Long term EEG recording and its role in clinical practice

In most monitoring units the differential diagnosis between epileptic and nonepileptic attacks is the main clinical application. Other uses of these facilities include: (1) Localisation of sites of onset of epileptic seizures in patients being. considered for surgical treatment. (2) Determining the frequency of inconspicuous seizures which may be overlooked by patients and carers. (3) Detection of seizures with subtle clinical manifestations, possibly involving only a change in psychological function. (4) Studying the effects of activities, stimuli or environments thought to precipitate seizures in particular patients. The interactive problem-oriented approach of intensive EEG monitoring may be contrasted with the more usual use of EEG as a routine screening test. Although monitoring is labour intensive, evaluation studies show it to be highly cost-effective in resolving otherwise intractable problems in people with apparently refractory epilepsy.