An evaluation of ambulatory, cassette EEG monitoring: I. Montage design.

Ambulatory EEGs using cassette tape recorders have only four channels. Questions have been raised about the limitations this imposes on detection of focal interictal epileptiform events. A review of EEGs from inpatients undergoing prolonged monitoring demonstrated an overwhelming representation of these abnormalities in the frontal and anterior temporal scalp regions. Three-channel montages were designed to sample these regions and were tested by simultaneously recording them with multichannel montages. Successful montages combining a frontal transverse and two longitudinal channels adequately detected 74 to 100% of interictal epileptic events.