Seizure symptoms and ambulatory EEG findings: incidence of epileptiform discharges
| Autor: | Nasser Y. Ali, Tanvir U. Syed, Faraaz M. Hussain, Amir Alnobani, Hai Chen, Muhammad Tahir Khan, Anas Fares, Hashem Al Bunni, Faraaz A. Khan, Jeremy D. Slater, Mohamad Z. Koubeissi, Talha Iqbal, Sana Aziz, Adam U. Syed |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Lightheadedness Video Recording Monitoring Ambulatory Electroencephalography 03 medical and health sciences 0302 clinical medicine Seizures Fibromyalgia medicine Humans Ictal Aged Retrospective Studies Auditory hallucination Epilepsy medicine.diagnostic_test business.industry Incidence Chronic pain General Medicine Odds ratio Middle Aged medicine.disease Neurophysiological Monitoring Neurology Practice Guidelines as Topic Ambulatory Female Self Report Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Epileptic Disorders. 22:752-758 |
| ISSN: | 1950-6945 1294-9361 |
| Popis: | Aims Ambulatory video-EEG monitoring has been utilized as a cost-effective alternative to inpatient video-EEG monitoring for non-surgical diagnostic evaluation of symptoms suggestive of epileptic seizures. We aimed to assess incidence of epileptiform discharges in ambulatory video-EEG recordings according to seizure symptom history obtained during clinical evaluation. Methods This was a retrospective cohort study. We queried seizure symptoms from 9,221 consecutive ambulatory video-EEG studies in 35 states over one calendar year. We assessed incidence of epileptiform discharges for each symptom, including symptoms that conformed to a category heading, even if not included in the ILAE 2017 symptom list. We report incidences, odds ratios, and corresponding p values using Fisher's exact test and univariate logistic regression. We applied multivariable logistic regression to generate odds ratios for the six symptom categories that are controlled for the presence of other symptoms. Results History that included motor symptoms (OR=1.53) or automatisms (OR=1.42) was associated with increased occurrence of epileptiform discharges, whereas history of sensory symptoms (OR=0.76) predicted lack of epileptiform discharges. Patient-reported symptoms that were associated with increased occurrence of epileptiform discharges included lip-smacking, moaning, verbal automatism, aggression, eye-blinking, deja vu, muscle pain, urinary incontinence, choking and jerking. On the other hand, auditory hallucination memory deficits, lightheadedness, syncope, giddiness, fibromyalgia and chronic pain predicted absence of epileptiform discharges. The majority of epileptiform discharges consisted only of interictal sharp waves or spikes. Conclusions Our study shows that the use of ILAE 2017 symptom categories may help guide ambulatory video-EEG studies. |
| Databáze: | OpenAIRE |
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