Abstracts

Rationale: Seizure patient satisfaction and quality of care are correlated with management of comorbidities in addition to good seizure control. Better characterization of patient profiles would help with improved care of comorbidities and allocation of resources to ensure improved quality of care and patient satisfaction, thus increasing patient compliance with recommendations. Admission to the Epilepsy monitoring unit aims to characterize and localize seizures to optimize management of epilepsy. Comorbid conditions including headache and psychiatric disorders impact the HRQoL in epilepsy , health care resource utilization and patient satisfaction during their stay. We intended to study the common conditions that impact management in the EMU. Methods: Patient charts for 359 unique patients from 406 admissions over an 18-month period were retrospectively reviewed with IRB approval. Patient characteristics and treatment decisions were analyzed from these charts. Incidence of headaches and psychiatric comorbidities in addition to treatments offered for these were also studied. Data were analyzed retrospectively to understand and improve current treatment protocols for admitted patients. Results: Levetiracetam was the most commonly used medication and was used in 209/359 patients (58%) on at least one occasion. Mesial temporal sclerosis was the commonest MRI abnormality (33/359 patients). 90/359 patients (25%) had captured nonepileptic events while 16/359 patients (4.5%) had captured epileptic and nonepileptic events during their admissions. 144/359 patients (40%) complained of headaches as a comorbidity of whom 114 described migrainous features. 74 of these patients (52%) described these headaches as being severe or frequent. 30/144 patients (18%) needed treatment of their headaches during EMU admission of whom 5 were treated using a valproic acid drip while the others responded to OTC medications. 76/359 patients (21%) had psychiatric comorbidities that were under medical or behavioral treatment. 5 patients needed inpatient cardiology consultations, 3 of whom were seen for possible urgent cardiac conditions. Conclusions: Levetiracetam remains the most commonly used seizure medication due to favorable pharmacokinetic and side effect profile. While nonepileptic events are commonly seen in the EMU, the number of patients with epileptic and nonepileptic events remains small. Headache is a common and well recognized comorbidity that affects quality of life and treatment directly correlates with patient satisfaction. Better inpatient and outpatient headache treatment protocols need to be instituted. Psychiatric comorbidities, while common, are underdiagnosed and as per AAN quality guidelines must be screened for in all EMU patients. Funding: None