Abstract
Background
Routine electroencephalography (EEG) with video (rVEEG) is a widely used, noninvasive
neurodiagnostic tool that aids in the diagnosis and classification of epilepsy by
detecting interictal epileptiform discharges. This study aimed to assess its diagnostic
utility and identify key clinical correlates in adult patients at a tertiary care
center in North India, where specific data on its yield in this resource-constrained
context are valuable.
Materials and Methods
We retrospectively analyzed routine EEGs with simultaneous video recording performed
in adults aged ≥18 years. Clinical and demographic data—including seizure type, age
at onset, etiology, antiepileptic drug use, seizure timing, and activation procedures—were
extracted from EEG records and electronic medical records. EEGs were categorized as
normal or abnormal, with abnormalities classified as epileptiform or nonepileptiform.
Results
Among 347 patients (mean age 41.6 ± 17.8 years), most were aged 18 to 30 (58.2%),
with 41.4% experiencing seizure onset before the age of 18 years. Focal seizures were
predominant (76.3%), especially focal impaired awareness seizures (52.7%). Etiology
was unclear in 85.3% of cases. Neuroimaging data (computed tomography or magnetic
resonance imaging) were available for 74 patients; 40 had normal findings, and 34
showed lesions. rVEEGs were commonly performed within 1 week of the last seizure (83%),
often during sleep (57.3%). EEG abnormalities were present in 37.5%, primarily generalized
spike-and-wave discharges (25.6%). Most patients were on monotherapy (86.2%). Video
recording led to a revision or refinement of the initial clinical diagnosis in 7.5%
(26) of patients. No significant clinical predictors of abnormal EEG findings were
identified (p > 0.05).
Conclusion
The diagnostic yield of rVEEG in this cohort was modest. Optimizing patient selection
based on detailed clinical history may improve EEG utility in resource-constrained
settings.
Keywords
routine EEG with video - epilepsy - diagnostic yield - seizures - resource-limited
settings
