Seizure symptoms and ambulatory EEG findings: incidence of epileptiform discharges.
Seizure symptoms and ambulatory EEG findings: incidence of epileptiform discharges.
- 2020
AIMS: Ambulatory video-EEG monitoring has been utilized as a cost-effective alternative to inpatient video-EEG monitoring for non-surgical diagnostic evaluation of symptoms suggestive of epileptic seizures. We aimed to assess incidence of epileptiform discharges in ambulatory video-EEG recordings according to seizure symptom history obtained during clinical evaluation. CONCLUSIONS: Our study shows that the use of ILAE 2017 symptom categories may help guide ambulatory video-EEG studies. METHODS: This was a retrospective cohort study. We queried seizure symptoms from 9,221 consecutive ambulatory video-EEG studies in 35 states over one calendar year. We assessed incidence of epileptiform discharges for each symptom, including symptoms that conformed to a category heading, even if not included in the ILAE 2017 symptom list. We report incidences, odds ratios, and corresponding p values using Fisher's exact test and univariate logistic regression. We applied multivariable logistic regression to generate odds ratios for the six symptom categories that are controlled for the presence of other symptoms. RESULTS: History that included motor symptoms (OR=1.53) or automatisms (OR=1.42) was associated with increased occurrence of epileptiform discharges, whereas history of sensory symptoms (OR=0.76) predicted lack of epileptiform discharges. Patient-reported symptoms that were associated with increased occurrence of epileptiform discharges included lip-smacking, moaning, verbal automatism, aggression, eye-blinking, deja vu, muscle pain, urinary incontinence, choking and jerking. On the other hand, auditory hallucination memory deficits, lightheadedness, syncope, giddiness, fibromyalgia and chronic pain predicted absence of epileptiform discharges. The majority of epileptiform discharges consisted only of interictal sharp waves or spikes.
English
1294-9361
10.1684/epd.2020.1220 [doi] epd.2020.1220 [pii]
*Electroencephalography/sn [Statistics & Numerical Data]
*Epilepsy/di [Diagnosis]
*Epilepsy/pp [Physiopathology]
*Monitoring, Ambulatory/sn [Statistics & Numerical Data]
*Seizures/di [Diagnosis]
*Seizures/pp [Physiopathology]
Adult
Aged
Epilepsy/ep [Epidemiology]
Female
Humans
Incidence
Male
Middle Aged
Neurophysiological Monitoring/sn [Statistics & Numerical Data]
Practice Guidelines as Topic
Retrospective Studies
Seizures/ep [Epidemiology]
Self Report/sn [Statistics & Numerical Data]
Video Recording
MedStar Union Memorial Hospital
Journal Article
AIMS: Ambulatory video-EEG monitoring has been utilized as a cost-effective alternative to inpatient video-EEG monitoring for non-surgical diagnostic evaluation of symptoms suggestive of epileptic seizures. We aimed to assess incidence of epileptiform discharges in ambulatory video-EEG recordings according to seizure symptom history obtained during clinical evaluation. CONCLUSIONS: Our study shows that the use of ILAE 2017 symptom categories may help guide ambulatory video-EEG studies. METHODS: This was a retrospective cohort study. We queried seizure symptoms from 9,221 consecutive ambulatory video-EEG studies in 35 states over one calendar year. We assessed incidence of epileptiform discharges for each symptom, including symptoms that conformed to a category heading, even if not included in the ILAE 2017 symptom list. We report incidences, odds ratios, and corresponding p values using Fisher's exact test and univariate logistic regression. We applied multivariable logistic regression to generate odds ratios for the six symptom categories that are controlled for the presence of other symptoms. RESULTS: History that included motor symptoms (OR=1.53) or automatisms (OR=1.42) was associated with increased occurrence of epileptiform discharges, whereas history of sensory symptoms (OR=0.76) predicted lack of epileptiform discharges. Patient-reported symptoms that were associated with increased occurrence of epileptiform discharges included lip-smacking, moaning, verbal automatism, aggression, eye-blinking, deja vu, muscle pain, urinary incontinence, choking and jerking. On the other hand, auditory hallucination memory deficits, lightheadedness, syncope, giddiness, fibromyalgia and chronic pain predicted absence of epileptiform discharges. The majority of epileptiform discharges consisted only of interictal sharp waves or spikes.
English
1294-9361
10.1684/epd.2020.1220 [doi] epd.2020.1220 [pii]
*Electroencephalography/sn [Statistics & Numerical Data]
*Epilepsy/di [Diagnosis]
*Epilepsy/pp [Physiopathology]
*Monitoring, Ambulatory/sn [Statistics & Numerical Data]
*Seizures/di [Diagnosis]
*Seizures/pp [Physiopathology]
Adult
Aged
Epilepsy/ep [Epidemiology]
Female
Humans
Incidence
Male
Middle Aged
Neurophysiological Monitoring/sn [Statistics & Numerical Data]
Practice Guidelines as Topic
Retrospective Studies
Seizures/ep [Epidemiology]
Self Report/sn [Statistics & Numerical Data]
Video Recording
MedStar Union Memorial Hospital
Journal Article