Experience of the First Epilepsy Monitoring Unit in South Dakota.

Abstract

Introduction: Long term video-electroencephalographic (EEG) monitoring in an epilepsy monitoring unit (EMU) is considered the gold standard for diagnosis of seizure disorders and differentiating epileptic seizures from non-epileptic events. EMUs provide 24-hour monitoring with specially trained staff, mounted cameras for seizure observation, the ability to withdraw anti-epileptic medication and the ability to utilize seizure provoking techniques such as hyperventilation and sleep deprivation. These benefits allow EMUs to obtain a definitive diagnosis in as many as 88% of visits. South Dakota opened its first EMU in January of 2024 allowing more patients to remain in-state for seizure diagnosis and increasing the quality of epilepsy care in South Dakota.

Methods: A retrospective analysis was performed of patients undergoing elective vEEG monitoring in South Dakota's first EMU from January 2024 to October 2024. Data points were recorded including patient demographics, reason for admission, adverse events during admission and outcome of the study.

Results: Thirty-six vEEG studies were conducted between January 1, 2024, and October 11, 2024. The median age of patient was 34.5 years with 21 females (58.3%) and 15 males (41.7%) served. Hispanic and Native American were the highest represented minorities, each forming 8.3% of patients. The median length of study was 93 hours. Twenty-seven studies (75.0%) were considered diagnostically conclusive while capturing a clinical event or recording epileptiform EEG activity that aided in diagnosis. Twenty-six EMU visits (72.2%) resulted in a medication change prior to discharge. Only 5 studies (13.9%) conducted in the EMU experienced adverse events including status epilepticus, rash, UTI and agitation.

Conclusion: The EMU has been an invaluable addition to medical care in South Dakota. It provides a safe and reliable diagnostic study that allows for better diagnosis and improved treatment of seizure patients while staying closer to home.