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Intensive monitoring in refractory epilepsy

From the Department of Neurology and the Comprehensive Epilepsy Program (Drs Sutula, Miller, and Dreifuss), University of Virginia School of Medicine, Charlottesville, VA, and the Department of Neurology (Dr. Sackellares), University of Michigan, Ann Arbor, MI.

Forty patients with intractable seizures were studied in an epilepsy unit for an average of 8 weeks with video-electroencephalographic telemetry and continuous observation by trained personnel. Drugs were administered on the basis of antiepileptic drug measurements and seizure classification determined by clinical observation and telemetry. Seizure frequency was reduced in 24 patients (60%). Unrecognized seizure types were identified in 8 patients (20%), and diagnostic classification was changed in 19 patients (47.5%). At least one antiepileptic drug was eliminated in 25 patients (6O%), and the average drug reduction per patientp0.60—was highly significant (p <0.01). In patients with seizures refractory to conventional out-patient and hospital management, improvement in diagnostic accuracy and refinement in observation techniques result in significant reduction of seizure frequency, elimination of drugs, and limitation of toxicity.

Address correspondence and reprint requests to Dr. Dreifuss, Department of Neurology, University of Virginia School of Medicine, Charlottesville, VA 22908.

Supported by NINCDS contract No. 1-NS 52329.

Accepted for publication June 12, 1980.

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