The usefulness of one to two hour video EEG monitoring in patients with refractory seizures.

Video EEG monitoring for 1-2 hours was performed on 100 outpatients (57 females and 43 males) with refractory seizures or frequent paroxysmal events. Patients' ages ranged from 8 days to 67 years (mean age 21). At least one clinical seizure or paroxysmal event was observed in 66 patients; 24 of these patients had subtle seizures that would be difficult to observe without videotape monitoring. The combination of videotape and EEG monitoring was able to confirm the diagnosis in 80 cases. The referral diagnosis was changed in 37 patients; they included changes in seizure types in 17 epileptic patients; 10 patients were found to have pseudoseizures and 10 patients had nonepileptic neurological disorders. The yield of EEG seizure activity differed significantly between video EEG monitoring and routine EEG recording (p < 0.001). EEG seizure activity was reported in 77 patients with video EEG monitoring compared to 49 patients with routine EEG recording. We conclude that outpatient video EEG monitoring yields more information on the presence or absence of seizures and their types, improving patient management, and averting the need for prolonged inpatient intensive monitoring.