The hospital experience and seizure control

Abstract

We studied 30 patients who were admitted to the hospital because of intractable seizures. Twenty-three had fewer seizures during one or both of the first 2 hospital weeks than before admission, although medication was not changed. The role of environment in seizure control is difficult to measure, but hospital admission itself is a form of environmental manipulation. When seizure control is achieved in the hospital, the hospital experience itself must be considered in addition to other therapeutic interventions.

Onset of Action of Levetiracetam: A RCT Trial Using Therapeutic Intensive Seizure Analysis (TISA)

“…Even in the placebo group, two patients were seizure-free during the study phase. Reasons for this could be as follows: (a) a hospitalization effect, which has been observed in other studies (28) and can account for seizure reduction in more than 50% of patients; and (b) Reduction or withdrawal from other AEDs for the purpose of the presurgical evaluation. It has been reported that during long-term AED therapy, a drug-holiday can bring a significant improvement in seizures (29).…”

Proceedings of the Seventh International Workshop on Advances in Electrocorticography

“…A common clinical observation in patients being evaluated for epilepsy surgery is that seizures may be less frequent immediately after implantation of intracranial electrodes [12, 13]. This “implant effect” has been variously attributed to anesthesia, the craniotomy, or the mechanical effect of electrodes.…”

Transient improvement after brief antiepileptic drug withdrawal in the epilepsy monitoring unit—possible relationship to AED tolerance

“…Previous studies have demonstrated improved seizure frequency after prolonged video‐EEG monitoring. This effect was attributed to improved diagnostic accuracy and refinement of pharmacologic approach or just the hospital experience (Riley et al, 1981; Sutula et al, 1981; Boon et al, 1994). Later studies suggested that improvement may also result from transient seizure medication withdrawal (Doyle et al, 1994; Laowattana et al, 1999).…”