Long-term video-EEG monitoring in the epilepsy monitoring unit (EMU), while generally a safe procedure (1,2), can be associated with adverse events. The majority of EMUs have experienced falls, status epilepticus, and postictal psychosis during monitoring (3); although rare, fatalities and near-fatalities have also occurred in the EMU (2,4). Even patients with psychogenic nonepileptic seizures are prone to adverse events, usually falls, at a significant rate (5). Provocative procedures such as antiepileptic drug (AED) withdrawal and sleep deprivation increase the risk for adverse events, particularly if there is a history of generalized tonic-clonic seizures (GTCs) as a proportion of them will inevitably experience difficult to control seizures that may require intubation and treatment in the intensive care unit (ICU). Such risks should be understood, prior to monitoring, by both the treating physician as well as the patient. Nonetheless, because video-EEG monitoring is an elective procedure for which possible morbidities are predictable and potentially systematically preventable, safety in the EMU must always be the primary goal of any admission plan.
展开▼
