Depending on the type of epilepsy, the sensitivity of the routine EEG can vary. IEDs should be distinct, standing out from the background, and usually appear as spikes, sharp waves and spike-wave complexes (St.
In adult epilepsy centres, the sensitivity of an initial routine EEG to reveal IEDs ranges from 29 to 55% (Pillai & Sperling, 2006). Sensitivity of Interictal Epileptiform Discharges (IEDs) The principal objective of the routine EEG, in the diagnosis of epilepsy, is to capture IEDs. Nonetheless, despite advances in both EEG and neuroimaging, the history is still the mainstay for the diagnosis (Amin & Benbadis, 2019). The routine EEG, lasting 20–30 minutes, is the most basic and inexpensive EEG test, and can support a diagnosis of epilepsy. In this article, we will discuss the following: Monitoring using one type or another is arguably the main activity of referral epilepsy centres, be it for children or adults, and is now also performed in smaller hospitals and in the ambulatory setting. With all these options and various combinations of duration and video or not, it is probably best to use specific descriptive terms. Obviously, the longer, the better, as this increases sample time, but there are practical limitations. The terms “ prolonged” and “ long-term” have no strict definition, so it is probably best to specify duration, that is, two hours, six hours, 24 hours, three days, and so on. It is usually associated with video recording even though the word “video” is not used Įpilepsy monitoring and EEG monitoring are general terms that specify neither what is monitored (video or not) nor for how long, and probably should not be used It does not necessarily include video, and there is no definition of how many hours constitute “long term”.
Long-term monitoring: this term is confusing because it only refers to duration, but it is often used implying the presence of video. Video-EEG monitoring: this is usually assumed to be inpatient and prolonged, but really does not have to be either it can be short or long, inpatient or ambulatory. Prolonged EEG may also mean extended recording in order to obtain sleep.Īmbulatory EEG: outpatient recording, usually for 1–3 days but duration varies, with or without video Prolonged EEG (1–2 hours): as for routine EEG above, this can be performed with or without video. The most commonly used activation procedures are photic stimulation, hyperventilation and sleep deprivation (staying up late the night before)
Often this is performed with standard “activation procedures” that increase the yield for capturing interictal epileptiform discharges (IEDs) or even seizures. Routine (or standard) EEG: 20–30 minutes, usually without video (but can easily be added).
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