Journal
JOURNAL OF CLINICAL NEUROPHYSIOLOGY
Volume 38, Issue 2, Pages 101-111Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/WNP.0000000000000601
Keywords
Ambulatory; EEG; Monitoring; Mobile; Computer-assisted; Seizure; Epilepsy
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Long-term video-EEG monitoring is essential for the diagnosis of epileptic and nonepileptic events, as it can provide valuable insights into cases that may not be easily identified through standard EEG. It can also help optimize treatment plans for patients.
Long-term video-EEG monitoring has been the gold standard for diagnosis of epileptic and nonepileptic events. Medication changes, safety, and a lack of recording EEG in one's habitual environment may interfere with diagnostic representation and subsequently affect management. Some spells defy standard EEG because of ultradian and circadian times of occurrence, manifest nocturnal expression of epileptiform activity, and require classification for clarifying diagnostic input to identify optimal treatment. Some patients may be unaware of seizures, have frequent events, or subclinical seizures that require quantification before optimal management. The influence on antiseizure drug management and clinical drug research can be enlightened by long-term outpatient ambulatory EEG monitoring. With recent governmental shifts to focus on mobile health, ambulatory EEG monitoring has grown beyond diagnostic capabilities to target the dynamic effects of medical and nonmedical treatment for patients with epilepsy in their natural environment. Furthermore, newer applications in ambulatory monitoring include additional physiologic parameters (e.g., sleep, detection of myogenic signals, etc.) and extend treatment relevance to patients beyond seizure reduction alone addressing comorbid conditions. It is with this focus in mind that we direct our discussion on the present and future aspects of using ambulatory EEG monitoring in the treatment of patients with epilepsy.
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