Abstract
Routine electroencephalogram (EEG) has many limitations, especially the inability to capture reported habitual events in question. A prolonged EEG with synchronized video (video-EEG) overcomes some of these limitations by improving the sensitivity, specificity and the diagnostic yield by attempting to record the habitual events when they are frequent and when indicated. Video-EEG is employed commonly for the diagnosis and classification of epilepsy/epilepsy syndromes, to distinguish between seizures and seizures mimickers, for pre-surgical evaluation and in the management of critically ill children. The duration of recording would vary depending on the indication and frequency of events. Ambulatory EEG is another cost effective and convenient alternative in certain circumstances. However, availability of the machines and expertise, accessibility, affordability and labor intensive nature of the procedure limit widespread use in India. This review explores the role of video-EEG in the management of children with epileptic and non-epileptic paroxysmal events with respect to routine clinical practice in India.
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References
Chadwick D. Diagnosis of epilepsy. Lancet. 1990;336:291–5.
Stroink H, van Donselaar CA, Geerts AT, Peters ACB, Brouwer OF, Arts WFM. The accuracy of the diagnosis of paroxysmal events in children. Neurology. 2003;60(6):979–82.
Uldall P, Alving J, Hansen LK, Kibæk M, Buchholt J. The misdiagnosis of epilepsy in children admitted to a tertiary epilepsy centre with paroxysmal events. Arch Dis Child. 2006;91(3):219–21.
Nagy E, Major A, Farkas N, Hollódy K. Epileptic seizure or not? Proportion of correct judgement based only on a video recording of a paroxysmal event. Seizure. 2017;53:26–30.
Tatum WO. EEG interpretation: common problems. Clin Pract. 2012;9(5):527–38.
Asano E, Pawlak C, Shah A, et al. The diagnostic value of initial video-EEG monitoring in children—review of 1000 cases. Epilepsy Res. 2005;66(1):129–35.
Koc G, Morkavuk G, Akkaya E, et al. Latencies to first interictal epileptiform discharges in different seizure types during video-EEG monitoring. Seizure. 2019;69:235–40.
Hisatomi A, Faulkner HJ, Mohamed A. Latency to first interictal epileptiform discharge in epilepsy with outpatient ambulatory EEG. Clin Neurophysiol. 2012;123:1732–5.
Jayakar P, Duchowny M, Resnick TJ, Alvarez LA. Localization of seizure foci: pitfalls and caveats. J Clin Neurophysiol. 1991;8(4):414–31.
Benbadis SR, Tatum WO. Overintepretation of EEGs and misdiagnosis of epilepsy. J Clin Neurophysiol. 2003;20(1):42–4.
Kuratani J, Pearl PL, Sullivan LR, et al. American clinical neurophysiology society guideline 5: minimum technical standards for pediatric electroencephalography. Neurodiagn J. 2016;56(4):266–75.
Watemberg N, Tziperman B, Dabby R, Hasan M, Zehavi L, Lerman-Sagie T. Adding video recording increases the diagnostic yield of routine electroencephalograms in children with frequent paroxysmal events. Epilepsia. 2005;46(5):716–9.
Dash D, Dash C, Primrose S, et al. Update on minimal standards for electroencephalography in Canada: a review by the Canadian Society of Clinical Neurophysiologists. Can J Neurol Sci. 2017;44(6):631–42.
Ashrafi MR, Mohammadi M, Tafarroji J, Shabanian R, Salamati P, Zamani GR. Melatonin versus chloral hydrate for recording sleep EEG. Eur J Paediatr Neurol. 2010;14(3):235–8.
Jain P, Sharma S, Sharma A, Goel S, Jose A, Aneja S. Efficacy and safety of oral triclofos as sedative for children undergoing sleep electroencephalogram: an observational study. J Pediatr Neurosci. 2016;11(2):105–8.
Wassmer E, Carter PFB, Quinn E, et al. Melatonin is useful for recording sleep EEGs: a prospective audit of outcome. Dev Med Child Neurol. 2001;43(11):735–8.
Nordli DR Jr. Usefulness of video-EEG monitoring. Epilepsia. 2006;47(s1):26–30.
Kim HL, Donnelly JH, Tournay AE, Book TM, Filipek P. Absence of seizures despite high prevalence of epileptiform EEG abnormalities in children with autism monitored in a tertiary care center. Epilepsia. 2006;47(2):394–8.
Itoh Y, Oguni H, Hirano Y, Osawa M. Study of epileptic drop attacks in symptomatic epilepsy of early childhood – differences from those in myoclonic-astatic epilepsy. Brain Dev. 2015;37(1):49–58.
Hirano Y, Oguni H, Funatsuka M, Imai K, Osawa M. Differentiation of myoclonic seizures in epileptic syndromes: a video-polygraphic study of 26 patients. Epilepsia. 2009;50(6):1525–35.
LaFrance WC Jr, Baker GA, Duncan R, Goldstein LH, Reuber M. Minimum requirements for the diagnosis of psychogenic nonepileptic seizures: a staged approach: a report from the international league against epilepsy nonepileptic seizures task force. Epilepsia. 2013;54(11):2005–18.
Williams K, Jarrar R, Buchhalter J. Continuous video-EEG monitoring in pediatric intensive care units. Epilepsia. 2011;52(6):1130–6.
Shahwan A, Bailey C, Shekerdemian L, Harvey AS. The prevalence of seizures in comatose children in the pediatric intensive care unit: a prospective video-EEG study. Epilepsia. 2010;51(7):1198–204.
