Kaufmann E
© E. Kaufmann

Talk by PH Dr. Med. Elisabeth Kaufmann (LMU München)

Abstract
Continuous EEG-video-monitoring (EVM) is a valuable tool for differential diagnostics of paroxysmal events as well as for presurgical evaluation of drug resistant epilepsy. The latter includes surface and intracranial EEG recording, as well as intracranial stimulation, neuropsychological testing and advanced multimodal imaging. In case resective surgery can be performed, it is associated with a high chance to become seizure free. EEG-video-monitoring, though, is time and cost intensive and data analysis is still based on a subjective analysis by an experienced epileptologist and thus error-prone. Further, a relevant number of patients are no candidate or failed resective surgery. In this patient group, neurostimulation should be evaluated as third line therapy option. However, in Europe, only vagal nerve stimulation (VNS) and deep brain stimulation of the anterior thalamic nucleus (ANT-DBS) have been approved for the treatment of pharmaco-resistant epilepsies. Knowledge of the mechanisms of action of neurostimulation are still limited and individualizable methods would be desirable.
In this talk, I will touch upon the interface between the clinical and scientific value of EVM. I will highlight scientific investigations aiming at cost reduction and improvement in diagnostic quality including initial approaches for an examiner-independent, i.e. objective seizure analysis based on audio data, seizure semiology and 3D movement analysis. Further, the rationale and data of a pilot study on cathodal transcranial direct current stimulation (c-tDCS) will be presented as an example for future effective, non-invasive treatment options for patients with pharmaco-resistant epilepsy.