Psicosis postictal con delusiones de contenido religioso: reporte de caso / Postictal psychosis with religious delusions: a case report

Desde la antigüedad se han descrito manifestaciones de religiosidad peri-ictal en epilepsia. Es frecuente la psicopatología asociada a epilepsia; entre otras manifestaciones, la psicosis asociada a epilepsia ha sido reportada aunque con menor frecuencia que la depresión y la ansiedad; en especial la psicosis postictal. El uso del monitoreo prolongado con Video- EEG en los últimos años ha permitido estudiar mejor estas manifestaciones. Presentamos un caso de epilepsia del lóbulo temporal farmacorresistente, con un episodio de psicosis postictal caracterizado por delusiones de contenido religioso. Se realizó un estudio detallado que incluyó resonancia de encéfalo y Video-EEG prolongado; revisamos la literatura y los mecanismos fisiopatogénicos propuestos para este fenómeno postictal.

Peri-ictal religious manifestations in epilepsy have been described since ancestral times. Psychopathology associated with epilepsy is frequent; among other manifestations, the psychosis associated with epilepsy has been reported, although less frequently than depression and anxiety; especially postictal psychosis. In recent years the use of prolonged monitoring with Video-EEG has allowed us to better study these manifestations. We present a case of drug-resistant temporal lobe epilepsy, with an episode of postictal psychosis characterized by religious delusions. A detailed study was performed that included brain imaging and prolonged Video-EEG. We review the literature and physiopathogenic mechanisms proposed for this postictal phenomenon.

El infrecuente signo de la cruz en epilepsia del lóbulo temporal: reporte de caso documentado con video-EEG / The infrequent sign of the Cross in temporal lobe epilepsy: case report documented with video-EEG

Las manifestaciones de religiosidad en epilepsia han sido descritas empíricamente desde la antigüedad. En los últimos 60 años con el uso del EEG y luego con la ayuda del Video-EEG se han estudiado mejor estas manifestaciones, en especial en su presentación peri-ictal. El signo de la cruz es un automatismo epiléptico muy infrecuente, con escasos reportes desde el 2009. Presentamos un caso de epilepsia del lóbulo temporal con este automatismo, con estudio detallado que incluyó el registro de la semiología por Video-EEG. Revisamos la literatura con el objetivo de entender los mecanismos fisiopatogénicos propuestos y conocer el valor localizador y/o lateralizador de este signo.

Religious manifestations in epilepsy have been described empirically since ancestral times. In the last 60 years with the use of the EEG and then with the help of the Video-EEG, these manifestations have been studied better, especially in their peri-ictal presentation. The Sign of the Cross is a very infrequent epileptic automatism, with few reports since 2009. We present a case of temporal lobe epilepsy with this automatism, with a detailed study that included the video-EEG recording of semiology. We review the literature with the objective of understanding the physiopathogenic mechanisms and know the localizing and / or lateralizing value of this sign.

Convulsiones neonatales: Diagnóstico clínico y electroencefalográfico / Neonatal seizures. Clinical and electroencephalographic diagnosis

Las convulsiones neonatales son una expresión común de lesiones cerebrales agudas durante el periodo perinatal y podrían incrementar el daño neuronal. La mayoría son electroencefalográficas y las clínicas pueden ser sutiles y difíciles de identificar por el personal médico. Las convulsiones neonatales son usualmente cortas pero frecuentes al inicio y tienden a desaparecer en un periodo corto. El video-EEG continuo es el test ideal para detectar estas convulsiones, pero el EEG de amplitud es útil cuando el EEG convencional no está disponible. El monitoreo con EEG no solo es necesario para evaluar la frecuencia y duración de estas convulsiones, también puede proporcionar información pronóstica importante.

Neonatal seizures are common expression of acute brain injury in the perinatal period and could potentiate the degree of neuronal injury. The majority of events are electroencephalographic and the clinical seizures can be subtle and difficult to identify by medical personnel. Neonatal seizures are usually short and frequent at onset and have a tendency to subside after a short period. Continuous video-EEG monitoring is the gold standard to detect seizures, but amplitude integrated EEG is a useful tool when conventional EEG is not available. EEG monitoring is important not only to monitor frequency and duration of seizures but to provide important prognostic information.

