Abstracts

Rationale: Inpatient EMU provides long-term video monitoring to accurately diagnose and manage epilepsy. Admissions during pregnancy would not be typically indicated with rare exceptions. In cases of pregnancy with refractory and frequent seizures, admission to EMU may aide in confirming a diagnosis and improving the management of seizures. Our goals are to better understand the indications for admitting pregnant women into EMU in order to form a standard approach regarding this specific population and management of their epileptic disease in regards to safety.

Methods: A retrospective review of electronic medical records of all pregnant women with EMU visits between the years 2010 and 2020 at University of Maryland Epilepsy Center was conducted. Upon chart review, 20 patients were identified. Only 5 out of 20 were EMU admissions; 15 were pregnant women on continuous EEGs.

Results: Interim analysis of the 5 patients who were admitted to EMU between 2010-2020 revealed: median age of 27 years (range 24-30), and mean length of stay 4.25 days. Reasons for admission were differential diagnosis in 3 (60%), quantification of number of seizures in 1 (20%), and medication management in 1 (20%) patient. Median number of weeks pregnant at the time of admission was 19.8, with OB-related complications only seen in 1 (20%), which was pre-term contractions. Median number of anti-seizure medications was 1, and none were weaned off while inpatient. Upon discharge from EMU, 3 (60%) patients had increased dose of anti-seizure medications with no changes in 2 (40%) as one patient left AMA, and one was diagnosed with psychogenic non-epileptic seizures (PNES).

Improvement of frequency and severity of seizures upon discharge were seen in 4 (80%) patients as 1 left Against Medical Advice (AMA). Reduction in seizure frequency by >50% within the 6 months period post-discharge was reported as 100%.

Conclusions: Our preliminary data document the most commonly found reasons for EMU admissions amongst the pregnant population are differential diagnosis, medication management and quantification of seizures. This admission proved to be safe with minimal to no complications while inpatient and aided in reducing the number of seizures on post-discharge follow up.

Funding: Please list any funding that was received in support of this abstract.: N/A.