Epilepsy Center Frankfurt Rhine-Main, Center of Neurology and Neurosurgery, University Hospital Frankfurt, Goethe-University Frankfurt, Frankfurt am Main, Germany; LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany.
Epilepsy Center Frankfurt Rhine-Main, Center of Neurology and Neurosurgery, University Hospital Frankfurt, Goethe-University Frankfurt, Frankfurt am Main, Germany; LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany.
Eur J Paediatr Neurol. 2021 May;32:29-35. doi: 10.1016/j.ejpn.2021.03.006. Epub 2021 Mar 10.
To investigate benefits of in-hospital, long-term video EEG monitoring (LVEM) for pediatric patients, from a therapeutic perspective and from the perspectives of patients and their families.
A monocentric retrospective cohort study was conducted. Patients aged 0-18 years who underwent LVEM for epilepsy surgery eligibility, epilepsy syndrome clarification, or medication adjustment were evaluated regarding paroxysmal event type, change in seizure frequency and patients' benefits using a standardized evaluation protocol.
A total of 163 (88 boys and 75 girls, mean age 10.9 years) pediatric patients underwent 178 LVEM sessions, with a mean duration of 5.4 days. The rate of habitual event detection was 69.1%. Epilepsy diagnosis was confirmed in 147 patients and excluded in 16 patients (9.8%). LVEM results altered the diagnosis of 37.4% of patients. Diagnosis remained unchanged in 49.1% of patients and was specified in 13.5% of patients. Epilepsy surgery was performed in 32 patients, and 64% of epilepsy patients deemed ineligible for epilepsy surgery underwent medication adjustments. Patients or their families found LVEM helpful in 75% of cases. Significant seizure reductions and improvements in the disease course were reported by 45% of epilepsy patients. Three episodes of non-convulsive status epilepticus occurred, representing 1.7% of admissions and 1.9% of patients diagnosed with epilepsy, while no injuries were observed.
LVEM is beneficial for pediatric patients from both a medical perspective and from the perspective of patients and their families, even if patients are ineligible for epilepsy surgery. LVEM is well-tolerated with a low risk of status epilepticus and injuries.
从治疗角度、患者及其家属角度出发，研究住院长期视频脑电图监测（LVEM）对儿科患者的益处。
进行单中心回顾性队列研究。评估了年龄在 0-18 岁、因癫痫手术适应证、癫痫综合征明确或药物调整而行 LVEM 的患者的阵发性事件类型、癫痫发作频率变化以及患者获益，使用标准化评估方案。
共 163 例（88 名男孩和 75 名女孩，平均年龄 10.9 岁）儿科患者行 178 次 LVEM 检查，平均持续时间为 5.4 天。习惯性事件检测率为 69.1%。147 例患者确诊为癫痫，16 例（9.8%）患者排除癫痫。LVEM 结果改变了 37.4%患者的诊断。49.1%的患者诊断保持不变，13.5%的患者诊断得到明确。32 例患者进行了癫痫手术，64%的癫痫患者认为不适合进行癫痫手术的患者进行了药物调整。75%的患者或其家属认为 LVEM 有帮助。45%的癫痫患者报告癫痫发作显著减少，疾病进程得到改善。发生了 3 例非惊厥性癫痫持续状态，占住院患者的 1.7%和确诊癫痫患者的 1.9%，但未观察到损伤。
即使患者不适合进行癫痫手术，LVEM 对儿科患者具有医疗和患者及其家属两方面的益处。LVEM 耐受性良好，癫痫持续状态和损伤的风险低。
