Effectiveness of Neuropsychological Protocol with Video Electroencephalography in Diagnosis of Epilepsy

Abstract Background: Epilepsy is one of the most frequent brain diseases. Epilepsy usually affects over 70 million people globally with the majority of people who suffer from it living in low- and middle-income countries, and the prevalence in Iraq from 2000 to 2016 nearly 21.74/1000. Neuropsychological protocol, certain protocols that proposed to cause cortical activation to induce the epileptiform abnormalities, by procedures such as reading, talking, writing, and solving mathematical tasks are all incorporated to activate the cortical neurons and then epileptic discharges. Objectives: Our aim is to study the effectiveness of neuropsychological activation protocols in inducing epileptiform discharges during video electroencephalography (EEG) recording. Materials and Methods: This is a cross-sectional study conducted in neurology ward/video EEG room in Al-Sadeq teaching hospital in Al-Hillah city, through the period from September 2022 till April 2023. The study included 47 patients with age distribution between 12 and 52 years and gender 25 men and 22 women. Patients are recruited from video EEG room in neurology ward after being diagnosed to have epilepsy by experienced neurologist. In addition to the diagnosis, type of epilepsy is stated also in the referral form. All the patients were evaluated with a thorough history and physical examination before being submitted to video electroencephalographic recording in an awake state with activation stages. Results: The study results revealed the percent of interictal epileptiform discharges (IEDs) that induces by neuropsychological activation protocol is 72.3%, and the mathematics (written calculation), is considered the higher activity that induced IEDs. Conclusions: Neuropsychological activation protocol is a useful tool in inducing interictal discharges.