March 29, 2019

In-Home Diagnostic Ambulatory Video-EEG Monitoring Useful for Non-Urgent Epilepsy Monitoring

Purpose: This study evaluate outcome of in-home diagnostic ambulatory video-EEG monitoring (AVEM) performed on a nationwide cohort of patients over one calendar year, and compares the findings with outcomes of inpatient adult and pediatric VEM performed during the same year at two academic epilepsy centers.

Methods: This is a retrospective cohort study. The researchers obtained AVEM outcome data from an independent ambulatory-EEG testing facility. Inpatient VEM data from a 4-bed adult epilepsy center and an 8-bed pediatric epilepsy center were also included. Primary outcome measure was composite percentage of VEM records with epileptiform activity on EEG tracings or at least one video-recorded pushbutton event. The team assessed patient-reported symptoms documented in AVEM event diaries.

Results: Of 9221 AVEM recordings performed across 28 states, 62.5% attained primary outcome. At least one patient-activated push-button event was captured on video in 54% of AVEM recordings (53.6% in adults, 56.1% in children). Epileptiform activity was reported in 1657 (18.0%) AVEM recordings (1473 [88.9%] only interictal, 9 [0.5%] only ictal, 175 [10.6%] both interictal and ictal). Most common patient-reported symptomatology during AVEM pushbutton events was behavioral/autonomic/emotional in adults and children. Compared to AVEM, inpatient VEM captured more confirmed representative events in adult and pediatric samples.

Conclusions: Ambulatory video-EEG monitoring is useful for non-urgent diagnostic evaluation of events.

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