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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
T. Kobulashvili, J. Höfler, J. Dobesberger, F. Ernst, P. Ryvlin, JH. Cross, K. Braun, P. Dimova, S. Francione, H. Hecimovic, C. Helmstaedter, VK. Kimiskidis, MI. Lossius, K. Malmgren, P. Marusic, BJ. Steinhoff, P. Boon, D. Craiu, N. Delanty, D....
Language English Country England, Great Britain
Document type Journal Article
- MeSH
- Child MeSH
- Adult MeSH
- Electroencephalography statistics & numerical data MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Monitoring, Physiologic statistics & numerical data MeSH
- Infant, Newborn MeSH
- Child, Preschool MeSH
- Drug Resistant Epilepsy diagnosis MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Infant, Newborn MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe MeSH
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.
Clinic of Neurology and neurosurgery Medical Faculty Vilnius University Vilnius Lithuania
Danish Epilepsy Center Filadelfia University of Copenhagen Kolonivej 1 4293 Dianalund Denmark
Département de Neurologie 1 Place de l'Hôpital 67091 Strasbourg France
Department of Child Neurology University Medical Center 3508 AB Utrecht The Netherlands
Department of Complex Epilepsy National Centre for Epilepsy Oslo University Hospital Oslo Norway
Department of Functional Neurology and Epileptology Hospices Civils de Lyon Lyon France
Department of Neurology Beaumont Hospital Dublin 9 Ireland
Department of Neurology Hospital Ruber Internacional La Maso 38 28034 Madrid Spain
Department of Neurology Kuopio University Hospital Kuopio Finland
Epilepsiezentrum Kork Landstraße 1 77694 Kehl Kork Germany
Epilepsy Surgery Center Neurosurgery department St Ivan Rilski University Hospital Sofia Bulgaria
European Epilepsy Monitoring Unit Association France
IRCCS Institute of Neurological Sciences Bellaria Hospital Bologna Italy
National Institute of Clinical Neurosciences Amerikai ut 57 Budapest H 1145 Hungary
School of Medicine University of Eastern Finland Kuopio Finland
References provided by Crossref.org
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- $a Kobulashvili, Teia $u Department of Neurology, Christian-Doppler-Klinik, Paracelsus Medical University, and Centre for Cognitive Neuroscience, Ignaz-Harrer-Straße 79, 5020 Salzburg, Austria.
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- $a 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 / $c T. Kobulashvili, J. Höfler, J. Dobesberger, F. Ernst, P. Ryvlin, JH. Cross, K. Braun, P. Dimova, S. Francione, H. Hecimovic, C. Helmstaedter, VK. Kimiskidis, MI. Lossius, K. Malmgren, P. Marusic, BJ. Steinhoff, P. Boon, D. Craiu, N. Delanty, D. Fabo, A. Gil-Nagel, A. Guekht, E. Hirsch, R. Kalviainen, R. Mameniskiené, Ç. Özkara, M. Seeck, G. Rubboli, P. Krsek, S. Rheims, E. Trinka,
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- $a 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.
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- $a Ryvlin, Philippe $u Département des Neurosciences Cliniques, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, CH-1011 Lausanne, France; European Epilepsy Monitoring Unit Association (EEMA), France.
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