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Neurophysiological investigations for the diagnosis of non-epileptic attack disorder in neuropsychiatry services: from safety standards to improved effectiveness

Published online by Cambridge University Press:  23 March 2016

Andrea E. Cavanna  and
Stefano Seri
Andrea E. Cavanna*
Affiliation:
School of Life and Health Sciences, Aston Brain Centre, Wellcome Trust Laboratory for MEG Studies, Aston University, Birmingham, UK Department of Neuropsychiatry, University of Birmingham and BSMHFT, Birmingham, UK Institute of Neurology, UCL, London, UK
Stefano Seri
Affiliation:
School of Life and Health Sciences, Aston Brain Centre, Wellcome Trust Laboratory for MEG Studies, Aston University, Birmingham, UK Department of Clinical Neurophysiology and Pediatric Epilepsy Surgery Programme, The Birmingham Children’s Hospital NHS Foundation Trust, Birmingham, UK
*
Prof. Andrea E. Cavanna, Department of Neuropsychiatry, National Centre for Mental Health, 25 Vincent Drive, Birmingham B15 2FG, UK. Tel: +44 121 3012280; Fax: +44 121 3012291; E-mail: a.cavanna@ion.ucl.ac.uk
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Abstract

Objective

The discipline of clinical neuropsychiatry currently provides specialised services for a number of conditions that cross the traditional boundaries of neurology and psychiatry, including non-epileptic attack disorder. Neurophysiological investigations have an important role within neuropsychiatry services, with video-electroencephalography (EEG) telemetry being the gold standard investigation for the differential diagnosis between epileptic seizures and non-epileptic attacks. This article reviews existing evidence on best practices for neurophysiology investigations, with focus on safety measures for video-EEG telemetry.

Methods

We conducted a systematic literature review using the PubMed database in order to identify the scientific literature on the best practices when using neurophysiological investigations in patients with suspected epileptic seizures or non-epileptic attacks.

Results

Specific measures need to be implemented for video-EEG telemetry to be safely and effectively carried out by neuropsychiatry services. A confirmed diagnosis of non-epileptic attack disorder following video-EEG telemetry carried out within neuropsychiatry units has the inherent advantage of allowing diagnosis communication and implementation of treatment strategies in a timely fashion, potentially improving clinical outcomes and cost-effectiveness significantly.

Conclusion

The identified recommendations set the stage for the development of standardised guidelines to enable neuropsychiatry services to implement streamlined and evidence-based care pathways.

Keywords

epilepsyneuropsychiatrynon-epileptic attack disordersafetyvideo-EEG telemetry
Type
Review Article
Information
Acta Neuropsychiatrica , Volume 28 , Issue 4 , August 2016 , pp. 185 - 194
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Copyright
© Scandinavian College of Neuropsychopharmacology 2016 

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