Ambulatory video-electroencephalography (video-EEG) represents a low-cost, convenient and accessible alternative to inpatient video-EEG monitoring, however few studies have examined their diagnostic yield. In this large-scale retrospective study conducted in Australia, we evaluated the efficacy of prolonged ambulatory video-EEG recordings in capturing diagnostic events and resolving the referring question. Sequential adult and paediatric ambulatory video-EEG reports from April 2020 to June 2021 were reviewed retrospectively. Data collection included patient demographics, clinical information, and details of events and EEG abnormalities. Clinical utility was assessed by examining i) time to first diagnostic event, and ii) ability to resolve the referring questions – seizure , , , and (differentiating seizures from non-epileptic events). Of the 600 reports analysed, 49 % captured at least one event, and 45 % captured interictal abnormalities (epileptiform or non-epileptiform). Seizures, probable psychogenic events (mostly non-convulsive), and other non-epileptic events occurred in 13 %, 23 % and 21 % of recordings respectively, with overlap. Unreported events were captured in 53 (9 %) recordings, and unreported seizures represented more than half of all seizures captured (51 %, 392/773). Nine percent of events were missing clinical, video or electrographic data. A diagnostic event occurred in 244 (41 %) recordings, of which 14 % were captured between the fifth and eighth day of recording. Reported event frequency ≥ 1/week was the only significant predictor of diagnostic event capture. In recordings with both seizures and psychogenic events, unrecognized seizures were frequent, and seizures may be missed if recording is terminated early. The referring question was resolved in 85 % of reports with at least one event, and 53 % of all reports. Specifically, this represented 46 % of reports (235/512) for of events, and 75 % of reports (27/36) for of seizures. Ambulatory video-EEG recordings are of high diagnostic value in capturing clinically relevant events and resolving the referring clinical questions.

中文翻译：

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长时间动态视频脑电图监测的诊断效用

动态视频脑电图（视频脑电图）是住院视频脑电图监测的一种低成本、方便且易于使用的替代方案，但很少有研究检验其诊断效果。在澳大利亚进行的这项大规模回顾性研究中，我们评估了长时间动态视频脑电图记录在捕获诊断事件和解决转介问题方面的功效。对 2020 年 4 月至 2021 年 6 月连续的成人和儿童动态视频脑电图报告进行了回顾性审查。数据收集包括患者人口统计、临床信息以及事件和脑电图异常的详细信息。通过检查 i) 首次诊断事件的时间，以及 ii) 解决相关问题的能力（癫痫发作、癫痫发作、癫痫发作和非癫痫事件）来评估临床效用。在分析的 600 份报告中，49% 捕获了至少一个事件，45% 捕获了发作间期异常（癫痫样或非癫痫样）。癫痫发作、可能的心因性事件（主要是非惊厥）和其他非癫痫事件分别占记录的 13%、23% 和 21%，且有重叠。 53 个 (9%) 记录中捕获了未报告的事件，未报告的癫痫发作占捕获的所有癫痫发作的一半以上 (51%, 392/773)。百分之九的事件缺少临床、视频或电图数据。 244 个 (41%) 记录中发生了诊断事件，其中 14% 是在记录的第五天到第八天之间捕获的。报告事件频率≥1次/周是诊断事件捕获的唯一显着预测因子。在癫痫发作和心因性事件的记录中，未识别的癫痫发作很常见，如果提前终止记录，可能会错过癫痫发作。 85% 的至少涉及一项事件的报告以及 53% 的所有报告中的转介问题得到了解决。具体而言，这占事件报告的 46% (235/512) 和癫痫发作报告的 75% (27/36)。动态视频脑电图记录在捕获临床相关事件和解决相关临床问题方面具有很高的诊断价值。