EpilepsieMonitoring

EpilepsieMonitoring is the set of techniques used to observe, record, and analyze brain activity in people with suspected or established epilepsy. It combines noninvasive and invasive methods and is often centered on long-term video-EEG monitoring performed in specialized epilepsy monitoring units.

Noninvasive methods include continuous video-EEG monitoring with scalp electrodes to capture habitual seizures, interictal discharges, and ictal events, together with synchronized video. Ambulatory EEG can extend monitoring outside the hospital but may provide less comprehensive video documentation. Invasive approaches place electrodes on the cortex (subdural grids) or within brain tissue (depth electrodes) to localize the seizure onset zone for surgical planning. Some centers use magnetoencephalography (MEG) and integrated imaging to supplement EEG findings.

Indications include confirming the diagnosis of epilepsy, distinguishing epileptic from non-epileptic events, evaluating drug-resistant focal epilepsy, and identifying seizure onset regions for surgery or neuromodulation therapy (RNS, VNS, or DBS). The typical process involves admission to an epilepsy monitoring unit, continuous recording for several days to weeks, and coordinated review by a multidisciplinary team.

Benefits include improved diagnostic precision, better localization for surgery, and informed decisions about therapies. Limitations include incomplete seizure capture, limited access to specialized centers, and risks associated with invasive monitoring. Ethical and logistical considerations address safety, privacy, and the impact on daily life.

EpilepsieMonitoring aims to optimize treatment outcomes by refining diagnosis, guiding surgical or device-based interventions, and reducing seizure burden while balancing safety and resources.