Application of root cause analysis on long-range video EEG monitoring quality on epilepsy patients / 现代临床护理

Objective To study the quality and effect of root cause analysis (RCA) on long-range video EEG monitoring on epilepsy patients.Methods The process of RCA long-range video EEG monitoring on patients with epilepsy was investigated to find out the root causes for quality of epilepsy capturing from pseudo differential of EEG and video effects.Then the measures were taken to improve the quality of monitoring.Result After the intervention,except canmera not clear enough,the incidences were significantly decreased compared with pre-intervention (all P ＜ 0.001).Conclusions Root cause analysis is effective in improving the quality of long-range video EEG monitoring on epilepsy patients.It is worth clinically promoting.

Value of video EEG and MRI in the diagnosis of intractable epilepsy / 中国生化药物杂志

Objective To study the value of video EEG combined with MRI in the diagnosis of intractable epilepsy.Methods40 patients with intractable epilepsy treated in our hospital from 2013 to 2015 were selected as the subjects.In 40 patients, 26 patients with hippocampal sclerosis, 2 cases of patients with temporal lobe atrophy with cerebral dysplasia, 4 cases of patients with cerebral gray matter and macrogyria, 3 cases of vascular malformation, 1 cases of patients with intracerebral cyst, 2 cases of patients with glioma, 2 cases of patients with traumatic epilepsy.Retrospective of The clinical data of the selected patients were analyzed and the manifestations of epileptic foci were reflected by MRI, The use of video EEG was used to detect the status and source of EEG during epileptic seizure and epilepsy Analysis, combined with MRI scan and video EEG results, control surgery pathological changes, analysis of the results, draw conclusions.ResultsThere were 21 cases of the accurate location of interictal EEG.The accuracy was 52.5%, and the accuracy of the location of epileptogenic foci was about 40, and the accuracy was about 100%.The accuracy of MRI in the diagnosis of epileptic foci and related lesions was 35 cases, the accuracy rate was 87.5%, and the number of lesions was qualitative and accurate in the case of 30 cases, with an accuracy rate of 75%.ConclusionVideo EEG combined with MRI examination for drug refractory epilepsy diagnosis has important clinical value, can make a more accurate diagnosis of patients with epileptogenic foci, provide information for surgical treatment of intractable epilepsy patients, with further clinical promotion and application significance.

Recurrent Syncope Triggered by Ictal Asystole

No abstract available.

Clinical study of continuous video EEG monitoring in patients with acute cerebral infarction / 中国综合临床

Objective To investigate the effect of continuous video EEG monitoring on acute cerebral infarction comorbid epileptiform discharges and clinical seizures,and the relationship between cerebral infarction site and seizures.Methods Of the 337 patients continuously video EEG monitored in NICU at our department,259 were included for this study according to our inclusion and exclusion criteria.We recorded patients' epileptiform discharges,type and time of clinical onset,detailed CT and (or) MRI display,cerebral infarction site,and demographic data including admission age,gender,disease history and NIHSS score.Results There were 227/259 (88％) cases showed abnormal discharge in EEG,including 94 with side hemispheric slow wave,99 with local changes,34 with slow wave combined with epileptiform discharges.Early seizures was found in 12 cases,including 3 cases with seizure-induced cerebral infarction,9 cases with attack within one week after cerebral infarction.Ten in the 12 patients had tonic-clonic seizures,and the other 2 cases hadlocal seizures.Epileptiform discharges in EEG was found in 9 cases of the 12 patients.Clinical seizures were not observed in 25 patients with epileptiform discharges in EEG.Results on the relationship between cerebral infarction site and epileptiform discharges showed that incidence of epilepsy in patients with watershed infarction was significantly higher than other types of cerebral infarction (29.0％ vs 13.4％ and 9.0％,P =0.03,0.01 ).Conclusion Continuous video EEG monitoring is capable of detecting early epilepsy and epileptiform discharges.It can provide theoretical basis for the prevention and treatment of epilepsy.

