The first-hour-of-the-day sleep EEG reliably identifies interictal epileptiform discharges during long-term video-EEG monitoring

Long-term video-EEG monitoring in the epilepsy monitoring unit (EMU) is the gold standard for the diagnosis, classification and localization of epileptic seizures. [1] Specific EEG epileptiform discharges allow better informed decisions regarding medical and surgical treatments and more accurate prediction of seizure control and ultimate remission. An epileptiform discharge is predictive of seizure recurrence, particularly in patients with idiopathic epilepsy [2]. EMU study has resulted in establishing a definitive diagnosis in 76% to 88% of patients and changing in diagnosis or treatment in up to 79% of patients.[3,4] Identification of interictal and ictal epileptiform discharges is essential for achieving these clinical objectives.