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Predicting Nonepileptic Seizures Utilizing Seizure Frequency, EEG, and Response to Medication

Davis B.J.
Montana Epilepsy Program, Great Falls, Mont., USA Eur Neurol 2004;51:153–156 (DOI:10.1159/000077287)

Abstract

The objective was to develop criteria that would prompt evaluation with video EEG monitoring in order to shorten the time to diagnosis of nonepileptic seizures. Over a period of 3 consecutive years, all patients being seen for seizures or the consideration of seizures meeting the following criteria were admitted for video EEG monitoring: (1) at least two events per week, (2) refractory to at least two medications, and (3) no prior EEG studies with epileptiform abnormalities after at least two attempts. A total of 13 patients met all three criteria, 11 of these patients had nonepileptic seizures, yielding a positive predictive value of 0.85. The median time from onset of symptoms until referral to the study institution was 3 years, with a range of 0–15 years. The median time from the first patient visit to a definitive diagnosis on video EEG monitoring was 1 month, with a range of 0–7 months. Patients meeting these three criteria frequently have nonepileptic seizures. These patients should undergo video EEG monitoring in a timely fashion to clarify the diagnosis.

 

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