Clinical value of video-EEG on adrenocorticotrophic hormone therapy for infantile spasms / 中国小儿急救医学

Objective To analyse the value of video-EEG (VEEG) in the infantile spasms (IS)children treated with adrenocorticotrophic hormone (ACTH). Methods The clinical data of 65 children with IS in our hospital from Jan 2005 to Dec 2009 were collected and the characteristics of VEEG were analyzed before and after treated with ACTH. Results All the 65 cases appeared hypsarrhythmia in the interphase before treated with ACTH. Cluster spasms and the characteristics of VEEG were recorded. After treated with ACTH,40 of 65 cases (61.5%) with epileptic seizure were controlled,in whom 27 cases (67.5% ,27/40)with hypsarrhythmia disappeared or improved obviously. The other 25 of 65 cases (38.5%) with epileptic seizure were uncontrolled,in whom only 5 cases (20. 0% ,5/25) with hypsarrhythmia disappeared. The rate of hypsarrhythmia disappeared or improved was significantly different between the epileptic seizure controlled and uncontrolled children (x2 = 13. 888, P ＜ 0. 000). Conclusion VEEG is not only important to make a definite diagnosis for IS,but also can provide an evidence in evaluating the effect of ACTH in IS children.

Video-EEG in the pursuit of documented coexistence of epileptic and psychogenic nonepileptic seizures: how long is too long? - a case report / Vídeo-EEG em busca da real necessidade da documentação em crises epilépticas e não-epilépticas psicogênicas: quanto tempo é demasiado longo? - relato de caso

Continuous Vídeo-EEG monitoring remains the gold-standard tool to confirm or disregard the diagnosis of epilepsy in selected cases in which a differential diagnosis is required and not clearly established in the basis of outpatient procedures. However, it may be a tiresome and stressful experience for patients and it is certainly an expensive test. Thus, we wonder how far (considering both financial and emotional costs) should we pursue the goal of documenting all suspicious events. An illustrative case is presented.

Monitorização continua com Video-EEG permanece como método de eleição no diagnóstico de epilepsia, em casos selecionados onde o diagnóstico diferencial não pode ser perfeitamente definido com base em procedimentos ambulatoriais. Entretanto, a monitorização contínua pode constituir uma experiência cansativa e estressante para os pacientes, além de custo envolvido. Considerando estes custos (emocional e financeiro) é especulada a real necessidade da documentação de todos os eventos suspeitos. Um caso ilustrativo é apresentado.

Papel de la monitorización electroencefalográfica continua en el diagnóstico de la epilepsia pediátrica / Role of continuous EEG monitoring in the diagnosis of pediatric epilepsy

El diagnóstico de la epilepsia es fundamentalmente clínico, pero frecuentemente se plantea el diagnóstico diferencial con fenómenos no epilépticos. El desarrollo de la monitorización EEG continua (MEEGC) en las últimas dos décadas ha permitido mejorar el diagnóstico de pacientes epilépticos de todas las edades. En este trabajo se revisan los datos de la literatura sobre la eficacia de los distintos tipos de MEEGC en el diagnóstico de la epilepsia pediátrica, resaltando especialmente nuestra experiencia personal. En nuestros estudios, la MEEGC ambulatoria suplementada con video permitió contestar la pregunta que determinó su petición en el 80% de pacientes diagnosticados de epilepsia y en el 83% de aquéllos con sospecha diagnóstica de epilepsia. Con la MEEGC ambulatoria asistida por ordenador, dichas cifras fueron 88% y 89%, respectivamente y con la MEEGC intrahospitalaria con video fueron 82% y 51%, respectivamente. La MEEGC intrahospitalaria con video es crucial en la evaluación de pacientes con epilepsia, candidatos al tratamiento quirúrgico. La MEEGC es también importante en pacientes con encefalopatías agudas ingresados en las unidades de cuidados intensivos. La MEEGC, tanto ambulatoria como intrahospitalaria, es muy útil en el diagnóstico diferencial de fenómenos clínicos epilépticos y no epilépticos y en la confirmación del tipo de epilepsia o síndrome epiléptico. Los avances tecnológicos y el desarrollo de nuevas modalidades de EEG en el futuro, harán que la electroencefalografía siga siendo una técnica muy importante en el estudio de la función cerebral en pacientes con enfermedades neurológicas agudas o crónicas.

