Safety of Long-term Video-Electroencephalographic Monitoring for Evaluation of Epilepsy
Safety of Long-term Video-Electroencephalographic Monitoring for Evaluation of Epilepsy
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DOI：
10.4065/84.6.495
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发表时间：
2009-06-01
影响因子：
8.9
通讯作者：
Drazkowski, Joseph F.
中科院分区：
文献类型：
--
作者：
Noe, Katherine H.;Drazkowski, Joseph F.
目的：确定癫痫长期视频脑电图 (EEG) 监测的医疗并发症发生率。 患者和方法：我们回顾了 2005 年 1 月 1 日至 2006 年 12 月 31 日期间在亚利桑那州梅奥诊所接受诊断性头皮视频脑电图监测的连续 28 名成年癫痫患者的医疗记录； 149 人符合该研究的纳入标准。记录癫痫发作的次数和类型以及癫痫发作相关不良后果的发生时间和存在情况。 结果：在该研究纳入的 149 名成年患者中，35 例（23%）发生丛集性癫痫发作；记录了 752 次癫痫发作。首次癫痫发作的平均时间为 2 天，平均住院时间为 5 天。在这些患者中，有 1 例癫痫持续状态发作，3 例潜在严重心电图异常，2 例发作后精神病，4 例全身性惊厥期间椎体压缩性骨折，占记录的全身强直阵挛性癫痫发作患者的 11%。没有死亡、转移到重症监护室、跌倒、牙齿受伤或肺部并发症的记录。其中 21% 的患者发生了需要干预或干扰正常活动的不良事件。住院时间不受不良事件发生的影响。结论：长时间视频脑电图监测是一种可接受的安全程序。不良事件发生，但不一定会导致严重的发病率或增加住院时间。必须采取适当的预防措施来防止跌倒，并及时发现和治疗丛集性癫痫、癫痫持续状态、严重心电图异常、精神病和骨折。
OBJECTIVE: To determine the rate of medical complications from long-term video-electroencephalographic (EEG) monitoring for epilepsy.PATIENTS AND METHODS: We reviewed the medical records of 28 consecutive adult patients with epilepsy who were admitted for diagnostic scalp video-EEG monitoring at Mayo Clinic's site in Arizona from January 1, 2005, to December 31, 2006; 149 met Inclusion criteria for the study. Seizure number and type as well as timing and presence of seizure-related adverse outcomes were noted.RESULTS: Of the 149 adult patients included in the study, seizure clusters occurred In 35 (23%); 752 seizures were recorded. The mean time to first seizure was 2 days, with a mean length of stay of 5 days. Among these patients, there was 1 episode of status epilepticus, 3 potentially serious electrocardiographic abnormalities, 2 cases of postictal psychosis, and 4 vertebral compression fractures during a generalized convulsion, representing 11% of patients with a recorded generalized tonic-clonic seizure. No deaths, transfers to the intensive care unit, falls, dental Injuries, or pulmonary complications were recorded. An adverse event requiring intervention or interfering with normal activity occurred In 21% of these patients. Length of stay was not affected by occurrence of adverse events.CONCLUSION: Prolonged video-EEG monitoring is an acceptably safe procedure. Adverse events occur but need not result In substantial morbidity or Increase length of hospitalization. Appropriate precautions must be in place to prevent falls and promptly detect and treat seizure clusters, status epilepticus, serious electrocardiographic abnormalities, psychosis, and fractures.