“Short-Term Outpatient EEG-Video Monitoring With
Induction in a Veterans Administration Population”

By: Heber L. Varela, Denise S. Taylor, and Selim R. Benbadis

SUMMARY:
The gold standard for diagnosis of psychogenic nonepileptic
seizures (PNES) is EEG-video monitoring. EEG-video
monitoring is usually prolonged and inpatient, but the availability of
this procedure for veterans is limited. This study thought to evaluate
the yield of short-term outpatient EEG-video monitoring for the
diagnosis of PNES in a V.A. population. We reviewed the data on
all short-term outpatient EEG-video monitoring performed at our
V.A. hospital over a 2-year period. Short-term EEG-video monitoring
was performed with induction according to a published protocol
[Benbadis et al., 2000]. Briefly, induction is performed without a
placebo, using hyperventilation, photic stimulation, and verbal suggestion.
This was performed on patients in whom there was a
clinical suspicion of PNES on clinical grounds. A total of 52
short-term EEG-video monitoring sessions were performed. Of
those, 40 patients (77%) were men. In 35 patients (67%) the
procedure recorded the habitual episode and resulted in a clear
diagnosis of PNES. The procedure was inconclusive in 17 patients
(33%), either because a non-habitual event was induced (7 patients,
14%), or no event was recorded (10 patients, 19%). The yield of
EEG-video monitoring with induction in a (predominantly male)
V.A. population is high, and comparable to a non-V.A. population
[Benbadis et al., 2000].

American Clinical Neurophysiology Society