Safety in Long-Term EEG/Video Monitoring

Developing a culture of safety in the epilepsy monitoring unit: A retrospective study of safety outcomes

“…The few studies reporting EMU-specific falls rates have ranged from 0 to 6.0 to 8.0 falls per 1000 patient-days [1,3,5]. However, not all these EMU reports may have included patients with PNES in the falls results.…”

“…Patient falls, status epilepticus (SE), and postictal psychosis have been reported as known risks and common adverse events in patients admitted to an epilepsy monitoring unit (EMU) for withdrawal of anti-seizure medications and prolonged video-EEG [1][2][3][4][5]. Choking and aspiration have been confirmed as rare risks to EMU patients [6].…”

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

“…The low rate of orthopedic injury and absence of any dental injuries in this series may in part reflect the absence of falls. As noted by Sanders et al,19 falls are an important potential source of injury during video-EEG monitoring. Falls may occur as a result of seizure or sedation and ataxia resulting from administered medications.…”

“…The EMU of Johns Hopkins Hospital reported a rate of 8 falls per 1000 patient-days, 60% of which resulted in abrasions or contusions. 19 Serious orthopedic injuries can result from falls or as a result of intense muscle contraction during seizures. The only previous study to examine orthopedic injuries during video-EEG monitoring focused on shoulder dislocations, which were observed in 5 of 806 patients.…”

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

“…Antiepileptik ilaçların kesilmesi hastanede kalış süresini kısaltarak ekonomik yükü azaltmasına rağmen status epileptikus, küme nöbetler, postiktal psikoz gibi bir takım komplikasyonları da beraberinde getirebilir. [1][2][3] Mevcut tedavilerin kesilmesi ile ortaya çıkan nöbetlerin nedeni, terapotik etkinliğin kaybıyla birlikte bazı ilaçlar için 'rebound: geri tepme' fenomeni ile de ilişkilidir. Antiepileptik ilaçların kesilmesini takiben akut dönemde ortaya çıkan jeneralize tonik klonik nöbet ya da nöbetlerin dirençli status epileptikusla sonlandığı bildirilmiştir.…”