The diagnosis of epilepsy is basically clinical, but it frequently raises the differential diagnosis with non-epileptic events. The development of continuous EEG monitoring (CEEGM) in the past decades has allowed a better diagnosis of epileptic patients of all ages. In this paper we review the data available in the literature about the efficacy of the different modalities of CEEGM in the diagnosis of pediatric epilepsy, emphasizing our personal experience. In our studies the ambulatory CEEGM supplemented with video allowed to answer the question that prompted its request in 80% of patients diagnosed with epilepsy and in 83% of those with the suspected diagnosis of epilepsy. With ambulatory computer-assisted CEEGM those figures were 88% and 89%, respectively, and with inpatient video-CEEGM they were 82% and 51%, respectively. The latter is crucial in the evaluation of epilepsy patients who are candidates for surgical treatment. Inpatient video-CEEGM is also very important in the management of patients with acute encephalopathies admitted to the Intensive Care Units. Both, ambulatory or inpatient CEEGM, are very useful in the differential diagnosis of clinical epileptic versus non-epileptic events, as well as in the confirmation of the type of epilepsy or epileptic syndrome. The development of technological advances and new EEG modalities in the future will help to continue to consider electroencephalography as a very important technique in the study of brain function in patients with acute or chronic encephalopathies.

Usefulness of video-EEG monitoring in paroxysmal nonepileptic events of children and adolescents / 소아과

PURPOSE: In addition to epileptic seizures (ES), a variety of physiologic, organic and psychogenic disorders can manifest as paroxysmal behavioral events. Paroxysmal nonepileptic events (PNEs) are quite encountered in infants, young children, and adolescents. In a substantial proportion of cases, a careful history and examination will elucidate their nature. However, in other cases, it is necessary to differentiate PNEs from ES by video-electroencephalographic (EEG) monitoring. We report our experiences with PNEs in a group of children and adolescents who underwent video-EEG monitoring. METHODS: From September, 2004 to June, 2006, one hundred thirty patients were monitored in the Pediatric Epilepsy Monitoring Units of Korea University Guro and Ansan hospitals. Their hospital charts were reviewed and video records of these events were analyzed. We observed all patients after video- EEG monitoring for more than 3 months. RESULTS: Typical spells occurred during monitoring in 33 patients, not associated with a seizure pattern on EEG recordings. Two patients were diagnosed as frontal lobe epilepsy on basis of typical semiology and clinical characteristics, so 31 patients were documented to have PNEs finally. The mean age of patients was 7.2+/-5.8 years. The male to female ratio was 15 (48.4%) to 16 (51.6%). Among 31 patients, fifteen patients had associated disorders such as epilepsy, developmental delay, cerebral palsy, gastric ulcer, attention deficit hyperactivity disorder or depressive disorder. Somatoform disorder and factitious disorder was frequently seen in children more than 5 years old (P0.05). CONCLUSION: Our study suggests that video-EEG monitoring is an important diagnostic tool in the evaluation of paroxysmal behavioral events. With correct diagnosis of the PNEs, several unnecessary treatment could be avoided.

Postoperative Electroclinical Features in Epilepsy Patients With Seizures After Anteromesial Temporal Resection

BACKGROUND: Anteromesial temporal resection (AMTR) is well established as effective in patients with intractable mesial temporal epilepsy. However, little electroclinical information is available relevant to poor surgical outcome after AMTR. We examined the postoperative electroclinical features based on postoperative MRI and video-EEG monitoring (VEM) in patients with poor surgical outcome. METHODS: We reviewed clinical features and postoperative VEM results in 20 patients with failure in AMTR. According to the postoperative electroclinical features, we classified them into mesial temporal (MT), bitemporal (BT), extramesial temporal (XMT), combined (C), and unclassified groups. The postoperative VEM results were compared among the groups. Surgical outcome was assessed in five patients who underwent reoperation. RESULTS: Patients comprised 6 MT, 2 BT, 6 XMT, 1 C, and 6 unclassified. Aura and automatism were more frequent in MT (50.0%, 83.3%) than in XMT (16.7%, 33.3%). Theta to delta rhythm, during the ictal onset and build-up period, was more frequent in MT (83.3%, 66.7%) than in XMT (33.3%, 33.3%). The ictal onset and build-up pattern of ictal EEG were most frequently localized to the frontotemporal region in MT (66.7%, 100.0%), while there was no predominantly localized region in XMT. The surgical outcome after reoperation was better in MT group than in XMT and C groups. CONCLUSIONS: Postoperative MRI and VEM are useful to assess the postoperative electroclinical features in failed AMTR. Reoperation of the residual mesiotemporal structures after confirming epileptogenic foci may have good surgical outcome.

