Experience with short video EEG in small town (yield and cost effectiveness)

Background: Semiology, type of seizure, true or pseudo-seizure (PNES – psychogenic non epileptic seizures) are often hard to differentiate clinically. Accurate diagnosis is essential for the optimum medical or surgical treatment and outcome for the patient. Most of the times, diagnosis requires inpatient video telemetry, which is both time consuming and expensive. Short video electroencephalography (SV-EEG) has been described previously and was shown to be a useful diagnostic tool in other specialist centres.

Objective: To determine the usefulness of SV-EEG in the diagnosis and management of various seizure types.

Method: After start of SV-EEG facility in Nashik, first 100 cases were selected, 1–55 years done over last 15 months.

Results: SV-EEG done on OPD basis for period of 1–8 h. Age – 1–62 years, M = 64:F = 36. Abnormal SV-EEG was reported in 75 patients. A positive SV-EEG supporting a diagnosis of true seizures occurred in 62 of patients (generalised epilepsy = 15, focal epilepsy = 47). PNES was diagnosed in 13 pts. Attacks recorded in these patients were 1–14. No attack or no interictal abnormality was noted in 25% of patients (n = 25), resulting in an inconclusive SV-EEG. One patient had undergone anterior temporal lobectomy surgery based on this SV-EEG.

Conclusion: The positive rates of attacks from SV-EEG were comparable and even better to previously published results and show that SV-EEG is easily implemented in small town centres. It is cost effective method with very good diagnostic yield.