Abstracts

Rationale: The INCN is a referral public hospital in Perú with close to 90000 neurological referrals per year, being epilepsy the main cause of morbidity, in the in- and out-patient setting. Long-term Video-EEG monitoring is an essential tool for the evaluation of patients diagnosed with refractory epilepsy, either for pre-surgical evaluation and to confirm diagnosis. Our goal was to determine the utility of this procedure in this set of patients. Methods: This is a retrospective review of 87 cases, assessed from October 2010 to April 2012 in the newly-established epilepsy monitoring unit. VEEG recordings were obtained with an 18 channel digital EEG device (NIHON KODEN) using standard montages and monitoring of vital parameters, for the duration of 1-8 hours. The indication of sleep deprivation and/or AED withdrawal was necessary in some cases. Results: Of the 87 total patients assessed in the 19-month period, 53% (n=46) were male, and 55% (n=48) were between 15-25 years. 70% (n=61) had a diagnosis of focal epilepsy (52 with symptomatic epilepsy), 16% (n=14) generalized epilepsy (93% idiopathic) and 14% (n=12) paroxysmal non-epileptic disorders. The most common reasons for admission were a) to classify epilepsy type or syndrome and quantification of seizure frequency (84%), b) diagnostic purposes (77%), and c) presurgical evaluation for medically refractory epilepsy (17%). Diagnosis was confirmed in 72% (n=63), while 28% (n=24) were discharged with a different diagnosis. These results allowed a better patient management including medication adjustment. Conclusions: When VEEG monitoring is used correctly, it is an invaluable tool in the diagnosis and management of epilepsy. A definite diagnosis helps to minimize the social, psychiatric, and financial burden that continued spells place on the patient and his or her family.