Video-electroencephalographic monitoring (VEM) is critical to the evaluation and treatment of patients with medication resistant epilepsy, defined by failure of two adequate trials of tolerated, appropriately-chosen antiseizure medications (ASM) at appropriate doses [1,2]. While some studies demonstrated that early surgical therapy for epilepsy may be more effective, the time from first seizure to VEM (TVEM) remains around 20 years and VEM remains underutilized [3–20]. For comparison, it typically takes 9 years to meet the definition of medication resistant epilepsy [13].
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