Impact of the Epilepsy Monitoring Unit on Management of Patients with Epilepsy
Abstract number :
3.246
Submission category :
3. Neurophysiology / 3A. Video EEG Epilepsy-Monitoring
Year :
2024
Submission ID :
187
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Mohankumar Kurukumbi, MD, FAES – Inova Fairfax Hopstial
Anne Giles, NP – Inova Fairfax Hospital
Erica Dowell, NP – Inova Fairfax Hospital
Manar Haroon, BS – Inova Fairfax Hospital
Erinn Kalantzis, BS, RN – Inova Fairfax Hospital
Becky Schrews, MSN, RN – Inova Fairfax Hospital
Yun Fang, MS – Inova Fairfax Hospital
Rationale: In patients with epilepsy, epilepsy monitoring unit (EMU) admission is an important tool that can help confirming the diagnosis and optimizing the treatment, which in turn can improve patient outcomes. EMU admissions can also result in economic savings by confirming diagnosis of epilepsy or nonepileptic events by optimizing the management. Despite these benefits, the EMU is an underutilized resource. In this retrospective review, we evaluated the impact of EMU on patient management. To evaluate the diagnostic utility of an epilepsy monitoring unit admission (EMU) for patients with seizures or suspected seizure events. To determine the impact and outcome after the EMU admission on the management of patients with epilepsy.
Methods: A retrospective review of the electronic medical records of a selection of 612 EMU visits between the years of 2021 and 2023 at a level 4 epilepsy center was conducted. Only patients over the age of 18 were included in the analysis.
Results: In the EMU patient population, there were many reasons listed for admission including classification of seizures (46.6%), diagnosis of events (confirming epilepsy or nonepileptic psychogenic seizures) (33.7%), AED optimization (20.1%), pre-surgical evaluation (4.9%) and evaluation of subclinical seizures: 0.7%. As a result of the EMU admission, there was a change in AED medications in 74.2% and no change in medications in 25.8% of admissions. Additionally, there were therapeutic and diagnostic intervention recommendations in 74.0% of admissions.
Conclusions: Our study demonstrates the utility of the EMU. Patients had a significant change in outcome after visiting the EMU, whether it was confirming a diagnosis of epilepsy, ruling out epilepsy, optimizing antiepileptic drug therapy or directing next level of treatment. These results strongly support that patients who qualify for the EMU per the National Association of Epilepsy Centers (NAEC) guidelines would benefit from a referral to a level 4 epilepsy center.
Funding: none
Neurophysiology