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EAN 2026 | The role of video-EEG in diagnosing paroxysmal events

Gordana Kiteva-Trenchevska, MD, PhD, Ss. Cyril and Methodius University in Skopje (UKIM), Skopje, North Macedonia, discusses the role of video-EEG in the differential diagnosis of paroxysmal events in adults. She explains how combining clinical observations with simultaneous EEG recordings improves seizure classification, helps distinguish epileptic seizures from seizure mimics, and supports more accurate treatment decisions. This interview took place at the 12th Congress of the European Academy of Neurology (EAN) in Geneva, Switzerland.

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Transcript

Video EEG is important because we can see what the clinical manifestations are. Because usually, when we are dealing with a patient with epilepsy, we are taking a history and we get information from the description of the history, how a person who is not educated explains what they see, but sometimes they miss some clinical manifestations. So on the video, we can see not just if it is epilepsy, but, more precisely, the side that is affected, and it can point to the location of the dysfunction in the brain...

Video EEG is important because we can see what the clinical manifestations are. Because usually, when we are dealing with a patient with epilepsy, we are taking a history and we get information from the description of the history, how a person who is not educated explains what they see, but sometimes they miss some clinical manifestations. So on the video, we can see not just if it is epilepsy, but, more precisely, the side that is affected, and it can point to the location of the dysfunction in the brain. It is important for seizure classification, and it is about the video. With video EEG, we simultaneously record the EEG features, and we can also record some epileptiform discharges, ictal or interictal, and we can combine the information from the EEG simultaneously with what we are seeing as the clinical manifestation. And it helps in the differentiation of epilepsy from non-epileptic events. It helps to classify the type of seizures, and it is important because if we are uncertain about whether it is epilepsy or not, it impacts the treatment, impacts the prognosis, and impacts the quality of life. So we don’t want to do harm to the patient. So we use all these tools to help in our clinical decision-making.

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