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

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.

[1]  J. H. Cross,et al.  Revised terminology and concepts for organization of seizures and epilepsies: Report of the ILAE Commission on Classification and Terminology, 2005–2009 , 2010, Epilepsia.

[2]  Joshua E. Motelow,et al.  Testing for minimal consciousness in complex partial and generalized tonic–clonic seizures , 2012, Epilepsia.

[3]  Jean Gotman,et al.  Recommendations Regarding the Requirements and Applications for Long‐term Recordings in Epilepsy , 2007, Epilepsia.

[4]  Yang Si,et al.  Human bedside evaluation versus automatic responsiveness testing in epilepsy (ARTiE) , 2016, Epilepsia.

[5]  Carlos E. M. Tassinari,et al.  Glossary of Descriptive Terminology for Ictal Semiology: Report of the ILAE Task Force on Classification and Terminology , 2001, Epilepsia.

[6]  C. Elger,et al.  The localizing value of ictal consciousness and its constituent functions: a video-EEG study in patients with focal epilepsy. , 2002, Brain : a journal of neurology.

[7]  Sándor Beniczky,et al.  Diagnostic usefulness and duration of the inpatient long-term video-EEG monitoring: Findings in patients extensively investigated before the monitoring , 2009, Seizure.

[8]  G. Cascino.  Clinical indications and diagnostic yield of video-electroencephalographic monitoring in patients with seizures and spells. , 2002, Mayo Clinic proceedings.

[9]  J. Giacino,et al.  Prospective assessment of ictal behavior using the revised Responsiveness in Epilepsy Scale (RES-II) , 2013, Epilepsy & Behavior.

[10]  Hal Blumenfeld,et al.  Impaired consciousness in epilepsy investigated by a prospective responsiveness in epilepsy scale (RES) , 2012, Epilepsia.

[11]  Philippe Kahane,et al.  A European survey on current practices in epilepsy monitoring units and implications for patients' safety , 2015, Epilepsy & Behavior.

[12]  L. Hirsch,et al.  Diagnostic Utility of an Epilepsy Monitoring Unit , 2007, American journal of medical quality : the official journal of the American College of Medical Quality.

[13]  J. Giacino,et al.  Impaired consciousness in partial seizures is bimodally distributed , 2014, Neurology.