Considerations for Reopening Epilepsy Centers in Light of COVID-19
June 1, 2020
There is significant variability in how COVID-19 is affecting epilepsy centers across the United States. Epilepsy organizations have worked together to draft this document to advise directors of epilepsy centers and other neurologists who provide epilepsy care regarding key considerations as they plan to reopen their centers to provide inpatient and outpatient services. These services include admission to an Epilepsy Monitoring Unit (EMU) for characterization of seizures and spells, as well as epilepsy surgery and outpatient EEG and clinic visits. In many cases, an admission to the EMU will be elective, but critically needed to provide an accurate diagnosis and effective treatment for a patient’s epilepsy or seizures. Epilepsy surgery, while usually not an urgent treatment, significantly reduces morbidity and mortality, and should be offered when benefits outweigh risks. Ultimately, each center will need to evaluate these factors in light of their particular situation and availability of resources. At all times, centers should act with the goal of ensuring patient and provider safety and should maintain the safety and quality practices required by the NAEC accreditation process.
Centers should establish a centralized process or committee to periodically review these considerations for re-opening as local circumstances evolve. Committee members could include center director, administrative director, representative from hospital administration, incident command or infection control, nursing supervisor of EMU, clinical neurophysiology/EMU laboratory director, and EMU Coordinator. Minutes of committee meetings or written policies and procedures should be created to document decision-making and evolving practices.
Discussions with patients about the risks and benefits of epilepsy monitoring, other testing and epilepsy surgery should include information to assess and balance risks of potential COVID-19 exposure as compared to risks of waiting or delaying testing and procedures, including surgery.