Timing of first event in inpatient long-term video-EEG monitoring for diagnostic purposes

- LTM is a useful tool in diagnosis of unclear clinical paroxysmal events.
- For diagnostic purposes, most events occur on the first two days of the recording.
- No clinical variables were associated with time required to record a first event.

BackgroundLong-term video-EEG monitoring (LTM) aims to record the habitual event and is a useful diagnostic tool for neurological paroxysmal clinical events. In our epilepsy monitoring unit (EMU) setting, admissions are usually planned to last up to five days. We ascertained time taken for the recording of a first event and determined correlations between different clinical characteristics and timings.MethodsWe retrospectively reviewed diagnostic and classification LTM recording performed at a tertiary epilepsy centre.ResultsSixty-three recordings were reviewed. Most subjects (89%) had events at least once a week prior to admission. In 40 (63%) a habitual event was recorded, mostly (93%) within the first two days. No events were recorded on day four or five. A few characteristics were associated with a trend for events occurring earlier (events more than once a week vs less than once a week, motor symptoms compared with aura or dyscognitive events, and reduction of antiepileptic drugs versus no reduction).ConclusionsOur finding suggests that, for diagnostic event recording in people with epilepsy or PNEA, a maximum recording time of three days is sufficient in two thirds of them, if event frequency is at least once a week. In the remaining third, prolonged recording up to five days did not result in capturing a clinical event. For these individuals, shorter admission could be planned, for example for 2 days rather than 5 days.