Safety at The William Quarrier Scottish Epilepsy Centre

Anderson, James A.; Grant, Victoria; Elgammal, Mariam; Campbell, Alison M.; Hampshire, Julia; Hansen, Stig; Russell, Aline

doi:10.1016/j.seizure.2017.10.003

Cited by 6 publications

(2 citation statements)

References 5 publications

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“…The 12‐bed unit features a network of cameras that continuously record patients, and any of these cameras can also be linked to ambulatory EEG for patients on telemetry. Such flexibility does not compromise patient safety compared to national standards in video telemetry units, and most seizures are attended by a member of staff in <1 minute …”

Section: Methodsmentioning

confidence: 99%

Peri‐ictal responsiveness to the social environment is greater in psychogenic nonepileptic than epileptic seizures

Wardrope

Wong

McLaughlan³

et al. 2020

Epilepsia

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Objective: To look for evidence of peri-ictal social interaction in psychogenic nonepileptic seizures (PNES) and epileptic seizures exploring the notion of PNES as a form of nonverbal communication. Methods: Video recordings of typical seizures experienced by patients with epilepsy and PNES were obtained in a naturalistic social setting (residential epilepsy monitoring unit). Video analysis by three nonexpert clinicians identified 18 predefined semiological and interactional features indicative of apparent impairment of consciousness or of peri-ictal responsiveness to the social environment with assessment of interrater reliability using Fleiss κ. Features were compared between epileptic seizures and PNES. Results: One hundred eighty-nine seizures from 50 participants (24 epilepsy, 18 PNES, eight combined) were analyzed. At least fair (κ > 0.20) interrater agreement was achieved for 14 features. The PNES and epileptic seizures compared were of similar severity in terms of ictal impairment of consciousness (κ = 0.34, odds ratio [OR] = 1.11, 95% confidence interval [CI] = 0.62-1.96) and responsiveness (κ = 0.52, OR = 1.01, 95% CI = 0.55-1.86). PNES were more likely to be preceded by attempts to alert others (κ = 0.52, OR = 12.4, 95% CI = 3.2-47.7, P < .001), to show intensity affected by the presence of others (κ = 0.44, OR = 199.4, 95% CI = 12.0-3309.9, P < .001), and to display postictal behavior affected by the presence of others (κ = 0.35, OR = 91.1, 95% CI = 17.2-482.1, P < .001). Significance: Nonexpert raters can, with fair to moderate reliability, rate features characterizing ictal impairment of consciousness and responsivity in video recordings of seizures. PNES are associated with greater peri-ictal responsiveness to the social environment than epileptic seizures. These findings are consistent with a potential communicative function of PNES and could be of differential diagnostic significance. K E Y W O R D S communication, dissociative disorders, nonepileptic seizures, psychology | 759 WARDROPE Et Al. How to cite this article: Wardrope A, Wong S, McLaughlan J, Wolfe M, Oto M, Reuber M. Peri-ictal responsiveness to the social environment is greater in psychogenic nonepileptic than epileptic seizures. Epilepsia. 2020;61:758-765. https://doi.

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Section: Methodsmentioning

confidence: 99%

Peri‐ictal responsiveness to the social environment is greater in psychogenic nonepileptic than epileptic seizures

Wardrope

Wong

McLaughlan³

et al. 2020

Epilepsia

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“…I would like to thank the members of the Dutch Tele‐Epilepsy Consortium for the work on which this paper is based.…”

Section: Acknowledgmentmentioning

confidence: 99%

Movement‐based seizure detection

Arends

2018

Epilepsia

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This is a critical review and comment on the use of movement detection in epileptic seizures. The detection of rhythmic movement components, such as the clonic part of tonic-clonic seizures, is essential in all seizure detection based on movement sensors. Of the many available movement sensor types, accelerometric sensors are used most often. Eleven video-electroencephalographic (EEG) and 1 field study have been carried out. The results of these clinical trials depend on the population, study design, and seizure evolution. In video-EEG monitoring units, sensitivity for tonic-clonic seizures varied from 31% to 95%, and positive predictive value from 4% to 60%. In a field trial in a residential adult population with intellectual disability, sensitivity was 14% and positive predictive value was 82%, whereas in patients admitted to an epilepsy clinic, a bed sensor had a sensitivity of 84% (no positive predictive value was given). The algorithms using the "rhythmic movement" component at the end of a tonic-clonic seizure are reliable (few false-positive alarms) but miss less typical seizure patterns that are mostly present in people with associated brain development disturbances. Other modalities (heart rate and electromyography) are needed to increase the detection performance. Advanced accelerometric techniques allow us to gain greater insight into seizure evolution patterns, possibilities for neuromodulation, and the influence of antiepileptic drugs on specific seizure components.

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