Guidelines Needed for Seizure Cluster Care During Epilepsy Monitoring

Seizure clusters — or two seizures occurring close together — present a treatment challenge for epileptologists caring for patients in the pediatric Epilepsy Monitoring Unit (EMU). Whether they occur spontaneously during long-term videoelectroencephalogram monitoring or result from adjustments to antiseizure medication dosages, seizure clusters can compromise presurgical evaluations, possibly requiring the patient to be transferred to the Intensive Care Unit (ICU).

Eric B. Segal, M.D., a pediatric epileptologist at Hackensack University Medical Center’s Joseph M. Sanzari Children’s Hospital, is among a group of researchers who published a study in Epilepsy & Behavior demonstrating the need for consensus-backed recommendations on the use of rescue medications for managing seizure clusters before, during, and after EMU admission.

The study surveyed 15 epilepsy experts regarding their definitions of seizure clusters and their experiences with them. Due to the variety of treatment approaches and the potential for seizure clusters to cause adverse outcomes, the researchers identified the need for recommendations on best practices for managing seizure clusters in specific patient populations.

“Our research demonstrated that evidence- and consensus-based guidelines for using rescue medications to manage seizure clusters in the EMU would benefit clinicians as well as patients,” said Dr. Segal.

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