Cascino Gregory D
Department of Neurology, Mayo Clinic, Rochester, Minn 55905, USA.
Mayo Clin Proc. 2002 Oct;77(10):1111-20. doi: 10.4065/77.10.1111.
Video-electroencephalographic (EEG) monitoring is an important neurodiagnostic technique that may be used for selected patients who present with recurrent and unprovoked spells. For most patients who have epilepsy, the "routine" EEG is sufficient for physicians to classify seizure types and initiate medical therapy; however, routine EEG has substantial limitations for approximately 20% of patients who do not have epilepsy but are referred to comprehensive epilepsy programs because of medically refractory "seizures." These patients may have physiological or psychological disorders that may cause diagnostic confusion with epilepsy and result in the patients being treated unnecessarily with antiepileptic drugs. Video-EEG monitoring, ie, ictal EEG monitoring, performed either on an outpatient basis or in an epilepsy monitoring unit, can help physicians identify ictal EEG patterns that may be necessary for classifying seizure types and determining surgical localization. The sensitivity and specificity of EEG recordings during clinical episodes are superior to those of the routine interictal EEG. Video-EEG monitoring may prove to be an essential procedure for helping physicians confirm diagnoses of seizure disorders, classify seizure types, and select surgical candidates who have intractable epilepsy.
视频脑电图（EEG）监测是一项重要的神经诊断技术，可用于患有反复发作且无诱因发作的特定患者。对于大多数癫痫患者而言，“常规”脑电图足以让医生对发作类型进行分类并启动药物治疗；然而，对于约20%没有癫痫但因药物难治性“发作”而被转诊至综合癫痫项目的患者，常规脑电图存在很大局限性。这些患者可能患有生理或心理障碍，可能会导致与癫痫的诊断混淆，并导致患者不必要地接受抗癫痫药物治疗。在门诊或癫痫监测单元进行的视频脑电图监测，即发作期脑电图监测，可帮助医生识别可能对发作类型分类和确定手术定位必要的发作期脑电图模式。临床发作期间脑电图记录的敏感性和特异性优于常规发作间期脑电图。视频脑电图监测可能被证明是帮助医生确诊癫痫发作障碍、分类发作类型以及选择患有难治性癫痫的手术候选者的重要程序。
