The additional diagnostic benefits of performing both video- polysomnography and prolonged video-EEG-monitoring: When and why

Objective: Video-polysomnography (VPSG) and prolonged video-EEG-monitoring (pVEEG-M) are neuro-physiological investigation modalities. Depending on indication either is performed, but occasionally patients undergo both (during the same or separate stays). We sought to assess the reasons and potential benefits of dual diagnostic assessments with both modalities.Methods: A retrospective chart-review was performed to identify patients who underwent both VPSG and pVEEG-M during the 10 year period between 2007 and 2017. One-hundred-nine patients were iden-tified who had undergone both studies. Patients were grouped according to indication and outcome.Results: One-hundred-nine patients had both, a VPSG and pVEEG-M, in 62 (56.9%) the studies were per -formed because of separate diagnoses independent from each other. In 47 patients (43.1%) investigation with both modalities was needed to clarify the suspected diagnosis or to refute differential diagnoses. Out of these 47,11 (10.1% of the whole group) arrived a new final diagnosis whereas in 36 (33%) the primary diagnosis was corroborated with the second modality.Conclusions: In the majority of cases VPSG plus pVEEG-M were indicated to diagnose or monitor different comorbid diseases (e.g. sleep-related breathing disorder and epilepsy). In the other cases, performing both modalities was useful to achieve a higher diagnostic accuracy or to refute differential diagnoses. Significance: VPSG and pVEEG-M are neurophysiological investigations which complement each other, especially in case of two different comorbid diseases in a single patient, to rule out differential diagnosis or when a higher diagnostic certainty is seeked.(c) 2022 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

The study investigated the reasons and benefits of dual diagnostic assessments using video-polysomnography (VPSG) and prolonged video-EEG-monitoring (pVEEG-M). The majority of cases involved the diagnosis or monitoring of different comorbid diseases, while in other cases, both modalities were useful to achieve a higher diagnostic accuracy or to refute differential diagnoses. The combination of VPSG and pVEEG-M complement each other, especially in cases of two different comorbid diseases, to rule out differential diagnoses or when a higher diagnostic certainty is sought.