Gaily E, Liukkonen E, Paetau R, Rekola M, Granström M-L. Infantile spasms: diagnosis and assessment of treatment response by video-EEG. Dev Med Child Neurol. 2001;43(10):658–67.
Valente KD, Freitas A, Fiore LA, Gronich G, Negrão N. The diagnostic role of short duration outpatient V-EEG monitoring in children. Pediatr Neurol. 2003;28(4):285–91.
Goldstein J, Slomski J. Epileptic spasms: a variety of etiologies and associated syndromes. J Child Neurol. 2008;23(4):407–14.
Srikumar G, Bhatia M, Jain S, Maheshwari M. Usefulness of short term video-EEG monitoring in children with frequent intractable episodes. Neurol India. 2000;48(1):29–32.
Montenegro MA, Sproule D, Mandel A, et al. The frequency of non-epileptic spells in children: results of video–EEG monitoring in a tertiary care center. Seizure. 2008;17(7):583–7.
Riquet A, Lamblin M-D, Bastos M, et al. Usefulness of video-EEG monitoring in children. Seizure. 2011;20(1):18–22.
Yang Z, Liu X, Qin J, et al. Clinical and electrophysiological characteristics of startle epilepsy in childhood. Clin Neurophysiol. 2010;121(5):658–64.
Tibussek D, Wohlrab G, Boltshauser E, Schmitt B. Proven startle-provoked epileptic seizures in childhood: semiologic and electrophysiologic variability. Epilepsia. 2006;47(6):1050–8.
Foley CM, Legido A, Miles DK, Grover WD. Diagnostic value of pediatric outpatient video-EEG. Pediatr Neurol. 1995;12(2):120–4.
Martin RC, Gilliam FG, Kilgore M, Faught E, Kuzniecky R. Improved health care resource utilization following video-EEG-confirmed diagnosis of nonepileptic psychogenic seizures. Seizure. 1998;7(5):385–90.
Eeg-Olofsson O, Petersén I, Selldén U. The development of the electroencephalogram in normal children from the age of 1 through 15 years. Paroxysmal activity Neuropadiatrie. 1971;2(4):375–404.
Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):512–21.
Ohtahara S, Yamatogi Y. Ohtahara syndrome: with special reference to its developmental aspects for differentiating from early myoclonic encephalopathy. Epilepsy Res. 2006;70(Suppl 1):S58–67.
Coppola G. Malignant migrating partial seizures in infancy: an epilepsy syndrome of unknown etiology. Epilepsia. 2009;50(Suppl 5):49–51.
Caraballo RH, Ruggieri V, Gonzalez G, et al. Infantile spams without hypsarrhythmia: a study of 16 cases. Seizure. 2011;20(3):197–202.
Hrachovy RA, Frost JD. Infantile epileptic encephalopathy with hypsarrhythmia (infantile spasms/west syndrome). J Clin Neurophysiol. 2003;20(6):408–25.
Caraballo RH, Capovilla G, Vigevano F, Beccaria F, Specchio N, Fejerman N. The spectrum of benign myoclonus of early infancy: clinical and neurophysiologic features in 102 patients. Epilepsia. 2009;50(5):1176–83.
Caraballo RH, Flesler S, Pasteris MC, Lopez Avaria MF, Fortini S, Vilte C. Myoclonic epilepsy in infancy: an electroclinical study and long-term follow-up of 38 patients. Epilepsia. 2013;54(9):1605–12.
Seneviratne U, Woo JJ, Boston RC, Cook M, D’Souza W. Focal seizure symptoms in idiopathic generalized epilepsies. Neurology. 2015;85(7):589–95.
Sankhyan N. Non-epileptic paroxysmal events mimicking seizures. Indian J Pediatr. 2014;81(9):898–902.
Szabó L, Siegler Z, Zubek L, et al. A detailed semiologic analysis of childhood psychogenic nonepileptic seizures. Epilepsia. 2012;53(3):565–70.
Popkirov S, Grönheit W, Wellmer J. A systematic review of suggestive seizure induction for the diagnosis of psychogenic nonepileptic seizures. Seizure. 2015;31:124–32.
Benbadis SR, Siegrist K, Tatum WO, Heriaud L, Anthony K. Short-term outpatient EEG video with induction in the diagnosis of psychogenic seizures. Neurology. 2004;63(9):1728–30.
Chung SS, Gerber P, Kirlin KA. Ictal eye closure is a reliable indicator for psychogenic nonepileptic seizures. Neurology. 2006;66(11):1730–1.
Bergen D, Ristanovic R. Weeping as a common element of pseudoseizures. Arch Neurol. 1993;50(10):1059–60.
Peguero E, Abou-Khalil B, Fakhoury T, Mathews G. Self-injury and incontinence in psychogenic seizures. Epilepsia. 1995;36(6):586–91.
Nagyova R, Horsburgh G, Robertson A, Zuberi SM. The clinical utility of ambulatory EEG in childhood. Seizure. 2019;64:45–9.
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LK, PJ, DN contributed equally to the manuscript preparation and editing. All three approved the final version. LK will act as the guarantor.
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Kannan, L., Jain, P. & Nayak, D. Role of Video-EEG in Children. Indian J Pediatr 88, 1007–1016 (2021). https://doi.org/10.1007/s12098-020-03605-4
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DOI: https://doi.org/10.1007/s12098-020-03605-4