The Role of Video-EEG Monitoring: Purpose and outcome / 대한간질학회지

BACKGROUND AND PURPOSE: We performed this study to explore the various diagnostic roles of video-EEG monitoring (VEM) and to assess the outcome after VEM. METHODS: 1749 patients who underwent VEM in the adult epilepsy section were included. We classified purposes of VEM and assessed outcome after VEM or epilepsy surgery guided by VEM. The outcome was assessed according to seizure frequency during the previous 12 months from the day of follow-up evaluation. RESULTS: The purposes of VEM were presurgical evaluation (68.5%), confirmation of epilepsy (15%), classification of seizures (9.4%), diagnosis of pseudoseizures (5.5%), and detection of nonconvulsive status epilepticus (1.7%). The efficiency of VEM was 89.2%, highest for presurgical evaluation (97.1%) and lowest for confirmation of seizures (66.0%). The number of events detected and the number of days needed differed according to the purposes of VEM. Epilepsy surgery was performed in 629 patients. The outcome of patients with epilepsy surgery was significantly better compared with patients without surgery despite presurgical evaluation (p<0.0001). Various other illnesses with transient symptoms as well as various epileptic syndromes were diagnosed by VEM. Better outcomes were observed in patients in whom VEM was used for classification and confirmation of seizures compared with patients in whom VEM was used for presurgical evaluation. CONCLUSIONS: VEM is a useful tool for various purposes. The efficiency, number of events and days of VEM differed according to the purposes. Patient outcome was also dependent on the purpose of the VEM as well as on treatment modalities.

Epilepsy surgery in patients with coexisting psychogenic nonepileptic seizures: diagnosis and treatment / Crises não-epilépticas e cirurgia na epilepsia: uma revisão

The prevalence of epileptic seizures among patients with psychogenic nonepileptic seizures may range from five to fifty percent. Diagnosis of both conditions occurring in association may be difficult and requires both clinical skills and prolonged video-EEG monitoring. Occurrence of seemingly psychogenic events during video-EEG monitoring should be interpreted with caution, and the relative role of both psychogenic and epileptic seizures in day-to-day living should be carefully evaluated for each individual patient. Surgery is not contraindicated in this setting, however patients and family members should be educated about both conditions before surgical decision. Psychogenic seizures and other psychiatric co-morbidities should be properly assessed and treated before surgery. Diagnosis and management of postoperative events (epileptic or psychogenic) is challenging. This difficulty can be minimized by appropriate presurgical management, that includes diagnostic testing, neurologic and psychiatric treatment and patient and family counseling.

A prevalência de crises epilépticas entre pacientes com crises não-epilépticas psicogênicas varia entre cinco e 50 por cento. A diagnóstico desta comorbidade pode ser difícil, e requer experiência clínica, além de monitorização prolongada por vídeo-EEG. A ocorrência de eventos sugestivos de crises não-epilépticas durante a monitorização por vídeo-EEG deve ser interpretada com cautela. O papel relativo de cada uma das co-morbidades na vida diária do paciente deve ser avaliada caso a caso. Não há contra-indicação formal para a cirurgia, contudo pacientes e familiares devem ser esclarecidos acerca de ambos os diagnósticos e as crises psicogênicas e outras comorbidades psiquiátricas devem ser diagnosticadas e tratadas adequadamente antes da cirurgia. O diagnóstico e tratamento de eventos epilépticos ou psicogênicos que ocorram após a cirurgia é ainda mais difícil, porém esta dificuldade pode ser minimizada com uma avaliação pré-operatória cuidadosa, que inclui diagnóstico e tratamento neurológico e psiquiátrico precisos, além de aconselhamento a pacientes e familiares.

