Emergent Admissions to the Epilepsy Monitoring Unit in the Setting of COVID-19 Pandemic-related, State-mandated Restrictions: Clinical Decision Making and Outcomes

被引:3
作者
Zepeda R. [1 ]
Lee Y. [1 ]
Agostini M. [1 ]
Alick Lindstrom S. [1 ]
Dave H. [1 ]
Dieppa M. [1 ]
Ding K. [1 ]
Doyle A. [1 ]
Harvey J. [1 ]
Hays R. [1 ]
Perven G. [1 ]
Podkorytova I. [1 ]
Das R.R. [1 ]
机构
[1] Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX
关键词
COVID-19; emergent admission; epilepsy monitoring unit (EMU); epileptic seizures (ES); psychogenic non-epileptic seizures (PNES);
D O I
10.1080/21646821.2021.1918512
中图分类号
学科分类号
摘要
Due to the coronavirus disease 2019 (COVID-19) pandemic, the state of Texas-limited elective procedures to conserve beds and personal protective equipment (PPE); therefore, between March 22 and May 18, 2020, admission to the epilepsy monitoring unit (EMU) was limited only to urgent and emergent cases. We evaluated clinical characteristics and outcomes of these patients who were admitted to the EMU. Nineteen patients were admitted (one patient twice) with average age of 36.26 years (11 female) and average length of stay 3 days (range: 2–9 days). At least one event was captured on continuous EEG (cEEG) and video monitoring in all 20 admissions (atypical in one). One patient had both epileptic (ES) and psychogenic non-epileptic seizures (PNES) while 10 had PNES and 9 had ES. In 8 of 9 patients with ES, medications were changed, while in 5 patients with PNES, anti-epileptic drugs (AED) were stopped; the remaining 5 were not on medications. Of the 14 patients who had seen an epileptologist pre-admission, 13 (or 93%) had their diagnosis confirmed by EMU stay; a statistically significant finding. While typically an elective admission, in the setting of the COVID-19 pandemic, urgent and emergent EMU admissions were required for increased seizure or event frequency. In the vast majority of patients (13 of 19), admission lead to medication changes to either better control seizures or to change therapeutics as appropriate when PNES was identified. © 2021 ASET–The Neurodiagnostic Society.
引用
收藏
页码:95 / 103
页数:8
相关论文
共 17 条
[1]  
Albert D.V.F., Das R.R., Acharya J.N., Lee J.W., Pollard J.R., Punia V., Keller J.A., Husain A.M., The impact of COVID-19 on epilepsy care: a survey of the American Epilepsy Society membership, Epilepsy Curr, 20, 5, pp. 316-324, (2020)
[2]  
Guideline twelve: guidelines for long-term monitoring for epilepsy, J Clin Neurophysiol, 25, 3, pp. 170-180, (2008)
[3]  
Amin U., Benbadis S.R., Frontera A.T., Outcome of prolonged video-EEG monitoring in a new VA monitoring unit, Epilepsy Behav, 102, (2020)
[4]  
Bamaga A.K., Alharbi O., Bajuaifer M., Batarfi A., Althobaiti K.H., AlQusaibi B., The effect of the COVID-19 pandemic on emergency department visits for neurological diseases in Saudi Arabia, Cureus, 12, 12, (2020)
[5]  
Burgess R.C., Design and evolution of a system for long-term electroencephalographic and video monitoring of epilepsy patients, Methods, 25, 2, pp. 231-248, (2001)
[6]  
Cascino G.D., Video-EEG monitoring in adults, Epilepsia, 43, pp. 80-93, (2002)
[7]  
Granata T., Bisulli F., Arzimanoglou A., Rocamora R., Did the COVID-19 pandemic silence the needs of people with epilepsy?, Epileptic Disord, 22, 4, pp. 439-442, (2020)
[8]  
Koralnik I.J., Tyler K.L., COVID-19: a global threat to the nervous system, Ann Neurol, 88, 1, pp. 1-11, (2020)
[9]  
Krumholz H., Where have all the heart attacks gone?, New York Times, (2020)
[10]  
Kumar-Pelayo M., Oller-Cramsie M., Mihu N., Harden C., Utility of video-EEG monitoring in a tertiary care epilepsy center, Epilepsy Behav, 28, 3, pp. 501-503, (2013)