Consensus-based guidelines for Video EEG monitoring in the pre-surgical evaluation of children with epilepsy in the UK. (August 2017)

• Record Type: Journal Article
• Authors: Pressler, Ronit M.; Seri, Stefano; Kane, Nick; Martland, Tim; Goyal, Sushma; Iyer, Anand; Warren, Elliott; Notghi, Lesley; Bill, Peter; Thornton, Rachel; Appleton, Richard; Doyle, Sarah; Rushton, Sarah; Worley, Alan; Boyd, Stewart G.
• Is Part Of: Seizure. Volume 50(2017)
• Page Start: 6
• Page End: 11
• Publication Date: 2017-08
• Subjects: Child -- Consensus -- Delphi process -- Epilepsy -- Epilepsy surgery -- Guidelines -- Video EEG monitoring; Epilepsy -- Periodicals; Epilepsy -- Periodicals; Seizures -- Periodicals; Épilepsie -- Périodiques; Electronic journals; Electronic journals; 616.853
• DOI: 10.1016/j.seizure.2017.05.008
• Languages: English
• ISSNs: 1059-1311

Abstract

Highlights: Consensus guidelines for pediatric epilepsy monitoring are proposed. Developed by the neurophysiology group of UK Children's Epilepsy Surgery Service. Emphasis is to improve patient safety of pediatric pre-surgical evaluation. Transferable to other paediatric video EEG monitoring settings. Abstract: Purpose: Paediatric Epilepsy surgery in the UK has recently been centralised in order to improve expertise and quality of service available to children. Video EEG monitoring or telemetry is a highly specialised and a crucial component of the pre-surgical evaluation. Although many Epilepsy Monitoring Units work to certain standards, there is no national or international guideline for paediatric video telemetry. Methods: Due to lack of evidence we used a modified Delphi process utilizing the clinical and academic expertise of the clinical neurophysiology sub-specialty group of Children's Epilepsy Surgical Service (CESS) centres in England and Wales. This process consisted of the following stages I: Identification of the consensus working group, II: Identification of key areas for guidelines, III: Consensus practice points and IV: Final review. Statements that gained consensus (median score of either 4 or 5 using a five-point Likerttype scale) were included in the guideline. Results: Two rounds of feedback and amendments were undertaken. The consensus guidelines includes the following topics: referral pathways, neurophysiological equipment standards, standards of recording techniques, with specific emphasis on safety of video EEG monitoring both with and without drug withdrawal, a protocol for testing patient's behaviours, data storage and guidelines for writing factual reports and conclusions. All statements developed received a median score of 5 and were adopted by the group. Conclusion: Using a modified Delphi process we were able to develop universally-accepted video EEG guidelines for the UK CESS. Although these recommendations have been specifically developed for the pre-surgical evaluation of children with epilepsy, it is assumed that most components are transferable to any paediatric video EEG monitoring setting.