Challenges and Prospects in Epilepsy Monitoring Units: A Comprehensive Review of Logistic Barriers

Abstract

Epilepsy is one of the most common neurological diseases with a prevalence ranging from 0.5% to 2% in different sittings. The World Health Organization (WHO) estimated that nearly 80% of this burden is borne by resource-poor countries where even conventional electroencephalogram (EEG) coverage is dramatically short.Video EEG monitoring applied for days as conducted in epilepsy monitoring units (EMUs) is aimed at seizure localization, anti-seizure medication (ASM) adjustment, or epilepsy surgery evaluation and planning. However, the EEG approach in EMUs has its obstacles. The present article is aimed to concentrate on the logistic challenges of EMUs, discussing existing data and limitations and offering suggestions for future planning to enhance the utilization of existing technology.Shortages of adult and pediatric epileptologists, qualified nurses, as well as EEG technologists have been reported in different countries. Moreover, injuries and falls, psychosis, status epilepticus, and unexpected death have been stated to be the most frequent safety issues in EMUs. Enhancements to mitigate logistical and healthcare system-related barriers in EMUs include the implementation of large cohort studies and the utilization of artificial intelligence (AI) for the identification and categorization of specific risks among EMU admissions. The establishment of EMUs and their associated challenges and barriers are best acknowledged through discussions and dialogue with various stakeholders.