DIFFERENTIAL DIAGNOSIS OF EPILEPSY IN CHILDHOOD: THE IMPACT OF THE VIDEO-EEG MONITORING

Objectives: Objective: To asses the utility of Video-EEG monitoring in defining the seizure semiology, the features of nonepileptic events, and the impact of the recording on the pre-monitoring diagnosis.

Methods: Methods: Sixty patients (31 males, 29 females) aged from 0 to 2 years (Group I, n=12), from 3 to 7 years (Group II, n=17), and from 8 to 17 years (Group III, n=31) suspected of having focal epilepsy were submitted to Vídeo-EEG recordings between March 2004 and August 2005. The inclusion criteria included: (1) frequent events, (2) suggestion of focal onset, and (3) uncertainty about the seizure semiology.

Results: Results: In Group I, 3/12 patients (25%) had nonepileptic events (NEE), and 9 (75%), seizures: tonic spasms in 2; infantile spasms following focal seizures in 2; behavioral arrest with oral automatisms in 3; tonic asymmetric posturing (TAP) in 1; staring in 1. In Group II, 4/17 patients (23%) had NEE, and 13 (77%) had seizures: generalized in 7; and focal in 6 (negative motor in 1, complex partial (CP) in 3, TAP in 2). In Group III, 8/31 patients (26%) had NEE, and 23 had seizures: generalized in 5; and focal in 18 (TAP in 5; CP in 5; staring in 3;and simple partial in 5).

Conclusion: Conclusions: In our series, almost 25% of the patients were diagnosed as having NEE. In almost 27% of the cases, the recorded seizures were generalized in spite of the focal abnormalities found in the interictal EEGs and/or MRIs. We conclude that Vídeo-EEG monitoring has a high yield in improving the precise diagnosis of epilepsy with consequent impact on treatment.