The epilepsy monitoring unit (EMU) is a complex and dynamic operational environment, where the cognitive and behavioural consequences of medical and environmental changes often go unnoticed. The psychomotor vigilance task (PVT) has been used to detect changes in cognition and behaviour in numerous contexts, including among astronauts on spaceflight missions, pilots, and commercial drivers. Here, we piloted serial point-of-care administration of the PVT in children undergoing invasive monitoring in the EMU. Seven children completed the PVT throughout their hospital admission and their performance was associated with daily seizure counts, interictal epileptiform discharges, number of antiseizure medications (ASMs) administered, and sleep quality metrics. Using mixed-effects models, we found that PVT reaction time and accuracy were adversely affected by greater number of ASMs and interictal epileptiform activity. We show that serial point-of-care PVT is simple and feasible in the EMU and may enable greater understanding of individual patient responses to medical and environmental alterations, inform clinical decision-making, and support quality-improvement and research initiatives.

中文翻译：

---

癫痫监测单位儿童精神运动警惕性的纵向护理点评估

癫痫监测单元 (EMU) 是一个复杂且动态的操作环境，其中医疗和环境变化的认知和行为后果常常被忽视。精神运动警戒任务（PVT）已被用来检测多种情况下的认知和行为变化，包括执行航天任务的宇航员、飞行员和商业司机。在这里，我们对在 EMU 中接受侵入性监测的儿童进行了 PVT 连续护理点管理试点。七名儿童在入院期间完成了 PVT，他们的表现与每日癫痫发作次数、发作间期癫痫样放电、服用的抗癫痫药物 (ASM) 数量以及睡眠质量指标相关。使用混合效应模型，我们发现 PVT 反应时间和准确性受到更多 ASM 和发作间期癫痫样活动的不利影响。我们证明，连续护理点 PVT 在 EMU 中简单可行，可以更好地了解个体患者对医疗和环境变化的反应，为临床决策提供信息，并支持质量改进和研究计划。