing to disclose. Dr. Turco has nothing to disclose. Dr. Goswami has nothing to disclose. Dr. Faulkner has nothing to disclose. Dr. Singh has received personal compensation for activities with Lundbeck Research USA, Inc. as a speakers bureau member.