Video EEG monitoring: the Pakistan experience

Journal of Neurology & Neurophysiology

ISSN - 2155-9562

Video EEG monitoring: the Pakistan experience

Joint Event on Neurology & Brain Injury

March 14-15, 2019 | Paris, France

Fowzia Siddiqui

Aga Khan University Hospital, Pakistan

Posters & Accepted Abstracts: J Neurol Neurophysiol

Abstract :

Our understanding of Epilepsy has been greatly advanced by video EEG monitoring which allows prolonged simultaneous recording of patientâ??s behavior and EEG. This allows precise correlation between seizure semiology and correlating activity in the brain. Video- EEG recordings can be done on hospitalized inpatients or on outpatients, In Pakistan where more than two million people are estimated to have epilepsy there is only one comprehensive video EEG monitoring unit at Aga khan University Hospital. We have only inpatient recording facilities, which is preferred as technologists are available to adjust electrodes and diminish outside artifacts. Video-EEG can be vital in the diagnosis of epilepsy and epileptic seizures. It allows the doctor to determine includes: Whether events with unusual features are epileptic seizures; the type of epileptic seizures; the region of the brain from which the seizures arise. This last step is critical in assessing a patient for possible epilepsy surgery (phase I and II). The Aga Khan University Hospital (AKU) is a private university hospital pioneering VEEG in Pakistan since 2006, but its use increased as the comprehensive epilepsy center was set up in 2010 and from an average of about 20 per year increased to over 60 per year. We reviewed past five years VEEGs and found 42.8% of total VEEG show non-epileptic events with normal EEGs 30.9% clearly ictal events with a focus corresponding to MRI. Non-convulsive status had 16.6% and frequent inter ictals, both NES and epileptic 4% events. This shows the immense number of non-epileptic patients on unnecessary AEDs as refractory seizures and also the ability to further epilepsy surgery in patients with clear focus.