May 18, 2022

Diagnostic Yield and Limitations of In-Hospital Documentation in Patients with Epilepsy

Abstract found on Wiley Online Library

Objective: To determine the diagnostic yield of in-hospital video-EEG monitoring to document seizures in epilepsy patients.

Methods: Retrospective analysis of electronic seizure documentation at the University Hospital Freiburg (UKF) and at King´s College London (KCL). Statistical assessment of the role of the duration of monitoring, and subanalyses on presurgical patient groups and patients undergoing antiseizure medication reduction.

Results: Out of over 4.800 patients with epilepsy undergoing in-hospital recordings at the two institutions since 2005, 43 % (KCL) and 73 % (UKF) had a seizure documented. Duration of monitoring was highly significantly associated with seizure recordings (p<0.0001), and presurgical patients as well as patients with drug reduction had a significantly higher diagnostic yield (p<00001). Recordings with a duration of >5?days only lead to additional new seizure documentation in less than 10% of patients.

Significance: There is a need for the development of new ambulatory monitoring strategies to document seizures for diagnostic and monitoring purposes for a relevant subgroup of epilepsy patients in whom in-hospital monitoring fails to document seizures.