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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

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Abstract
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.
Keywords
Epilepsy, Video-EEG monitoring, Long-term monitoring, Epilepsy monitoring unit, Presurgical evaluation, Safety, ADVERSE EVENTS, AMBULATORY EEG, RISK-FACTORS, SAFETY, UNITS, COMPLICATIONS, ELECTRODES, TELEMETRY, UTILITY, HOME

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Citation

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Chicago
Kobulashvili, Teia, Julia Höfler, Judith Dobesberger, Florian Ernst, Philippe Ryvlin, J Helen Cross, Kees Braun, et al. 2016. “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.” Seizure-european Journal of Epilepsy 38: 38–45.
APA
Kobulashvili, T., Höfler, J., Dobesberger, J., Ernst, F., Ryvlin, P., Cross, J. H., Braun, K., et al. (2016). 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. SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, 38, 38–45.
Vancouver
1.
Kobulashvili T, Höfler J, Dobesberger J, Ernst F, Ryvlin P, Cross JH, et al. 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. SEIZURE-EUROPEAN JOURNAL OF EPILEPSY. 2016;38:38–45.
MLA
Kobulashvili, Teia, Julia Höfler, Judith Dobesberger, et al. “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.” SEIZURE-EUROPEAN JOURNAL OF EPILEPSY 38 (2016): 38–45. Print.
@article{8085507,
  abstract     = {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.},
  author       = {Kobulashvili, Teia and H{\"o}fler, Julia and Dobesberger, Judith and Ernst, Florian and Ryvlin, Philippe and Cross, J Helen and Braun, Kees and Dimova, Petia and Francione, Stefano and Hecimovic, Hrvoje and Helmstaedter, Christophe and Kimiskidis, Vasilios K and Lossius, Morten Ingvar and Malmgren, Kristina and Marusic, Petr and Steinhoff, Bernhard J and Boon, Paul and Craiu, Dana and Delanty, Norman and Fabo, Daniel and Gil-Nagel, Antonio and Guekht, Alla and Hirsch, Edouard and Kalviainen, Reetta and Mameniskien{\'e}, Ruta and {\"O}zkara, \c{C}i\u{g}dem and Seeck, Margitta and Rubboli, Guido and Krsek, Pavel and Rheims, Sylvain and Trinka, Eugen},
  issn         = {1059-1311},
  journal      = {SEIZURE-EUROPEAN JOURNAL OF EPILEPSY},
  language     = {eng},
  pages        = {38--45},
  title        = {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},
  url          = {http://dx.doi.org/10.1016/j.seizure.2016.03.009},
  volume       = {38},
  year         = {2016},
}

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