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The Role of Telemetry (Simultaneous Video and EEG Monitoring) in the Proper Management of Epilepsy

Author: Ghaieb B Aljandeel,Gonzalo Alarcon
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 3 Pages: 408-413
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Telemetry is defined as simultaneous video and EEG monitoring of presumably epileptic patients while they are hospitalized in telemetry ward so that one or more of the habitual seizures or funs are captured and recorded; these events would be visualized and analyzed later by expert epileptologists for the sake of proper diagnosis, classification, presurgical evaluation or else.OBJECTIVE:To define and evaluate simultaneous Video –EEG monitoring in epilepsy management.METHODS:Two hundreds consecutive telemetries at King's College Hospital in London over the period of nine months starting from Jan 2007 back to May 2006 were reviewed and the conclusive yields were evaluated.RESULTS:It showed that the three main indications for referral were to be ’the diagnosis' in a proportion of 56.5% 'presurgical evaluation ' in 19.8% and ' classification' in 15.2% whereas other application like assessment for vagal nerve stimulation (VNS) candidacy , sleep studies , follow up and frequency estimation constitute the remaining 8.5 % . It was conclusive in 63% for 'classification', 60 % for 'diagnosis', and only 34%for presurgical evaluation, whereas categorically was conclusive in 56.55 of all referrals.CONCLUSION:The study shows that telemetry is a crucial and probably an indispensable tool if the proper understanding of the problem, and consequently proper handling and management are to be considered.


Article
Common Ictal Patterns in Patients with Documented Epileptic Seizures

Author: Ghaieb Bashar ALJandeel
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: supplement Pages: 637-642
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:The ictal EEG patterns are the electrical triggers of 'epileptic seizures' and they are different from the familiar 'inter-ictal' discharges that are encountered during the normal 'non-seizing' states of epileptic patients. This study concentrates on the 'seizing discharges' among in-patients with documented seizures through a 'simultaneous EEG-Video' monitoring (telemetry) facilityOBJECTIVE:To identify the common ictal patterns in patients with documented epileptic seizures METHODS:Two hundred consecutive telemetries at King's College Hospital in London over the period of nine months starting from Jan 2007 back to May 2006 were reviewed and the common ictal patterns were evaluated by using 'simultaneous EEG-Video' monitoring (telemetry) facility RESULTS: Three main ictal patterns were observed in the 81 patients with documented epileptic seizures. 'Rhythmic theta ictal pattern' was observed in 46.9% of patients, all showed focal seizures whereas 26.1% of patients showed the 'decremental ictal pattern' (fast activity). Focal seizures were presented in 81.8% and 18.2% with generalized ones. 'Polyspike-wave' activity was observed in 9.8% of patients and all of them have genrralized seizuresCONCLUSION:At least three commonly encountered ictal patterns were identified. They are distinct, may be readily recognizable and showed their prevalence in King's telemetry.

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