PMID- 27351727
OWN - NLM
STAT- MEDLINE
DCOM- 20170817
LR  - 20181202
IS  - 1525-5069 (Electronic)
IS  - 1525-5050 (Linking)
VI  - 61
DP  - 2016 Aug
TI  - Safety in the epilepsy monitoring unit: A retrospective study of 524 consecutive 
      admissions.
PG  - 162-167
LID - S1525-5050(16)30144-5 [pii]
LID - 10.1016/j.yebeh.2016.06.002 [doi]
AB  - The yield of monitoring patients at an epilepsy monitoring unit (EMU) depends on 
      the recording of paroxysmal events in a timely fashion, however, increasing the 
      risk of safety adverse events (AEs). We aimed to retrospectively study the 
      frequency and risk factors for AE occurrences in all consecutive admissions to an 
      adult EMU in a tertiary medical center. We also compared our findings with 
      published data from other centers. Between January 2011 and June 2014, there were 
      524 consecutive admissions to the adult EMU at the Tel Aviv Sourasky Medical 
      Center. Adverse events were recorded in 47 (9.0%) admissions. The most common AE 
      was 4-hour seizure cluster (58.7% of AEs) and, in decreasing frequency, AEs 
      related to antiepileptic drugs (AEDs, 11.1%), falls and traumatic injuries 
      (9.5%), intravenous line complications (9.5%), electrode-related (4.8%), status 
      epilepticus (SE, 3.2%), and cardiac (1.6%) and psychiatric (1.6%) complications. 
      There were significantly more AEs among patients with a younger age at disease 
      onset (p=0.005), a history of temporal lobe epilepsy (p=0.046), a history of 
      focal seizures with altered consciousness (p=0.008), a history of SE (p=0.022), 
      use of a vagal nerve stimulator (p=0.039), and intellectual disability (p=0.016) 
      and when the indication for EMU monitoring was noninvasive or invasive 
      presurgical evaluation (p=0.001). Adverse events occurred more frequently when 
      patients had more events in the EMU (p=0.001) and among those administered 
      carbamazepine (p=0.037), levetiracetam (p=0.004), clobazam (p=0.008), and 
      sulthiame (p=0.016). Patients with a history of psychogenic nonepileptic seizures 
      (PNESs) had significantly fewer AEs (p=0.013). Adverse events were not associated 
      with the age, gender, duration of hospitalization or monitoring, AED withdrawal 
      and renewal, seizure frequency by history, presence of major psychiatric 
      comorbidities, abnormal neurological exam, or the presence of a lesion as on 
      brain magnetic resonance imaging. In conclusion, this study reveals that AEs are 
      not unusual in the EMU and that seizure clustering is the most common among them. 
      Adverse events occur more frequently in patients with more severe epilepsy and 
      intellectual disability and in patients undergoing presurgical evaluations and 
      less frequently in patients with PNESs.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - Fahoum, Firas
AU  - Fahoum F
AD  - Epilepsy and EEG Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, 
      Tel Aviv 6423906, Israel. Electronic address: firasf@tlvmc.gov.il.
FAU - Omer, Nurit
AU  - Omer N
AD  - Epilepsy and EEG Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, 
      Tel Aviv 6423906, Israel.
FAU - Kipervasser, Svetlana
AU  - Kipervasser S
AD  - Epilepsy and EEG Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, 
      Tel Aviv 6423906, Israel; Sackler School of Medicine, Tel Aviv University, Tel 
      Aviv 69978, Israel.
FAU - Bar-Adon, Tal
AU  - Bar-Adon T
AD  - Epilepsy and EEG Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, 
      Tel Aviv 6423906, Israel.
FAU - Neufeld, Miri
AU  - Neufeld M
AD  - Epilepsy and EEG Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, 
      Tel Aviv 6423906, Israel; Sackler School of Medicine, Tel Aviv University, Tel 
      Aviv 69978, Israel.
LA  - eng
PT  - Journal Article
DEP - 20160625
PL  - United States
TA  - Epilepsy Behav
JT  - Epilepsy & behavior : E&B
JID - 100892858
RN  - 0 (Anticonvulsants)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age of Onset
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticonvulsants/adverse effects/therapeutic use
MH  - Electroencephalography
MH  - Epilepsy/drug therapy
MH  - Female
MH  - Hospital Units/*statistics & numerical data
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Monitoring, Physiologic/*adverse effects
MH  - Patient Safety/*statistics & numerical data
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Seizures/epidemiology
MH  - Young Adult
OTO - NOTNLM
OT  - Antiepileptic drugs
OT  - Epilepsy monitoring unit
OT  - Psychogenic nonepileptic seizure
OT  - Safety adverse events
OT  - Seizure clusters
OT  - Status epilepticus
EDAT- 2016/06/29 06:00
MHDA- 2017/08/18 06:00
CRDT- 2016/06/29 06:00
PHST- 2016/02/18 00:00 [received]
PHST- 2016/05/03 00:00 [revised]
PHST- 2016/06/02 00:00 [accepted]
PHST- 2016/06/29 06:00 [entrez]
PHST- 2016/06/29 06:00 [pubmed]
PHST- 2017/08/18 06:00 [medline]
AID - S1525-5050(16)30144-5 [pii]
AID - 10.1016/j.yebeh.2016.06.002 [doi]
PST - ppublish
SO  - Epilepsy Behav. 2016 Aug;61:162-167. doi: 10.1016/j.yebeh.2016.06.002. Epub 2016 
      Jun 25.