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Timing of seizure occurrence and response of medical staff in video-EEG monitoring for drug-resistant epilepsy

机译：视频-EEG监测耐药性癫痫发作的发作时间和医务人员的反应

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Purpose : The purpose of this study was to determine the optimal duration of long-term video-EEG monitoring (VEEG) in patients with epilepsy. The response time of medical staff to seizures was also evaluated from the viewpoint of safety of the monitoring. Methods : We estimated the optimal duration of VEEG from the seizure onset pattern. We retrospectively investigated all VEEG sessions performed in our department during the period between June 2005 and July 2016. Sessions with no seizures and with only non-epileptic seizures were excluded. Using 91 sessions from 69 patients, information on the onset time and response time of medical staff to seizures was collected. Results : The median duration from the start of VEEG to the first seizure was 2 days. Seventy-seven percent of first seizures occurred within 3 days of VEEG. The median duration from the first seizure to the third seizure was 2 days. Eighty percent of third seizures occurred within 3 days of the first seizure. There was no significant diurnal distribution of seizure occurrence. Medical staff did not respond to 20% of generalized seizures and 69% of focal seizures. The overlooking of generalized seizures occurred mainly during the hours of 1-2 pm and 8-9 pm but there was no significant diurnal pattern in overlooking generalized and focal seizures. Conclusion : Based on these findings, we suggest that VEEG can be terminated when no seizure occurs within 4 days after onset. In our VEEG protocol, in which all anti-epileptic drugs were dis-continued before the start of a session, there was no diurnal pattern of seizure occurrence. This is the first study investigating the diurnal pattern of overlooking seizures by medical staff during VEEG. Since there was no diurnal pattern to the overlooking, medical staff should pay equal, 24-hour attention to patients on VEEG.
机译：目的：本研究的目的是确定癫痫患者的长期视频脑电图监测（VEEG）的最佳持续时间。从监视的安全性的角度，还评估了医务人员对癫痫发作的反应时间。方法：我们根据癫痫发作模式估算了最佳的VEEG持续时间。我们回顾性调查了我科在2005年6月至2016年7月期间进行的所有VEEG会议。没有癫痫发作且只有非癫痫发作的会议被排除。使用来自69位患者的91次治疗，收集了有关医务人员对癫痫发作的发作时间和反应时间的信息。结果：从VEEG开始到第一次发作的中位持续时间为2天。初发癫痫发作的百分之七十七发生在VEEG的3天内。从第一次发作到第三次发作的中位持续时间为2天。 80％的第三次癫痫发作在第一次发作后3天内发生。癫痫发作没有明显的昼夜分布。医务人员对20％的全身性癫痫和69％的局部性癫痫无反应。全面性癫痫发作的忽略主要发生在下午1-2点和晚上8-9 pm的时间内，但是在全面性癫痫和局灶性癫痫发作中没有明显的昼夜模式。结论：根据这些发现，我们建议在发病后4天内没有发作时可以终止VEEG。在我们的VEEG方案中，在疗程开始前停用所有抗癫痫药，没有昼夜发作的规律。这是第一个研究VEEG期间医务人员忽略癫痫发作的昼夜模式的研究。由于没有昼夜变化的规律，医务人员应在VEEG上对患者进行24小时同样的关注。

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