Nwogu Chukwudi, Nwaze Chukwuma, Avah Adaeze, Anyanwu Benjamin, Anyanwu Chinekwu
Department of Neurology, Regions Healthcare Hospitals and Specialist Clinics, Mgbirichi, Imo, Nigeria.
Department of Neurology, Carilion Roanoke Memorial Hospital, Roanoke, Virginia, USA.
Epilepsia Open. 2025 Apr;10(2):487-493. doi: 10.1002/epi4.70000. Epub 2025 Feb 19.
Long-term video electroencephalogram monitoring (LTVEM) is a standard practice in epilepsy centers to diagnose and characterize paroxysmal events. With the lack of data on LTVEM in Africa, we aimed to determine the clinical yield of LTVEM performed for 24-72 h to diagnose seizures in an epilepsy center in Nigeria.
This was a retrospective review of all patients admitted to our Epilepsy Monitoring Unit (EMU) from September 2018 to September 2021, with monitoring lasting between 24 and 72 h. We reviewed the patients' seizure semiology, time to the first event, and final diagnosis. The frequency of seizures was classified as "daily" in patients with one or more seizures per day, "persistent" in patients with less than one seizure per day but at least once in 6 months, and "rare" in patients with less than one seizure in 6 months. Patients with unclear duration due to recent onset were classified as "undefined".
Seventy patients (34 males, 36 females) were included in our study. The mean age was 22.86 ± 18.00 years. The average duration of monitoring was 44.23 ± 16.16 h. Fifty-seven patients (81.4%) were confirmed to have seizures. Thirteen patients experienced non-epileptic events. Of these 13 patients, nine were diagnosed with psychogenic non-epileptic spells (PNES). Two patients were diagnosed with essential myoclonus and two patients were diagnosed with syncope. The time to the first interictal epileptiform discharge was within 8 h. In the first 24 h, 56 of 57 patients had ictal and interictal discharge (98.2%). These included 100% daily seizures, 100% persistent seizures, and 100% undefined events. One rare seizure was observed within 48 h.
The diagnostic yield of the LTVEM in well-selected patients for seizures in this study is 81.4%. Most patients received a diagnosis within 48 h of monitoring, and we found that extending the study beyond 72 h may not offer significant additional benefits in diagnosing seizures in patients presenting with paroxysmal events.
There is limited information about the usefulness of long-term video electroencephalogram (EEG) monitoring in diagnosing seizures in Africa. Several conditions that resemble seizures (paroxysmal events) could be misdiagnosed, leading to inappropriate treatment. This study evaluated the effectiveness of 24- to 72-h video EEG monitoring in diagnosing seizures at an epilepsy center in Nigeria. Among 70 patients, 81.4% were diagnosed with seizures, with most diagnoses made within 48 h. The findings suggest that video EEG performed within 48 h can significantly help distinguish seizures from other paroxysmal events, thereby contributing to better management and outcomes.
长期视频脑电图监测（LTVEM）是癫痫中心诊断和描述阵发性事件的标准做法。由于非洲缺乏关于LTVEM的数据，我们旨在确定在尼日利亚一家癫痫中心进行24至72小时的LTVEM以诊断癫痫发作的临床收益。
这是一项对2018年9月至2021年9月入住我们癫痫监测单元（EMU）的所有患者的回顾性研究，监测持续时间为24至72小时。我们回顾了患者的癫痫发作症状学、首次发作时间和最终诊断。癫痫发作频率在每天发作一次或多次的患者中分类为“每日”，在每天发作少于一次但6个月内至少发作一次的患者中分类为“持续性”，在6个月内发作少于一次的患者中分类为“罕见”。因近期发病而发作持续时间不明确的患者分类为“未定义”。
我们的研究纳入了70名患者（34名男性，36名女性）。平均年龄为22.86±18.00岁。平均监测持续时间为44.23±16.16小时。57名患者（8l.4%）被确诊有癫痫发作。13名患者经历了非癫痫性事件。在这13名患者中，9名被诊断为精神性非癫痫性发作（PNES）。2名患者被诊断为特发性肌阵挛，2名患者被诊断为晕厥。首次发作间期癫痫样放电时间在8小时内。在最初的24小时内，57名患者中的56名有发作期和发作间期放电（98.2%）。这些包括100%的每日发作、100%的持续性发作和100%的未定义事件。在48小时内观察到1次罕见发作。
本研究中，LTVEM对精心挑选的癫痫发作患者的诊断率为81.4%。大多数患者在监测48小时内得到诊断。我们发现，将研究延长至72小时以上可能不会为诊断阵发性事件患者的癫痫发作带来显著的额外益处。
关于长期视频脑电图（EEG）监测在非洲诊断癫痫发作的有用性信息有限。几种类似癫痫发作（阵发性事件）的情况可能被误诊，导致不适当的治疗。本研究评估了24至72小时视频EEG监测在尼日利亚一家癫痫中心诊断癫痫发作的有效性。在70名患者中，81.4%被诊断为癫痫发作多数诊断在48小时内做出。研究结果表明，48小时内进行的视频EEG可以显著帮助区分癫痫发作与其他阵发性事件，从而有助于更好的管理和治疗效果。
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