Journal
JOURNAL OF CLINICAL NEUROPHYSIOLOGY
Volume 26, Issue 2, Pages 123-128Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/WNP.0b013e31819d8030
Keywords
Cost-effectiveness; Epileptic seizures; Epilepsy surgery; Outcome; Psychogenic nonepileptic seizures; Video-EEG monitoring
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To investigate diagnostic value, therapeutic benefit and cost-effective utilization of video-EEG monitoring (VEM) in a comprehensive epilepsy program in a developing country, The authors prospectively recruited all patients who underwent long-term (>= 3 hours) inpatient VEM during a 10-month period. The cohort was followed to gather information about the proportion of patients in whom long-term management was altered by VEM and resultant impact on direct health care costs. Out of 143 study subjects (median age 22 years), 102 (71.3%) were referred for presurgical evaluation. The median duration of VEM was 61 hours, and median number of events recorded per patient was 3. Video-EEG monitoring helped to clarify the epilepsy syndromic diagnosis in 123 of 132 (93.2%) patients referred with the diagnosis of epileptic seizures. Video-EEG monitoring confirmed coexistent complex partial seizures in 4 of 11 (36.4%) patients with a referral diagnosis of psychogenic nonepileptic events. During mean follow-up period of 2.2 years, 48 patients (33.6%) underwent epilepsy Surgery. A significant decrease in antiepileptic drug polytherapy, and minimization in recurring direct medical and nonmedical costs occurred. In addition to immediate diagnostic usefulness, VEM contributes significantly to long-term therapeutic and economic benefits for patients with difficult to diagnose and treat paroxysmal events.
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