Monitoring time of interictal epileptiform discharges by long-term video EEG in patients with epilepsy / 浙江大学学报·医学版

To optimize the monitoring time of interictal epileptiform discharges (IED) in patients with epilepsy by long-term video electroencephalogram (VEEG).The cumulative percentages of IED detected by VEEG in 346 epilepsy patients (349 times) with different purposes, different waking sleep states and different MRI findings were retrospectively analyzed. According to the purposes, there were 164 patients (165 times) for clarifying diagnosis, 124 patients (124 times) for preoperative evaluation and 58 patients (60 times) for adjustment of medications. According to MRI results, there were responsible lesions in 98 patients (98 times) and no responsible lesions in 173 patients (174 times).Among 346 patients (349 times), IED was detected within 24 h in 231 patients (times). The percentage of detection in patients with purpose of preoperative evaluation was higher than those with purpose of diagnosis and medication adjustment. The detection of LED was gradually increased in first 8 h with 59.0%, then stably in 24 h. 46.8% IED was recorded during sleep time, particularly in the second stage of sleep. The cumulative percentage of IED in patients with abnormal MRI findings was higher in all periods. It reached 83.7% within 8 h, and then tended to be stable.The study shows that LED should be monitored by VEEG at least 8 hours and should include the second stage of sleep in patients with epilepsy. Patients with refractory epilepsy and with abnormal lesions on MRI should record IED more frequently.

Video electroencephalogram in occipital lobe epilepsy / 中华神经医学杂志

Objective To investigate the characteristics of video electroencephalogram (VEEG) in patients with occipital lobe epilepsy (OLE) to improve the clinical diagnostic rate of OLE.Methods Twenty-five patients with OLE were collected in our hospital from June 2013 to February 2017 and received VEEG monitoring in our epilepsy center.Their clinical symptoms and VEEG characteristics were retrospectively analyzed.Results Nineteen patients (76.00％) had visual auras based on previous history,five (38.46％) had visual auras during VEEG monitoring.Three patients had epileptic discharge confined to occipital lobe and two had epileptic discharge confined to posterior temporal lobe in interictal phase,while 20 had epileptic discharge involved more than one lobe of the brain.In ictal phase,8 had clear discharge origin or earliest evolution in occipital lobe.Five showed abnormal EEG in the other brain areas,which needed other clinical information for diagnosing OLE.Conclusions The visual aura is typical characteristic of OLE,and there are specific manifestations of EEG in both inter-ictal phase and ictal phase.