Emergent Admissions to the Epilepsy Monitoring Unit in the Setting of COVID-19 Pandemic-related, State-mandated Restrictions: Clinical Decision Making and Outcomes.

Zepeda, Rodrigo; Lee, Yoona; Agostini, Mark; Alick Lindstrom, Sasha; Dave, Hina; Dieppa, Marisara; Ding, Kan; Doyle, Alexander; Harvey, Jay; Hays, Ryan; Perven, Ghazala; Podkorytova, Irina; Das, Rohit R.

Due to the coronavirus disease 2019 (COVID-19) pandemic, the state of Texas-limited elective procedures to conserve beds and personal protective equipment (PPE); therefore, between March 22 and May 18, 2020, admission to the epilepsy monitoring unit (EMU) was limited only to urgent and emergent cases. We evaluated clinical characteristics and outcomes of these patients who were admitted to the EMU. Nineteen patients were admitted (one patient twice) with average age of 36.26 years (11 female) and average length of stay 3 days (range: 2–9 days). At least one event was captured on continuous EEG (cEEG) and video monitoring in all 20 admissions (atypical in one). One patient had both epileptic (ES) and psychogenic non-epileptic seizures (PNES) while 10 had PNES and 9 had ES. In 8 of 9 patients with ES, medications were changed, while in 5 patients with PNES, anti-epileptic drugs (AED) were stopped; the remaining 5 were not on medications. Of the 14 patients who had seen an epileptologist pre-admission, 13 (or 93%) had their diagnosis confirmed by EMU stay; a statistically significant finding. While typically an elective admission, in the setting of the COVID-19 pandemic, urgent and emergent EMU admissions were required for increased seizure or event frequency. In the vast majority of patients (13 of 19), admission lead to medication changes to either better control seizures or to change therapeutics as appropriate when PNES was identified.

TREATMENT of epilepsy; EVALUATION of medical care; HOSPITAL emergency services; PATIENTS; FISHER exact test; HOSPITAL admission & discharge; PATIENT monitoring; HOSPITAL wards; HOSPITAL care; DESCRIPTIVE statistics; DECISION making in clinical medicine; DATA analysis software; COVID-19 pandemic

Neurodiagnostic Journal, 2021, Vol 61, Issue 2, p95

2164-6821

Academic Journal

10.1080/21646821.2021.1918512