Abstracts

Rationale: A significant proportion of the developmental delay (DD) population has epilepsy (26-70%) and lives in institutions. These patients tend to have atypical presentation of epileptic seizures with higher risk of misdiagnosis, and often have drug resistant epilepsy requiring polypharmacy with increased risk of morbidity. The aim of this study was to determine usefulness of Epilepsy Monitoring Unit (EMU) in diagnosis and management of these patients. Methods: This is a retrospective observational study at London Health Sciences center (LHSC) of people with epilepsy and DD living in institutions that were admitted to the EMU, from January 2014 to December 2016. Results: 1121 patients were admitted to the EMU and 2.05 %(N=23) fulfilled the inclusion criteria. The mean age was 38.8 years (20-71), 52.2%(N=12) were male and 78.3% (N=18) had generalized epilepsy. 26.1%(N=6) had a history of Status Epilepticus. In 34.8 % (N=8) had seizures daily according to the caregivers. The language was severely impaired in 39.1 % (N=9) in these patients. The mean number of antiepileptic medications in those patient was 3(1-5). 4 patients were using Vagus Nerve Stimulation (VNS) (17.4%). 52.2%(N=12) had mood disorder and 30.4%(N=7) of them were taking antipsychotic medication. The mean admission time was 7.14 days (2-18). The number of seizures captured was daily or several per day in 73.9% (N=17). There was a good correlation between the behavioral events and seizures in 82.6%(N=19) of the patients, answering the reason of the admission in EMU. Conclusions: EMU admission can provide an accurate diagnosis as well characterization of spells in patients with DD who live in an institution and have epilepsy. Improved seizure management with optimization of the treatment and improved quality of life are the results the characterization of the events. Funding: None.