Uzun süreli Video-EEG Monitörizasyon Sonuçlarının Değerlendirilmesi

Abstract

AMAÇ: Epilepsi, serebrovasküler hastalıklardan sonra en yaygın görülen nörolojik sorunlardan biridir. Bu çalışmada, epilepsi ve nonepileptik psikojen nöbetlerin (NEPN) ayırıcı tanısında Video-EEG Monitörizasyonu'nun (VEM) önemini vurgulamak amaçlanmıştır. Merkezimizde VEM yapılan hastalarda epileptik ve nonepileptik nöbet tiplerini karşılaştırarak tanısal süreçlerin iyileştirilmesi hedeflenmiştir. GEREÇ VE YÖNTEM: Merkezimizde 2012-2022 yılları arasında en az 24 saatlik VEM çekimi yapılan 1024 hasta retrospektif olarak incelenmiştir. İstatistiksel analizler Kolmogorov-Smirnov, Bağımsız t testi, Mann-Whitney U, Spearman's rho korelasyon ve PearsonChi-square (χ2) testleri kullanılarak yapılmıştır. BULGULAR: Çalışmaya dahil edilen 1024 hastanın %60,3'ü erkek (n=617), %39,7'si kadın (n=407) olup, yaş ortalaması 27,6 ± 10,4 yıldır. Epileptik nöbetler 232 hastada (%22,6) saptandı; bunların %17,9'u jeneralize, %3,7'si fokal, %0,9'u absans nöbetiydi. Ayrıca, hastaların %8,4'ünde (n=86) nonepileptik psikojen nöbet belirlendi. SONUÇ: Epilepsi tanısını koymada, özellikle zor olgularda anamnez, fizik muayene ve görüntüleme yöntemleri yetersiz kalabilmektedir. Bu hastalarda VEM, tanıyı kesinleştirmek açısından önemli bir araçtır. Tedaviye dirençli vakalarda ise NEPN ayırıcı tanısı göz önünde bulundurulmalıdır. Merkezimizdeki VEM uygulamaları, hem NEPN ayrımında hem de nöbet tiplerinin doğru şekilde belirlenmesinde kritik bir rol oynamaktadır.

Keywords

• Epilepsi
• EEG
• VEM
• Nöbet
• NEPN

Evaluation of long-term Video-EEG Monitoring Results

Abstract

Objective: Epilepsy is one of the most common neurological disorders after cerebrovascular diseases. This study aimed to emphasize the importance of Video-EEG Monitoring (VEM) in the differential diagnosis of epileptic and psychogenic nonepileptic seizures (PNES). We also ought to assess and compare the differences between epileptic and nonepileptic seizures in patients monitored at our center to improve diagnostic processes. Methods: This retrospective study included 1,024 patients who underwent VEM for at least 24 hours between 2012 and 2022 at our center. Statistical analyses were performed using Kolmogorov-Smirnov, Independent t-test, Mann-Whitney U, Spearman's rho correlation, and PearsonChi-square (χ2) tests. Results: Of the 1,024 patients, 60.3% (n = 617) were male and 39.7% (n = 407) were female, with a meanage of 27.6 ± 10.4 years. Epileptic seizures were detected in 232 patients (22.6%); 17.9% were generalized, 3.7% were focal, and 0.9% were absence seizures. Psychogenic nonepileptic seizures (PNES) were identified in 86 patients (8.4%). Conclusions: In cases where diagnosing epilepsy is challenging, anamnesis, physical examination, and imaging may be insufficient. In such instances, VEM should be considered to confirm the diagnosis. Furthermore, PNES should be evaluated in treatment-resistant cases. VEM plays a critical role in distinguishing PNES and accurately identifying seizure types.

Keywords

• Epilepsy
• EEG
• VEM
• Seizure
• PNES

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