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Evaluation of ambulatory cassette EEG monitoring

III. Diagnostic accuracy compared to intensive inpatient EEG monitoring

Epilepsy Center (Drs. Ebersole and Leroy), West Haven VA Medical Center, West Haven, CT, and the Department of Neurology (Drs. Ebersole and Leroy), Yale University School of Medicine, New Haven, CT.

We assessed the ability to recognize epileptiform abnormalities on a video review of ambulatory cassette EEGs (A/EEG) by comparing two independent interpretations of an A/EEG to those derived from a routine recording and intensive monitoring by cable telemetry (CDEG) of the same 40 patients. Both ABEG readings concurred with the C/EEG interpretation as to normality or epileptiform abnormality in 77% of cases. Seventy-nine percent of focal and 100% of generalized interictal abnormalities, as well as all seizures, noted on C/EEG were detected by both A/EEG reviewers. Of patients with normal baseline EEGs, 37% showed epileptiform features on A/EEG versus 44% with C/EEG. Limits to the characterization of abnormalities by A/EEG and a protocol for the video review of A/EEG tapes are discussed. In those specific areas for which intensive surface EEG monitoring is most useful, ambulatory cassette EEG appears to be an acceptable intermediate-level alternative.

Address correspondence and reprint requests to Dr. Ebersole, Epilepsy Center, West Haven VA Medical Center, Weat Haven, CT 06516.

This work was supported by the Epilepsy Foundation of America.

Presented in part at the thirty-fourth annual meeting of the American Academy of Neurology, Washington, DC, April 1982.

Accepted for publication November 9, 1982.

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