The Etiology and Outcome Analysis of Neonatal Burst Suppression EEG / 华中科技大学学报（医学）（英德文版）

The neonatal burst suppression is a severe EEG pattern and always demonstrates serious damage of nerve system. But the outcome of these patients depends on the different etiology. A total of 256 cases of video EEG recordings were analyzed in order to summarize the etiology and outcome of burst suppression. The results showed that some patients in all 17 cases of burst suppression showed EEG improvement. The etiology was the dominant factor in long term outcome. It was sug-gested that effective video EEG monitoring is helpful for etiologic study and prognosis evaluation.

The Clinical and Electroencephalographic Characteristics of Hypomotor Seizures in Children

PURPOSE: A hypomotor seizure is a useful descriptive terminology, but its clinical and ictal characteristics are not fully understood. We investigated the clinical and electrophysiological characteristics of hypomotor seizures in children. METHODS: We reviewed 394 video-taped recordings, performed between Dec. 1994 and Feb. 2003., to select patients of hypomotor seizures. Exclusion criteria were as follows; i) hypomotor seizures accompanied with other types of seizures in a single event, ii) patients without neurocognitive dysfunctions who were older than 3 years old, iii) non-convulsive status epilepticus, iv) poor video quality. A total of 329 hypomotor seizures from 42 patients (M:F=27:15) were included. The mean age of onset was 1.9 years old, the mean age at the monitoring 4.5 years old, and the mean duration of follow-ups 3.9 years. RESULTS: Thirteen patients (31%) showed generalized onset, hypomotor seizures while 29 patients (69%) showed partial onset hypomotor seizures. 35 patients (83.3%) had neurocognitive deficits. Significant abnormalities in the on brain MRIs were revealed in 23 patients (54.8 %). The concordance rates of interictal epileptiform discharges were 29.0%. In 8 patients, (hypomotor seizures were separately accompanied by other types of seizures (19.0%)). Comparing generalized seizures (group 1) with partial seizures (group 2), there were no significant differences in the clinical parameters between the two groups. In brain MRIs, group 2 tended to have focal lesions. On the analysis of ictal rhythms in group 1, diffuse spike and wave discharges were noted in 8 patients, rhythmic beta in 2 patients, semirhythmic theta in 1 patient, diffuse attenuation of the background in 1 patient, and bilateral beta in 1 patient. Among 5 patients with ictal rhythms other than diffuse spike and wave discharges, 4 patients were younger than 3 years old. On the analysis in group 2, rhythmic ictal patterns were noted in 24 patients (82.8%), seimirhythmic in 2 patients (6.9%), and irregular in 3 patients (10.3%). The distribution of ictal frequencies was as follows:alpha in 3 (10.3%), beta in 4 (13.8%), theta in 10 (34.5%), delta in 4 (13.8%), repetitive spikes or sharp waves in 5 (17.3%), and spikes and waves in 3 (10.3%). Rhythmic beta patterns tended to be localized into the posterior quadrant. CONCLUSION: Hypomotor seizures consist of generalized-onset (31%) and partial-onset (69 %). No clinical parameters can predict the ictal patterns. Various patterns in patients with generalized onset hypomotor seizures under 3 years old may suggest different mechanisms of generalized hypomotor seizures from absence seizures. Rhythmic beta patterns from the posterior quadrant may suggest the localization-specific ictal patterns.

FDG-positron emission tomography and EEG:The comparison in localizing in refractory epilepsy / 中国康复理论与实践

@#ObjectiveTo study the values of EEG and [18F]2-deoxyglucose(FDG) positron emission tomography in localizing the epiletogenic cortex,and evaluate their relation.MethodsVideo-EEG(VEEG) and FDG-PET scans were performed in 44 patients with refractory epilepsy.Electrocorticography(ECoG) in surgery and patholopy were performed in 38 patients who had undergone neurosurgical therapy.Congruence among them were studied.Results43 patients(98%) had FDG-PET hypometabolism.42 patients(95%) had epileptiform wave.There were 22 patients(50%) whose PET and EEG were in complete congruence,whereas 10 patients(23%) in part congruence.12 patients who had undergone operation had controversial results in PET and EEG,8 cases had agreement between ECoG and PET,and 2 cases had agreement between ECoG and VEEG. ConclusionFDG-PET is a effective,sensitive and non-invasive investigation.It can provide valuable supplemental data in patients with unlocalized surface EEG.

