New Research Reports on Interventions that May Alter the Course of Epilepsy Diagnosis and Management
Data to be Presented at 62nd Annual Meeting of the American Epilepsy Society
Early diagnosis and treatment that quickly achieves seizure freedom with nominal side effects is the key goal to epilepsy management. Three studies highlighted at the AES annual meeting address this goal from different vantage points:
- The course to seizure freedom? Identifying factors that may change the landscape of epilepsy treatment to improve patients’ quality of life.
- New EEG technology that may facilitate accurate seizure screening by non-specialists in urgent care settings.
- Task force report on disparity in standards for Epilepsy Monitoring Units amidst rise in number of epilepsy treatment centers.
“Each clue we uncover in understanding epilepsy and how to suppress the disruptions it causes for those affected takes us closer to the goal of successfully treating this chronic condition. Data from this year’s meeting lead us towards answers about characteristics we can focus on to more effectively diagnose and treat epilepsy,” said
Epilepsy Patients Achieving Seizure Freedom More Quickly, According to New Analysis
An analysis of epilepsy patients demonstrated that the time to seizure freedom significantly decreased by 10% every year from 1995 to 2005, according to data presented by
Dr. Peltola and his colleagues studied records of 571 epilepsy patients aged nine to 78 years, who were diagnosed and treated in
- Patients diagnosed in 1995-1998: 10 years.
- Patients diagnosed in 1999-2001: 6 to 7 years.
- Patients diagnosed in 2002-2005: 4 years.
“The first-line treatment protocol has not changed over the duration of this study in
New EEG Technology — a Seizure Vector Algorithm — Facilitates Seizure Screening in Urgent Care Settings
A group of researchers from Infinite Biomedical Technologies (IBT) and The
“Access to an EEG reading, the gold standard for identifying and classifying seizures, is limited in most urgent care settings. Often the EEG machine and/or technologists are not readily available to the Emergency Department (ED), and eventual diagnosis by a specialist may be delayed for hours, or in some cases days,” said study author Peter W. Kaplan, MB, FRCP, Professor of Neurology, The
To address this problem, the collaborative team, with grant support from the National Institutes of Health, designed the Seizure Vector (SV) algorithm to express EEG readings as a numeric seizure score. Based on the score, ED staff could quickly classify and triage patients. Potential classifications include:
- Epileptic seizures: refer to a neurologist for further evaluation.
- Non-epileptic events: refer for neurological, medical or psychiatric evaluation.
The team’s hope is that this technology, when used in the ED setting, will enable first-response personnel to screen for seizures in patients and make rapid triage decisions, such as timely referral to a specialist for evaluation, diagnosis and treatment.
To validate the algorithm, researchers collected EEGs from 40 adults with a variety of seizure types, and a blinded epileptologist classified them into “normal” or “seizure” categories. A total of 2,035 episodes of seizures and 3,867 episodes of normal data were recorded. When the SV algorithm was applied to the same recordings, it differentiated between “seizure” and “normal” episodes with 95.0% sensitivity and 95.2% specificity.
Surveys Reveal Lack of Consensus on Patient Care, Safety Measures in Epilepsy Monitoring Units
A new AES survey of physicians and nurses provided the basis for a working group discussion at this week’s meeting regarding a need for the creation of standards in patient care and safety measures in epilepsy monitoring units (EMUs) across
Patients are admitted to EMUs to determine if they are having seizures, to consider if surgery is an option, for medication changes, or other diagnostic procedures. Some of the monitoring procedures require sleep deprivation and/or taking patients off medications to provoke seizures for simultaneous recording of symptoms and related brain wave activity.
The surveys evaluated EMU practices related to these monitoring procedures, as well as patient supervision. Results revealed discrepancies across EMUs in these areas, with relatively few physicians and nurses reporting that their facilities had protocols in place for seizure monitoring or patient supervision.
“In the continuum of patient care, EMUs are critically important and can significantly drive outcomes,” said EMU Study Group member
About the American Epilepsy Society (AES)
AES is a 3,000 member society of physicians and scientists working to improve and advance the treatment of seizures through the promotion of research and education of professionals dedicated to the prevention, treatment and cure of epilepsy.
About Epilepsy
An estimated three million people in
A Multi-Parametric Seizure Screening Algorithm for Clinical EEG
Watson AC, Sherman DL, Kaplan PW, et al.
Abstract # 3.11
Poster presentation on
Decrease in “time to maximum seizure freedom” by year of diagnosis: A new approach to evaluate trend of overall success in epilepsy treatment
Falah M, Kharazmi E, Kolios S, et al.
Abstract # 1.179
Poster presentation on
Expert Consensus Process on Patient Safety in the Epilepsy Monitoring Unit
Symposium:
Contacts:
Peter Van Haverbeke/703-960-1213
E-mail: pvanhaverbeke@aesnet.org
Natalie Judd/203-605-9515
E-mail: natalie@bigvoicecomm.com
In Seattle 12/4-12/9:
American Epilepsy Society Annual Meeting
Press Room: 601, Washington State Convention & Trade Center
Phone: (206) 219-4702
SOURCE American Epilepsy Society
