The role of patient companions in long-term video-EEG monitoring

In developing countries it is difficult to have full-time dedicated nurses in Epilepsy Monitoring Units (EMU). Our one-bed EMU is within the Neurology Service and is adequately staffed during daytime working hours only. So we created a new model where the patient's companion was asked to press a nurse call button, allowing the examination of the patient by the nurse. In this study we aimed to understand how patient companions behaved and which factors influenced their behaviour. Patients were allowed to choose a single companion who were educated by the specialist monitoring nurse according to a protocol. Only the first recorded seizures of the patients were included in the study. The seizures were reviewed from the video-cassette recordings and the behaviour of the companions was scored according to the results of the following three questions: (1) when was the seizure noticed?; (2) was the nurse call button pushed?; and (3) did the companion prevent the recording of the seizure by the camera? The companions were grouped according to the following criteria; age, sex, level of education, type of relationship. The scores were compared for each criterion separately. The behaviours of the 50 companions (34F, 16M; age: 25-72) were studied. When statistically compared for age, sex and level of education, there were no significant differences between different groups. However, the mean score of the 47 companions who were immediate family members (3.72) was greater than those three who were not (1.66) In one-bed EMUs, patient companions who are family members can help nurses in the early detection of seizures.