Testing Balance and Reaction Time in the Epilepsy Monitoring Unit: A Pilot Study
Abstract number :
1.312
Submission category :
7. Antiepileptic Drugs / 7D. Drug Side Effects
Year :
2018
Submission ID :
494399
Source :
www.aesnet.org
Presentation date :
12/1/2018 6:00:00 PM
Published date :
Nov 5, 2018, 18:00 PM
Authors :
Alendia Hartshorn, Dartmouth-Hitchcock Medical Center; Krzysztof Bujarski, Dartmouth-Hitchcock Medical Center; Angeline Andrew, Dartmouth-Hitchcock Medical Center; and Erik J. Kobylarz, Dartmouth-Hitchcock Medical Center
Rationale: People with epilepsy (PWE) have worse balance and slower reaction time compared to the general population. This may be related to the effects of antiepileptic drugs (AEDs). It is not clear whether there is an immediate improvement in balance and reaction time following AED withdrawal. We aim to record balance and reaction time in patients undergoing AED taper in the epilepsy monitoring unit to determine if there is a reversible, dose dependent effect of AEDs on balance and reaction time. Methods: We recruited patients in the EMU who were taking AEDs and were likely to undergo taper during admission. Inclusion criteria were: age 18-55, on stable dose of AEDs. We excluded patients with neuropathy, prior surgery or an inability to stand for 30 seconds. We also recruited age matched healthy controls taking no medications. Patients underwent two trials; trial 1 while on AEDs, trial 2 after AEDs were withheld. Blood AED levels were checked during each trial and were negligible during trial 2. A Wii balance board measured sway from center of pressure (COP) on two feet with eyes open, two feet with eyes closed, and one foot with eyes open. Two trials of each were undertaken and averaged. Reaction times were determined using a computer-based test and five trials were averaged for each participant. Results: Compared to controls, patients taking AEDs had more sway from COP and slower reaction times. There was an increased sway from COP while standing on one leg on AEDs compared to off AEDs. The number of days since last seizure, gender, age, or number of AEDs did not significantly affect reaction time or sway from COP.Only 8% of patients could not complete the overall testing. Therefore, this method of testing balance appears to be feasible in the monitoring unit. Conclusions: We conclude that using a Wii balance board is a viable method of testing balance in the epilepsy monitoring unit. Patients on AEDs had worse balance and reaction times compared to controls and had improvement in single leg balance immediately after stopping AEDs. This suggests that some detrimental effects of AEDs may be rapidly reversible. The results should be confirmed with a larger study. Funding: Epilepsy Study Consortium Mini-Grant