title: [Slow anti-epileptic drug taper protocol in video-EEG monitoring for presurgical evaluation of epilepsy].
abstract: OBJECTIVE
  To evaluate the efficacy and safety of slow anti-epileptic drug (AED) taper protocol and a rescue benzodiazepine protocol in video-electroencephalography (video-EEG) monitoring for presurgical evaluation of epilepsy.
  
  
  METHODS
  Sixty-two of 109 patients with refractory focal epilepsy underwent pre-surgical video-EEG monitoring with a slow AEDs taper protocol and a rescue benzodiazepine protocol. Seizures were recorded by video-EEG in 56 patients. The time to the first seizure, duration of monitoring, incidence of 4-h and 24-h seizure clustering, secondarily generalized tonic-clonic seizures (sGTCS), status epilepticus, falls and cardiac asystole were evaluated.
  
  
  RESULTS
  A total of 191 seizures were recorded in the 56 cases, and the diagnostic efficiency of video-EEG was 90.3%. The mean time to the first seizure was 2.4 days and the time to conclude video-EEG monitoring averaged 6.8 days. Eight (12.9%) patients had 4-h clusters and 24 (38.7%) had 24-h clusters. Seizure clusters were more frequent in extra temporal epilepsy than in temporal lobe epilepsy. While 19 sGTCS were recorded in 15 patients (26.8%), status epilepticus did not occur and no seizure was complicated by cardiac asystole. Epileptic falls with no significant injuries occurred in 4 patients.
  
  
  CONCLUSIONS
  Seizure clustering is common during presurgical video-EEG monitoring, but serious adverse events are rare with a slow AED tapering and a rescue benzodiazepine protocols. These two protocols are effective and save in presurgical video-EEG monitoring for refractory focal epilepsy.
authors.affiliation: Department of Neurology, Foshan First People's Hospital, Foshan, China. 13802620264@139.com
authors.forename: Quan
authors.initials: Q
authors.lastname: Zhou
authors.forename: Xiaobing
authors.initials: X
authors.lastname: Hou
authors.forename: Zhimin
authors.initials: Z
authors.lastname: Huang
authors.forename: Guofu
authors.initials: G
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D004569:Electroencephalography / Q000379:methods*; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000517:prevention & control; D014741:Video Recording; D055815:Young Adult
chemical_list: D000927:Anticonvulsants