Seizure clusters and adverse events during pre-surgical video-EEG monitoring with a slow anti-epileptic drug (AED) taper

Giancarlo Di Gennaro, Angelo Picardi, Antonio Sparano, Addolorata Mascia, Giulio N. Meldolesi, Liliana G. Grammaldo, Vincenzo Esposito, Pier P. Quarato

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Objective: To evaluate the efficiency and safety of pre-surgical video-EEG monitoring with a slow anti-epileptic drug (AED) taper and a rescue benzodiazepine protocol. Methods: Fifty-four consecutive patients with refractory focal epilepsy who underwent pre-surgical video-electroencephalography (EEG) monitoring during the year 2010 were included in the study. Time to first seizure, duration of monitoring, incidence of 4-h and 24-h seizure clustering, secondarily generalised tonic-clonic seizures (sGTCS), status epilepticus, falls and cardiac asystole were evaluated. Results: A total of 190 seizures were recorded. Six (11%) patients had 4-h clusters and 21 (39%) patients had 24-h clusters. While 15 sGTCS were recorded in 14 patients (26%), status epilepticus did not occur and no seizure was complicated with cardiac asystole. Epileptic falls with no significant injuries occurred in three patients. The mean time to first seizure was 3.3. days and the time to conclude video-EEG monitoring averaged 6. days. Conclusion: Seizure clustering was common during pre-surgical video-EEG monitoring, although serious adverse events were rare with a slow AED tapering and a rescue benzodiazepine protocol. Significance: Slow AED taper pre-surgical video-EEG monitoring is fairly safe when performed in a highly specialised and supervised hospital setting.

Original languageEnglish
Pages (from-to)486-488
Number of pages3
JournalClinical Neurophysiology
Volume123
Issue number3
DOIs
Publication statusPublished - Mar 2012

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Electroencephalography
Seizures
Pharmaceutical Preparations
Status Epilepticus
Heart Arrest
Benzodiazepines
Cluster Analysis
Partial Epilepsy
Safety
Incidence
Wounds and Injuries

Keywords

  • Adverse events
  • Epilepsy surgery
  • Seizure clusters
  • Video-EEG monitoring

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Physiology (medical)
  • Sensory Systems

Cite this

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title = "Seizure clusters and adverse events during pre-surgical video-EEG monitoring with a slow anti-epileptic drug (AED) taper",
abstract = "Objective: To evaluate the efficiency and safety of pre-surgical video-EEG monitoring with a slow anti-epileptic drug (AED) taper and a rescue benzodiazepine protocol. Methods: Fifty-four consecutive patients with refractory focal epilepsy who underwent pre-surgical video-electroencephalography (EEG) monitoring during the year 2010 were included in the study. Time to first seizure, duration of monitoring, incidence of 4-h and 24-h seizure clustering, secondarily generalised tonic-clonic seizures (sGTCS), status epilepticus, falls and cardiac asystole were evaluated. Results: A total of 190 seizures were recorded. Six (11{\%}) patients had 4-h clusters and 21 (39{\%}) patients had 24-h clusters. While 15 sGTCS were recorded in 14 patients (26{\%}), status epilepticus did not occur and no seizure was complicated with cardiac asystole. Epileptic falls with no significant injuries occurred in three patients. The mean time to first seizure was 3.3. days and the time to conclude video-EEG monitoring averaged 6. days. Conclusion: Seizure clustering was common during pre-surgical video-EEG monitoring, although serious adverse events were rare with a slow AED tapering and a rescue benzodiazepine protocol. Significance: Slow AED taper pre-surgical video-EEG monitoring is fairly safe when performed in a highly specialised and supervised hospital setting.",
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AU - Di Gennaro, Giancarlo

AU - Picardi, Angelo

AU - Sparano, Antonio

AU - Mascia, Addolorata

AU - Meldolesi, Giulio N.

AU - Grammaldo, Liliana G.

AU - Esposito, Vincenzo

AU - Quarato, Pier P.

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