A Multicenter Survey Comparing the Pre-Monitoring Diagnosis and Treatment to the Diagnosis and Treatment after EMU Evaluation.
Abstract number :
2.096
Submission category :
Year :
2001
Submission ID :
1704
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
J.L. Moore, MD, Neurology, Ohio State University, Columbus, OH; J.G. Boggs, MD, Neurology, University of South Alabama, Mobile, AL; C. Bazil, MD, Neurology, Columbia University, New York, NY; D.M. Ficker, MD, Neurology, University of Cincinnati, Cincinnat
RATIONALE: This survey was an attempt to quantify the impact of inpatient epilepsy monitoring on treatment and diagnosis. The purpose was to determine how often Epilepsy Monitoring Unit(EMU) admissions change the diagnosis or treatment plan.
METHODS: Eight comprehensive epilepsy centers in the Consortium for Research in Epilepsy () completed one-page surveys about the pre and post-EMU monitoring. The surveys were completed on a prospective cohort of EMU patients admitted to those centers from February through April of 2001. The surveys asked about admitting diagnosis, discharge diagnosis and whether the patient[ssquote]s care was modified by the EMU evaluation.
RESULTS: Surveys were completed for 139 patients. Eighty-two patients(59%) had their diagnosis modified based on the EMU evaluation. One hundred-eight patients(78%) had their care modified in some way as a result of EMU inpatient monitoring. The post-EMU diagnoses included: classification of epileptic seizure type(s) (40%) psychogenic seizures (34%) and organic non-epileptic disorders (12%) Fifteen patients (11%) had inconclusive monitoring results.
CONCLUSIONS: To our knowledge this is the first prospective assessment of the diagnostic yield of EMU monitoring. The results demonstrate that nearly 60% of patients have some modification of their diagnosis during EMU monitoring. More importantly, almost eighty percent of patients had their treatment plan modified by their inpatient EMU monitoring. In some cases the diagnosis was unchanged but confirmed; this often lead to modification of the treatment plan based on the supportive findings.