What is the optimal duration of home-video-EEG monitoring for patients with <1 seizure per day? A simulation study
Ambulatory “at home” video-EEG monitoring (HVEM) may offer a more cost-effective and accessible option as compared to traditional inpatient admissions to epilepsy monitoring units. However, home monitoring may not allow for safe tapering of anti-seizure medications (ASM). As a result, longer periods...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-08-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.938294/full |
| _version_ | 1818000139700142080 |
|---|---|
| author | Tatiana Vander Tatiana Vander Tatiana Stroganova Diya Doufish Dawn Eliashiv Tal Gilboa Tal Gilboa Mordekhay Medvedovsky Dana Ekstein Dana Ekstein |
| author_facet | Tatiana Vander Tatiana Vander Tatiana Stroganova Diya Doufish Dawn Eliashiv Tal Gilboa Tal Gilboa Mordekhay Medvedovsky Dana Ekstein Dana Ekstein |
| author_sort | Tatiana Vander |
| collection | DOAJ |
| description | Ambulatory “at home” video-EEG monitoring (HVEM) may offer a more cost-effective and accessible option as compared to traditional inpatient admissions to epilepsy monitoring units. However, home monitoring may not allow for safe tapering of anti-seizure medications (ASM). As a result, longer periods of monitoring may be necessary to capture a sufficient number of the patients' stereotypic seizures. We aimed to quantitatively estimate the necessary length of HVEM corresponding to various diagnostic scenarios in clinical practice. Using available seizure frequency statistics, we estimated the HVEM duration required to capture one, three, or five seizures on different days, by simulating 100,000 annual time-courses of seizure occurrence in adults and children with more than one and <30 seizures per month (89% of adults and 85% of children). We found that the durations of HVEM needed to record 1, 3, or 5 seizures in 80% of children were 2, 5, and 8 weeks (median 2, 12, and 21 days), respectively, and significantly longer in adults −2, 6, and 10 weeks (median 3, 14, and 26 days; p < 10−10 for all comparisons). Thus, longer HVEM than currently used is needed for expanding its clinical value from diagnosis of nonepileptic or very frequent epileptic events to a presurgical tool for patients with drug-resistant epilepsy. Technical developments and further studies are warranted. |
| first_indexed | 2024-04-14T03:18:03Z |
| format | Article |
| id | doaj.art-6afb652e29ea444c812a5e67598ad769 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-14T03:18:03Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-6afb652e29ea444c812a5e67598ad7692022-12-22T02:15:23ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-08-011310.3389/fneur.2022.938294938294What is the optimal duration of home-video-EEG monitoring for patients with <1 seizure per day? A simulation studyTatiana Vander0Tatiana Vander1Tatiana Stroganova2Diya Doufish3Dawn Eliashiv4Tal Gilboa5Tal Gilboa6Mordekhay Medvedovsky7Dana Ekstein8Dana Ekstein9Herzfeld Geriatric Rehabilitation Medical Center, Gedera, IsraelThe Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelMEG-Center, Moscow State University of Psychology and Education, Moscow, RussiaDepartment of Neurology and Agnes Ginges Center for Human Neurogenetics, Hadassah Medical Organization, Jerusalem, IsraelDepartment of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United StatesThe Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelThe Neuropediatric Unit, Division of Pediatrics, Hadassah Medical Organization, Jerusalem, IsraelDepartment of Neurology and Agnes Ginges Center for Human Neurogenetics, Hadassah Medical Organization, Jerusalem, IsraelDepartment of Neurology and Agnes Ginges Center for Human Neurogenetics, Hadassah Medical Organization, Jerusalem, IsraelDepartment of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United StatesAmbulatory “at home” video-EEG monitoring (HVEM) may offer a more cost-effective and accessible option as compared to traditional inpatient admissions to epilepsy monitoring units. However, home monitoring may not allow for safe tapering of anti-seizure medications (ASM). As a result, longer periods of monitoring may be necessary to capture a sufficient number of the patients' stereotypic seizures. We aimed to quantitatively estimate the necessary length of HVEM corresponding to various diagnostic scenarios in clinical practice. Using available seizure frequency statistics, we estimated the HVEM duration required to capture one, three, or five seizures on different days, by simulating 100,000 annual time-courses of seizure occurrence in adults and children with more than one and <30 seizures per month (89% of adults and 85% of children). We found that the durations of HVEM needed to record 1, 3, or 5 seizures in 80% of children were 2, 5, and 8 weeks (median 2, 12, and 21 days), respectively, and significantly longer in adults −2, 6, and 10 weeks (median 3, 14, and 26 days; p < 10−10 for all comparisons). Thus, longer HVEM than currently used is needed for expanding its clinical value from diagnosis of nonepileptic or very frequent epileptic events to a presurgical tool for patients with drug-resistant epilepsy. Technical developments and further studies are warranted.https://www.frontiersin.org/articles/10.3389/fneur.2022.938294/fulldrug-resistant epilepsyseizure frequencycycling seizuresepilepsy surgerypresurgical evaluation |
| spellingShingle | Tatiana Vander Tatiana Vander Tatiana Stroganova Diya Doufish Dawn Eliashiv Tal Gilboa Tal Gilboa Mordekhay Medvedovsky Dana Ekstein Dana Ekstein What is the optimal duration of home-video-EEG monitoring for patients with <1 seizure per day? A simulation study Frontiers in Neurology drug-resistant epilepsy seizure frequency cycling seizures epilepsy surgery presurgical evaluation |
| title | What is the optimal duration of home-video-EEG monitoring for patients with <1 seizure per day? A simulation study |
| title_full | What is the optimal duration of home-video-EEG monitoring for patients with <1 seizure per day? A simulation study |
| title_fullStr | What is the optimal duration of home-video-EEG monitoring for patients with <1 seizure per day? A simulation study |
| title_full_unstemmed | What is the optimal duration of home-video-EEG monitoring for patients with <1 seizure per day? A simulation study |
| title_short | What is the optimal duration of home-video-EEG monitoring for patients with <1 seizure per day? A simulation study |
| title_sort | what is the optimal duration of home video eeg monitoring for patients with 1 seizure per day a simulation study |
| topic | drug-resistant epilepsy seizure frequency cycling seizures epilepsy surgery presurgical evaluation |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.938294/full |
| work_keys_str_mv | AT tatianavander whatistheoptimaldurationofhomevideoeegmonitoringforpatientswith1seizureperdayasimulationstudy AT tatianavander whatistheoptimaldurationofhomevideoeegmonitoringforpatientswith1seizureperdayasimulationstudy AT tatianastroganova whatistheoptimaldurationofhomevideoeegmonitoringforpatientswith1seizureperdayasimulationstudy AT diyadoufish whatistheoptimaldurationofhomevideoeegmonitoringforpatientswith1seizureperdayasimulationstudy AT dawneliashiv whatistheoptimaldurationofhomevideoeegmonitoringforpatientswith1seizureperdayasimulationstudy AT talgilboa whatistheoptimaldurationofhomevideoeegmonitoringforpatientswith1seizureperdayasimulationstudy AT talgilboa whatistheoptimaldurationofhomevideoeegmonitoringforpatientswith1seizureperdayasimulationstudy AT mordekhaymedvedovsky whatistheoptimaldurationofhomevideoeegmonitoringforpatientswith1seizureperdayasimulationstudy AT danaekstein whatistheoptimaldurationofhomevideoeegmonitoringforpatientswith1seizureperdayasimulationstudy AT danaekstein whatistheoptimaldurationofhomevideoeegmonitoringforpatientswith1seizureperdayasimulationstudy |