Patients' safety in the epilepsy monitoring unit: time for revising practices

Détails

ID Serval
serval:BIB_4A843A4FEF62
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Patients' safety in the epilepsy monitoring unit: time for revising practices
Périodique
Curr Opin Neurol
Auteur(s)
Rheims S., Ryvlin P.
ISSN
1473-6551 (Electronic)
ISSN-L
1350-7540
Statut éditorial
Publié
Date de publication
04/2014
Volume
27
Numéro
2
Pages
213-8
Langue
anglais
Notes
Rheims, Sylvain
Ryvlin, Philippe
eng
Review
England
Curr Opin Neurol. 2014 Apr;27(2):213-8. doi: 10.1097/WCO.0000000000000076.
Résumé
PURPOSE OF REVIEW: Long-term video-electroencephalography monitoring (LTM) in epilepsy monitoring units (EMUs) exposes patients to a variety of serious adverse events (SAEs) and safety issues, which have recently caught attention and are summarized in this review. RECENT FINDINGS: SAEs observed during LTM affect about 10% of patients and include secondary generalized tonic-clonic seizures, seizure clusters and status epilepticus, unusual for the patient; seizure-related falls, injuries, fractures, and aspiration; postictal psychosis; and cardiorespiratory distress, including sudden unexpected death in epilepsy (SUDEP) and near-SUDEP, which were encountered by more than 10% of European and Australian EMUs. Accordingly, 3% of US-based EMUs suffer a death within a 1-year duration census. Many of these SAEs might be promoted by antiepileptic drugs (AEDs) withdrawal, for which no specific guideline is currently available. Current recommendations regarding optimal organization of EMUs, and in particular continuous supervision by a dedicated staff, are not followed by respectively 20 and 26% of European and US-based EMUs. SUMMARY: SAEs during LTM are a significant concern and might be aggravated by suboptimal EMU organization and staff education. Lack of high-level evidence stands out as the main limiting factor to the development and dissemination of appropriate guidelines.
Mots-clé
Anticonvulsants/*adverse effects, Death, Sudden, Electroencephalography, Epilepsy/*diagnosis/*drug therapy, Humans, *Monitoring, Physiologic, Risk Factors
Pubmed
Création de la notice
29/11/2018 13:37
Dernière modification de la notice
20/08/2019 14:58
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