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.
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.
['Kobulashvili|Teia|T|', 'Höfler|Julia|J|', 'Dobesberger|Judith|J|', 'Ernst|Florian|F|', 'Ryvlin|Philippe|P|', 'Cross|J Helen|JH|', 'Braun|Kees|K|', 'Dimova|Petia|P|', 'Francione|Stefano|S|', 'Hecimovic|Hrvoje|H|', 'Helmstaedter|Christoph|C|', 'Kimiskidis|Vasilios K|VK|', 'Lossius|Morten Ingvar|MI|', 'Malmgren|Kristina|K|', 'Marusic|Petr|P|', 'Steinhoff|Bernhard J|BJ|', 'Boon|Paul|P|', 'Craiu|Dana|D|', 'Delanty|Norman|N|', 'Fabo|Daniel|D|', 'Gil-Nagel|Antonio|A|', 'Guekht|Alla|A|', 'Hirsch|Edouard|E|', 'Kalviainen|Reetta|R|', 'Mameniskiené|Ruta|R|', 'Özkara|Çiğdem|Ç|', 'Seeck|Margitta|M|', 'Rubboli|Guido|G|', 'Krsek|Pavel|P|', 'Rheims|Sylvain|S|', 'Trinka|Eugen|E|']
D000293:Adolescent D000328:Adult D002648:Child D002675:Child, Preschool D000069279:Drug Resistant Epilepsy D004569:Electroencephalography D005060:Europe D005260:Female D006801:Humans D007223:Infant D007231:Infant, Newborn D008297:Male D008991:Monitoring, Physiologic D055815:Young Adult
Video-EEG monitoring Epilepsy Epilepsy monitoring unit Safety Long-term monitoring Presurgical evaluation