Abstracts

Rationale: Patients with epilepsy constitute a vulnerable population due to long term dependence on antiepileptic agents to prevent recurrence of seizures. The purpose of this study is to review the incidence and identify possible risk factors associated with development of seizures in patients with epilepsy, who are hospitalized for a reason other than epilepsy, which includes elective procedures. We have limited this cohort to patients admitted for cardiac catheterization for evaluation of coronary artery disease.Methods: After obtaining IRB approval, all patients with a diagnosis of epilepsy and undergoing cardiac cathetarizetion were identified through our electronic health record system, with an age range from 18 to 89 years, and with a hospital stay longer than 24 hours. We excluded those patients without confirmed epilepsy. Patients who were not on antiepileptic medication were excluded from the study.Results: A total of 1447 patients were identified through our electronic health record system with diagnosis codes for epilepsy and who were admitted to Hahnemann University Hospital for at least 24 hours. A chart review was performed for a total of 48 Patients who had coronary artery disease and epilepsy and were undergoing cardiac catheterization. 31 patients were identified to have active epilepsy, and were on antiepileptic medications at the time of admission. Three patients (9.6%) experienced seizures as an inpatient, all of which were generalized convulsive seizures. Two of these patients were kept “nil per os” (NPO) prior to cardiac catheterization and were not given their antiepileptic medication and experienced seizures within 48 hours. One patient experienced a seizure due to an error in translating the correct antiepileptic medication dose from outpatient to inpatient prior to his scheduled procedure.Conclusions: This study points out to some important issues regarding the care of patients with epilepsy who are hospitalized for coronary artery disease. In our study, we conclude that patients with epilepsy have an approximate risk of 9.6% of experiencing a seizure, while undergoing cardiac procedures. These causes are potentially preventable, which include accurate translation of the patient's antiepileptic medication dose from outpatient to inpatient, and the importance of administering the patients their regular antiepileptic medication, when hospitalized, especially when they are kept NPO.