Orientações ao paciente epiléptico submetido ao vídeo-eletrencefalograma: comparação dos níveis de ansiedade com o uso de diferentes estratégias / Orientations to epileptic patient undergoing a video-EEG monitoring: comparison of anxiety levels using different strategies

Trata-se de um estudo experimental, correlacional, com abordagem quantitativa que compara os níveis de ansiedade de dois grupos de pacientes epilépticos submetidos ao vídeo-eletrencefalograma (vídeo-EEG) que tiveram diferentes estratégias de orientação para o exame; o controle teve apenas orientações verbais e o experimental, além das orientações verbais, também, recebeu um manual de orientações, variável independente do estudo. A amostra foi, aleatoriamente, composta por dois grupos de 30 pacientes. Para avaliar o uso de diferentes estratégias de orientação, foi comparada a ansiedade dos grupos, por meio da aplicação do Inventário de Ansiedade Traço-Estado (IDATE), sendo o estado de ansiedade, avaliado pré e pós-exame. Os resultados mostraram que o grupo experimental apresentou perfil de ansiedade superior, porém, estado de ansiedade inferior, antes do exame, em relação ao controle. A ansiedade do grupo experimental foi mais baixa, antes do exame do que seu perfil, entretanto, o mesmo não ocorreu com o grupo controle. Após o exame, a grande maioria de ambos os grupos apresentou ansiedade baixa e menor que seu perfil. A estratégia de orientação com o manual parece ter beneficiado os pacientes que o receberam, promovendo a redução da ansiedade antes do exame ser realizado.

This exploratory, correlated and quantitative study had the objective to identify and compare the anxiety level between two groups of epileptic patients undergoing a video-EEG monitoring using different patients guidelines strategies. The random sample was composed by two groups of 30 patients each one. The control group only had verbal orientations and the experimental group, beyond the same orientations received a written guide (a booklet) with all the procedures too. The anxiety was assessed using State-Trait Anxiety Inventory (STAI-T and STAI-S) with the STAI-S being applied for both groups before and after examination as described above. The results demonstrated that, before video-EEG, the anxiety-trait score of the experimental group was higher and the anxiety-state was lower than the control group. After video-EEG, the majority of both groups demonstrated low anxiety-state score and lower than their anxiety-trait score. The strategy used with the written guide associated to verbal orientations seems to help to reduce the anxiety level before the video-EEG.

Diagnostic Value of Video-EEG in Children's Non-epileptic Seizures / 中国医师杂志

Objective To evaluate the value of Video-EEG for the diagnosis of children's non-epileptic seizures (NES). Methods A retrospective analysis was conducted in 105 cases of children with NES, which were diagnosed by 1 to 4 hours' video-EEG surveillance. Risk factors that interfered with the diagnosis were discussed. Results There were 91 cases (87%) of physiological NES and 14 cases (13%) of psychological NES among the total 105 NES. Misdiagnoses were made in 11 of 43 cases who received common EEG examination before. Conclusion Video-EEG was a reliable method to confirm the clinical diagnosis of non-epileptic seizures and differentiate it from epilepsy. EEG abnormality during seizure-free periods was the main risk factor for the misdiagnosis of NES.

A Case of Suspected Autosomal Dominant Nocturnal Frontal Lobe Epilepsy

Autosomal dominant nocturnal frontal lobe epilepsy(ADNFLE) is a recently identified partial epilepsy. This disorder is characterized by a variable age of onset(mostly in childhood), autosomal dominant inheritance, clusters of brief frontal nocturnal seizures, negative findings on neuroimaging, and fairly good prognosis. Carbamazepine is known to be the most useful drug in this type of epilepsy. We experienced a case of 5-year-old boy who had unusual arousal and irritability every night for 3 years and had sharp & wave discharges from frontal lobe region in long-term video-EEG monitoring, who was suspected as an autosomal dominant nocturnal frontal lobe epilepsy. We report a case with a brief review of literatures.