Advantages of respiratory monitoring during video-EEG evaluation to differentiate epileptic seizures from other events.

Differentiating between epileptic seizures (ES) and seizure-like nonepileptic events (SLNE) is often difficult using descriptions of seizure semiology. Cardiopulmonary dysfunction is frequent in ES but has not been objectively examined in relation to SLNE. Our purpose was to compare cardiopulmonary dysfunction between ES and SLNE. We prospectively recorded cardiopulmonary function using pulse oximetry, EKG, and respiratory inductance plethysmography (RIP) in 52 ES and 22 SLNE. Comparison of cardiopulmonary complications between ES and SLNE was done using two-sample T-tests and logistic regression. Ictal bradypnea and preictal bradycardia were more frequent in ES than SLNE (p<0.05). Desaturation was found in 57% of ES and in 0% of SLNE (p<0.0001). Oxygen saturation nadir was significantly lower in ES vs. SLNE (p<0.0001). Ictal apnea was present in 31% ES and 9% SLNE (p=0.06). Preictal, ictal, and postictal tachycardia did not significantly differ between ES and SLNE (p>1.0). Cardiorespiratory dysfunction, specifically bradypnea, apnea, preictal bradycardia, and oxygen desaturation, is more frequently seen in ES than in SLNE. Tachycardia was not discriminant between ES and SLNE.