Abstracts

Rationale: Epilepsy is a chronic neurological disorder affecting about 3.4 million people in the United States alone. Approximately 25-30% of these individuals do not attain seizure control and suffer from intractable seizures. This population would benefit from being evaluated at an epilepsy monitoring unit (EMU), which is an important tool that can help guide treatment. Despite this, the EMU is an underutilized resource. The objective of this study was to evaluate the impact of an EMU for patients with seizures or suspected seizure activity. Methods: A retrospective review of electronic medical records of a selection of 143 EMU visits between the years 2016 and 2019 at a level 4 epilepsy center was conducted. Only patients over the age of 18 were included in the analysis. Results: The most common reason for admission to the EMU was the characterization of known seizures (35%), followed by diagnosis of spells (33%) and admissions for multiple reasons (20%), including presurgical evaluation. By the end of the EMU visit, 88% of patients received a definitive diagnosis, with epilepsy being confirmed in 72% of patients and excluded in 16%. There was a change in medication management for 70% of patients, and at least 22% of patients were recommended advanced surgical intervention such as, resection surgery, Vagus Nerve Stimulator (VNS) or Responsive Neurostimulation (RNS) placement after discharge from the EMU. Conclusions: Our study demonstrates the utility of the EMU. Patients had a significant change in outcome after visiting the EMU, whether it was confirming a diagnosis of epilepsy, ruling out epilepsy, optimizing antiepileptic drug therapy, or directing the next level of treatment. These results strongly support that patients who qualify for the EMU per the National Association of Epilepsy Centers (NAEC) guidelines would benefit from a referral to a level 4 epilepsy center for EMU monitoring. This is a preliminary study and we are continuing to collect data. Funding: No funding