Occurrence of seizure clusters and status epilepticus during inpatient video-EEG monitoring

Rose, Andrew; McCabe, Paul H.; Gilliam, Frank; Smith, Brien; Boggs, Jane G.; Ficker, David M.; Moore, James L.; Passaro, Erasmo A.; Bazil, Carl W.

doi:10.1212/01.wnl.0000053748.83309.28

Cited by 126 publications

(103 citation statements)

References 16 publications

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“…Our findings of a mean time from admission to seizure activity of 2 days and a mean total length of stay of 5 to 6 days are in line with those of earlier reports on outcome of video-EEG monitoring. [7][8][9] Procedures to increase the likelihood of recording seizures, such as sleep deprivation and medication withdrawal, are known to increase the risk of seizure clusters, prolonged seizures, and status epilepticus. Sei- In the current study, seizure clusters were present in onefourth of patients.…”

Section: Discussionmentioning

confidence: 99%

Safety of Long-term Video-Electroencephalographic Monitoring for Evaluation of Epilepsy

Noe

Drazkowski

2009

Mayo Clinic Proceedings

113

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Section: Discussionmentioning

confidence: 99%

Safety of Long-term Video-Electroencephalographic Monitoring for Evaluation of Epilepsy

Noe

Drazkowski

2009

Mayo Clinic Proceedings

113

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“…There were no previous studies in which all AEDs were discontinued before the VEEG admission. Interestingly, we and a number of other authors observed no complications related to discontinuation or dose reduction of AEDs [2,9,10,18,19,[21][22][23][24][25]. However, it is too early to conclude that we can discontinue all AEDs from our single series of VEEG monitoring.…”

Section: Discussionmentioning

confidence: 47%

“…Importantly, tapering or withdrawal of AEDs has been believed to be potentially dangerous, as it carries a 3% risk of status epilepticus or cluster seizures [4,13,21,22]. Therefore, most epilepsy centers gradually taper or partially discontinue AEDs [10,19].…”

Section: Discussionmentioning

confidence: 99%

Timing of seizure occurrence and response of medical staff in video-EEG monitoring for drug-resistant epilepsy

Dhuha

Konno

Yokota

et al. 2017

E&S

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Purpose:The pur pose of this study was to deter mine the optimal dur ation of long-term video-EEG monitoring (VEEG) in patients with epilepsy. The response time of medical staff to seizures was also evaluated from the viewpoint of safety of the monitoring. Methods: We estimated the optimal duration of VEEG from the seizure onset pattern. We retrospectively investigated all VEEG sessions performed in our department during the period between June 2005 and July 2016. Sessions with no seizures and with only non-epileptic seizures were excluded. Using 91 sessions from 69 patients, information on the onset time and response time of medical staff to seizures was collected. Results: The median duration from the start of VEEG to the first seizure was 2 days. Seventy-seven percent of first seizures occurred within 3 days of VEEG. The median duration from the first seizure to the third seizure was 2 days. Eighty percent of third seizures occurred within 3 days of the first seizure. There was no significant diurnal distribution of seizure occurrence. Medical staff did not respond to 20% of generalized seizures and 69% of focal seizures. The overlooking of generalized seizures occurred mainly during the hours of 1-2 pm and 8-9 pm but there was no significant diurnal pattern in overlooking generalized and focal seizures.Conclusion：Based on these findings, we suggest that VEEG can be terminated when no seizure occurs within 4 days after onset. In our VEEG protocol, in which all antiepileptic drugs were discontinued before the start of a session, there was no diurnal pattern of seizure occurrence. This is the first study investigating the diurnal pattern of overlooking seizures by medical staff during VEEG. Since there was no diurnal pattern to the overlooking, medical staff should pay equal, 24-hour attention to patients on VEEG.

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“…Bu çalışmada toplam 169 nöbet izlenirken 24 saatte küme nöbet geçirme yüzdesi 48.5 ve dört saatte ise %17.8 olarak saptanmıştır. [6] Gennaro ve ark.nın [7] yaptığı çalışmada ise bu oranlar sırasıyla %39 ve %11 olarak bildirilmiştir. Hem bizim çalışmamızda hem de bu çalışmada hiç status epileptikus saptanmazken, Rose ve ark.nın [6] yaptığı çok merkezli çalışmada ise %3 sıklıkta status epileptikus bildirilmesi hasta sayısının fazla olmasından kaynaklanabilir.…”

Section: Discussionunclassified

“…[6] Gennaro ve ark.nın [7] yaptığı çalışmada ise bu oranlar sırasıyla %39 ve %11 olarak bildirilmiştir. Hem bizim çalışmamızda hem de bu çalışmada hiç status epileptikus saptanmazken, Rose ve ark.nın [6] yaptığı çok merkezli çalışmada ise %3 sıklıkta status epileptikus bildirilmesi hasta sayısının fazla olmasından kaynaklanabilir. Çalışmamızda hiç status epileptikus tablosunun izlenmemiş olması antiepileptik ilaçların yavaş kesilmesi ve benzodiazepin grubu ilaçların kesilmemesi ile ilişkilendirilebilir.…”

Section: Discussionunclassified

The Effects of Slow Withdrawal of Antiepileptic Drugs During Long-Term Video-EEG Monitoring on Seizure Clusters and Status Epilepticus

Barçın¹,

Gunal²,

Aktekin³

2013

Epilepsi

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SummaryObjectives: In this retrospective study, frequency of seizure clustering and occurrence of status epilepticus were investigated in patients with drug resistant focal epilepsy who were admitted in long term video-EEG monitoring unit (VEM) for presurgical evaluation. Methods: The VEM records of 49 patients (26 female, 23 male; mean age 26.35±10.2 years) between April 2004-April 2008 were reviewed. Results: Although there was no status epilepticus occured, seizure clustering was observed in 21 (%42.9) patients during VEM. Conclusion: Seizure clustering was common during presurgical VEM. The risk of seizure clustering might be reduced with a slow antiepileptic drugs tapering protocol and to avoid changing the presently used benzodiazepine dosage.Key words: Antiepileptic drugs; drug resistant epilepsy; seizure clustering; status epilepticus; video-EEG monitoring. ÖzetAmaç: Bu geriye dönük çalışmada dirençli epilepsi tanısı ile takip edilen ve cerrahi öncesi epileptik odağın tespiti amacıyla uzun süreli video-EEG monitorizasyonu (VEM) yapılan hastalarda küme nöbet ve status epileptikus gelişme sıklığı araştırıldı. Sonuç: Küme nöbet cerrahi öncesi video-EEG monitorizasyonu sırasında sık görülür. Bununla birlikte antiepileptik ilaçların yavaş kesilmesi ve kullanılmakta olan benzodiazepin dozunda değişiklikten kaçınılması durumunda küme nöbetlerin gelişme riski azalabilir. Gereç ve

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Occurrence of seizure clusters and status epilepticus during inpatient video-EEG monitoring

Cited by 126 publications

References 16 publications

Safety of Long-term Video-Electroencephalographic Monitoring for Evaluation of Epilepsy

Safety of Long-term Video-Electroencephalographic Monitoring for Evaluation of Epilepsy

Timing of seizure occurrence and response of medical staff in video-EEG monitoring for drug-resistant epilepsy

The Effects of Slow Withdrawal of Antiepileptic Drugs During Long-Term Video-EEG Monitoring on Seizure Clusters and Status Epilepticus

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