Current practices in long-term video-EEG monitoring services: A survey among partners of the E-PILEPSY pilot network of reference for refractory epilepsy and epilepsy surgery

Teia Kobulashvili, Julia Höfler, Judith Dobesberger, Florian Ernst, Philippe Ryvlin, J. Helen Cross, Kees Braun, Petia Dimova, Stefano Francione, Hrvoje Hecimovic, Christoph Helmstaedter, Vasilios K. Kimiskidis, Morten Ingvar Lossius, Kristina Malmgren, Petr Marusic, Bernhard J. Steinhoff, Paul Boon, Dana Craiu, Norman Delanty, Daniel FaboAntonio Gil-Nagel, Alla Guekht, Edouard Hirsch, Reetta Kalviainen, Ruta Mameniskiené, Çiǧdem Özkara, Margitta Seeck, Guido Rubboli, Pavel Krsek, Sylvain Rheims, Eugen Trinka*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose The European Union-funded E-PILEPSY network aims to improve awareness of, and accessibility to, epilepsy surgery across Europe. In this study we assessed current clinical practices in epilepsy monitoring units (EMUs) in the participating centers. Method A 60-item web-based survey was distributed to 25 centers (27 EMUs) of the E-PILEPSY network across 22 European countries. The questionnaire was designed to evaluate the characteristics of EMUs, including organizational aspects, admission, and observation of patients, procedures performed, safety issues, cost, and reimbursement. Results Complete responses were received from all (100%) EMUs surveyed. Continuous observation of patients was performed in 22 (81%) EMUs during regular working hours, and in 17 EMUs (63%) outside of regular working hours. Fifteen (56%) EMUs requested a signed informed consent before admission. All EMUs performed tapering/withdrawal of antiepileptic drugs, 14 (52%) prior to admission to an EMU. Specific protocols on antiepileptic drugs (AED) tapering were available in four (15%) EMUs. Standardized Operating Procedures (SOP) for the treatment of seizure clusters and status epilepticus were available in 16 (59%). Safety measures implemented by EMUs were: alarm seizure buttons in 21 (78%), restricted patient's ambulation in 19 (70%), guard rails in 16 (59%), and specially designated bathrooms in 7 (26%). Average costs for one inpatient day in EMU ranged between 100 and 2200 Euros. Conclusion This study shows a considerable diversity in the organization and practice patterns across European epilepsy monitoring units. The collected data may contribute to the development and implementation of evidence-based recommended practices in LTM services across Europe.

Original languageEnglish
Pages (from-to)38-45
Number of pages8
JournalSeizure : the Journal of the British Epilepsy Association
Volume38
DOIs
Publication statusPublished - May 2016

Keywords

  • Epilepsy
  • Epilepsy monitoring unit
  • Long-term monitoring
  • Presurgical evaluation
  • Safety
  • Video-EEG monitoring

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