title: Video-EEG monitoring: safety and adverse events in 507 consecutive patients.
abstract: OBJECTIVE
  Video-electroencephalography (EEG) monitoring plays a central role in the presurgical evaluation of medically refractory epilepsies and the diagnosis of nonepileptic attack disorders (NEADs). The aim of this study was to analyze safety and adverse events (AEs) during video-EEG monitoring.
  
  
  METHODS
  We retrospectively evaluated 596 video-EEG sessions in 507 patients (233 men, mean age 36 years, standard deviation = 14, range 9-80 years) within a 6-year period. AEs were examined in detail and their risk factors were assessed using multiple logistic regression analysis.
  
  
  RESULTS
  Forty-four patients (9%) experienced 53 AEs: 20 had psychiatric events (17 postictal psychosis, 2 panic attacks, 1 interictal psychosis), 15 had injuries (14 falls with minor injuries, 2 falls with fractures, 2 fractures without fall, 1 fall with epidural hematoma), 10 patients had 13 episodes of status epilepticus (SE), and one AE was treatment-related (valproic acid--induced encephalopathy). Patients with AEs were older (p = 0.036) and had a longer duration of epilepsy (p = 0.019). All AEs resulted in a prolonged hospital stay (p < 0.001). Ninety-one percent of the AEs occurred within the first 4 days of monitoring. Independent risk factors were duration of epilepsy >17 years [odds ratio (OR) 3.096; 95% confidence interval (CI) 1.548-6.189], a previous history of psychiatric illness (OR 16.882; 95% CI 5.469-52.110), a history of seizure-related injuries (OR 3.542; 95% CI 1.069-11.739), or a history of SE (OR 3.334; 95% CI 1.297-8.565).
  
  
  CONCLUSIONS
  The most common AEs were postictal psychosis, falls, and SE. Patients with an older age, long disease duration, psychiatric comorbidity, history of injuries, and SE have a higher risk.
authors.affiliation: Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Judith
authors.initials: J
authors.lastname: Dobesberger
authors.forename: Gerald
authors.initials: G
authors.lastname: Walser
authors.forename: Iris
authors.initials: I
authors.lastname: Unterberger
authors.forename: Klaus
authors.initials: K
authors.lastname: Seppi
authors.forename: Giorgi
authors.initials: G
authors.lastname: Kuchukhidze
authors.forename: Julia
authors.initials: J
authors.lastname: Larch
authors.forename: Gerhard
authors.initials: G
authors.lastname: Bauer
authors.forename: Thomas
authors.initials: T
authors.lastname: Bodner
authors.forename: Tina
authors.initials: T
authors.lastname: Falkenstetter
authors.forename: Martin
authors.initials: M
authors.lastname: Ortler
authors.forename: Gerhard
authors.initials: G
authors.lastname: Luef
authors.forename: Eugen
authors.initials: E
authors.lastname: Trinka
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects; D004567:Electrodes, Implanted / Q000009:adverse effects; D004569:Electroencephalography / Q000009:adverse effects*; D004827:Epilepsy / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000009:adverse effects*; D012307:Risk Factors; D017751:Safety Management; D012815:Signal Processing, Computer-Assisted; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis; D055536:Vagus Nerve Stimulation / Q000009:adverse effects; D014741:Video Recording
chemical_list: D000927:Anticonvulsants