OBJECTIVE: To evaluate the efficiency and safety of pre-surgical video-EEG monitoring with a slow anti-epileptic drug (AED) taper and a rescue benzodiazepine protocol. METHODS: Fifty-four consecutive patients with refractory focal epilepsy who underwent pre-surgical video-electroencephalography (EEG) monitoring during the year 2010 were included in the study. Time to first seizure, duration of monitoring, incidence of 4-h and 24-h seizure clustering, secondarily generalised tonic-clonic seizures (sGTCS), status epilepticus, falls and cardiac asystole were evaluated. RESULTS: A total of 190 seizures were recorded. Six (11%) patients had 4-h clusters and 21 (39%) patients had 24-h clusters. While 15 sGTCS were recorded in 14 patients (26%), status epilepticus did not occur and no seizure was complicated with cardiac asystole. Epileptic falls with no significant injuries occurred in three patients. The mean time to first seizure was 3.3days and the time to conclude video-EEG monitoring averaged 6days. CONCLUSION: Seizure clustering was common during pre-surgical video-EEG monitoring, although serious adverse events were rare with a slow AED tapering and a rescue benzodiazepine protocol. SIGNIFICANCE: Slow AED taper pre-surgical video-EEG monitoring is fairly safe when performed in a highly specialised and supervised hospital setting.
OBJECTIVE: To evaluate the efficiency and safety of pre-surgical video-EEG monitoring with a slow anti-epileptic drug (AED) taper and a rescue benzodiazepine protocol. METHODS: Fifty-four consecutive patients with refractory focal epilepsy who underwent pre-surgical video-electroencephalography (EEG) monitoring during the year 2010 were included in the study. Time to first seizure, duration of monitoring, incidence of 4-h and 24-h seizure clustering, secondarily generalised tonic-clonic seizures (sGTCS), status epilepticus, falls and cardiac asystole were evaluated. RESULTS: A total of 190 seizures were recorded. Six (11%) patients had 4-h clusters and 21 (39%) patients had 24-h clusters. While 15 sGTCS were recorded in 14 patients (26%), status epilepticus did not occur and no seizure was complicated with cardiac asystole. Epileptic falls with no significant injuries occurred in three patients. The mean time to first seizure was 3.3days and the time to conclude video-EEG monitoring averaged 6days. CONCLUSION:Seizure clustering was common during pre-surgical video-EEG monitoring, although serious adverse events were rare with a slow AED tapering and a rescue benzodiazepine protocol. SIGNIFICANCE: Slow AED taper pre-surgical video-EEG monitoring is fairly safe when performed in a highly specialised and supervised hospital setting.
Authors: Victor Ferastraoaru; Daniel M Goldenholz; Sharon Chiang; Robert Moss; William H Theodore; Sheryl R Haut Journal: Epilepsia Open Date: 2018-07-04
Authors: Manuela Ochoa-Urrea; Nuria Lacuey; Laura Vilella; Liang Zhu; Shirin Jamal-Omidi; M R Sandhya Rani; Johnson P Hampson; Mojtaba Dayyani; Jaison Hampson; Norma J Hupp; Shiqiang Tao; Rup K Sainju; Daniel Friedman; Maromi Nei; Catherine Scott; Luke Allen; Brian K Gehlbach; Victoria Reick-Mitrisin; Stephan Schuele; Jennifer Ogren; Ronald M Harper; Beate Diehl; Lisa M Bateman; Orrin Devinsky; George B Richerson; Guo-Qiang Zhang; Samden D Lhatoo Journal: Front Neurol Date: 2021-02-12 Impact factor: 4.003
Authors: Adam Strzelczyk; Laurent M Willems; Ricardo Kienitz; Lara Kay; Isabelle Beuchat; Sarah Gelhard; Sophie von Brauchitsch; Catrin Mann; Alexandra Lucaciu; Jan-Hendrik Schäfer; Kai Siebenbrodt; Johann-Philipp Zöllner; Susanne Schubert-Bast; Felix Rosenow Journal: CNS Drugs Date: 2022-08-16 Impact factor: 6.497