Clinical Indications and Efficacies of Video-Electroencephalographic Monitoring in the Diagnosis and Treatment of Childhood Epilepsy

Suh, Hyun Ah; Kim, Sung Eun; Yum, Mi Sun; You, Su Jeong; Kim, Deok Soo; Ko, Tae Sung

Abstract

PURPOSE
The routine electroencephalography is a pivotal diagnostic study in the evaluation of patients with seizure disorders, but often proves incomplete. Video-Electroencephalographic Monitoring (VEM) is an important diagnostic innovation for intractable epilepsy. We performed this study to evaluate clinical indications and efficacies of VEM in childhood epilepsy.
METHODS
The study group consisted of 231 children under the age of 15 year, admitted to the Asan Medical Center for VEM from November 1995 to February 2005. We classified the group on the basis of reasons for admission and did analyze the EEG, the change of diagnosis, treatment modality, and seizure control.
RESULTS
Eighty seven (38%) patients underwent VEM for the exact classification of seizure types in patients who have epilepsy (Group I), 95 (41%) for presurgical evaluation (Group II) and 49 (21%) to confirm the diagnosis of a seizure disorder (Group III). The diagnosis was altered after VEM in 111 (48%) cases. The treatment modality was altered after VEM in 161 (70%) patients. In Group I, 53 (61%) had a changed treatment plan, 32 of whom had changes in antiepileptic drug and 7 underwent ketogenic diet. In Group II the treatment modality was changed in 82 (86%) cases, 68 of whom had done epileptic surgery and 6 had done VNS. In Group III, 26 (53%) changed the treatment modality. After VEM study, eventually 149 (65%) patients received changed modality of treatment and 91 (61%) patients of them showed improvement in the seizure control.
CONCLUSIONS
VEM showed a high yield in changing diagnosis and management of childhood epilepsy in our study, and we confirmed it is effectively used in the treatment of the intractable childhood epilepsy.