Testing patients during seizures: A European consensus procedure developed by a joint taskforce of the ILAE - Commission on European Affairs and the European Epilepsy Monitoring Unit Association

Sándor Beniczky; Miri Neufeld; Beate Diehl; Judith Dobesberger; Eugen Trinka; Ruta Mameniskiene; Sylvain Rheims; Antonio Gil-Nagel; Dana Craiu; Ronit Pressler; David Krysl; Angelina Lebedinsky; Laura Tassi; Guido Rubboli; Philippe Ryvlin

doi:10.1111/epi.13472

Testing patients during seizures: A European consensus procedure developed by a joint taskforce of the ILAE - Commission on European Affairs and the European Epilepsy Monitoring Unit Association

Epilepsia. 2016 Sep;57(9):1363-8. doi: 10.1111/epi.13472. Epub 2016 Jul 21.

Authors

Sándor Beniczky^{1

2}, Miri Neufeld³, Beate Diehl⁴, Judith Dobesberger⁵, Eugen Trinka⁵, Ruta Mameniskiene^{6

7}, Sylvain Rheims⁸, Antonio Gil-Nagel⁹, Dana Craiu¹⁰, Ronit Pressler^{11

12}, David Krysl^{13

14}, Angelina Lebedinsky³, Laura Tassi¹⁵, Guido Rubboli¹⁶, Philippe Ryvlin^{17

18}

Affiliations

¹ Department of Clinical Neurophysiology, Danish Epilepsy Center, Dianalund, Denmark.
² Aarhus University, Aarhus, Denmark.
³ The EEG and Epilepsy Unit, Department of Neurology, Tel Aviv Medical Center, Tel Aviv, Israel.
⁴ Departments of Clinical Neurophysiology and Clinical and Experimental Epilepsy, Institute of Neurology, National Hospital for Neurology and Neurosurgery, University College London, London, United Kingdom.
⁵ Department of Neurology, Christian-Doppler-Klinik, Paracelsus Medical University, and Center for Cognitive Neuroscience, Salzburg, Austria.
⁶ Clinic of Neurology and Neurosurgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
⁷ Department of Neurology, Vilnius University Hospital, Vilnius, Lithuania.
⁸ Department of Functional Neurology and Epileptology, University Hospital of Lyon and Lyon 1 University, Lyon, France.
⁹ Department of Neurology, Epilepsy Program, Hospital Ruber Internacional, Madrid, Spain.
¹⁰ Department of Clinical Neurosciences (No. 6), Pediatric Neurology Clinic, Alexandru Obregia Hospital, "Carol Davila" University of Medicine, Bucharest, Romania.
¹¹ Department of Clinical Neurophysiology, Great Ormond Street Hospital, London, United Kingdom.
¹² Clinical Neuroscience, UCL Institute of Child Health, London, United Kingdom.
¹³ Departments of Clinical Neurophysiology and Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.
¹⁴ Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
¹⁵ "Claudio Munari" Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy.
¹⁶ Danish Epilepsy Center and University of Copenhagen, Dianalund, Denmark.
¹⁷ Department of Clinical Neurosciences, CHUV, Lausanne, Switzerland.
¹⁸ European Epilepsy Monitoring Association, Lyon, France.

PMID: 27440172
DOI: 10.1111/epi.13472

Abstract

There is currently no international consensus procedure for performing comprehensive periictal testing of patients in the epilepsy monitoring units (EMUs). Our primary goal was to develop a standardized procedure for managing and testing patients during and after seizures in EMUs. The secondary goal was to assess whether it could be implemented in clinical practice (feasibility). A taskforce was appointed by the International League Against Epilepsy (ILAE)-Commission on European Affairs and the European Epilepsy Monitoring Unit Association, to develop a standardized ictal testing battery (ITB) based on expert opinion and experience with various local testing protocols. ITB contains a comprehensive set of 10 items that evidence the clinically relevant semiologic features, and it is adaptive to the dynamics of the individual seizures. The feasibility of the ITB was prospectively evaluated on 250 seizures from 152 consecutive patients in 10 centers. ITB was successfully implemented in clinical practice in all 10 participating centers and was considered feasible in 93% of the tested seizures. ITB was not feasible for testing seizures of very short duration.

Keywords: Epilepsy monitoring unit; Feasibility; Postictal; Seizures; Semiology; Testing.

MeSH terms

Advisory Committees*
Consensus*
Disease Management*
Electroencephalography
Europe / epidemiology
Female
Humans
Male
Monitoring, Physiologic*
Practice Guidelines as Topic / standards*
Seizures / diagnosis*
Seizures / epidemiology