Early specialized care after a first unprovoked epileptic seizure

Details

Serval ID
serval:BIB_9BA2FCFE1AC8
Type
Article: article from journal or magazin.
Collection
Publications
Title
Early specialized care after a first unprovoked epileptic seizure
Journal
J Neurol
Author(s)
Fisch L., Lascano A. M., Vernaz Hegi N., Girardin F., Kapina V., Heydrich L., Rutschmann O., Sarasin F., Vargas M. I., Picard F., Vulliemoz S., Heritier-Barras A. C., Seeck M.
ISSN
1432-1459 (Electronic)
ISSN-L
0340-5354
Publication state
Published
Issued date
12/2016
Volume
263
Number
12
Pages
2386-2394
Language
english
Notes
Fisch, L
Lascano, A M
Vernaz Hegi, N
Girardin, F
Kapina, V
Heydrich, L
Rutschmann, O
Sarasin, F
Vargas, M I
Picard, F
Vulliemoz, S
Heritier-Barras, A C
Seeck, M
eng
Randomized Controlled Trial
Germany
J Neurol. 2016 Dec;263(12):2386-2394. doi: 10.1007/s00415-016-8272-3. Epub 2016 Sep 7.
Abstract
A first seizure is a life-changing event with physical and psychological consequences. We aimed to assess the role of early comprehensive patient care after a first unprovoked seizure to improve diagnostic accuracy and follow-up adherence. From April 2011 to March 2012, patients presenting a first unprovoked epileptic seizure received standard patient care (SPC), i.e., a consultation in the ED, an EEG and a CT scan. The patients were notified of the follow-ups. We compared this protocol to subsequently acquired "early comprehensive patient care" (ECPC), which included a consultation by an epileptologist in the emergency department (ED), a routine or long-term monitoring electroencephalogram (LTM-EEG), magnetic resonance imaging and three follow-up consultations (3 weeks, 3 months, 12 months). 183 patients were included (113 ECPC, 70 SPC). LTM-EEG and MRI were performed in 51 and 85 %, respectively, of the patients in the ECPC group vs in 7 and 52 % of the patients in the SPC group (p < 0.001). A final diagnosis was obtained in 64 vs 43 % of the patients in the ECPC vs SPC group (p < 0.01). Patient attendance at 3-month was 84 % in the ECPC group vs 44 % in the SPC group (p < 0.001). At 12-month follow-up, the delay until the first recurrence was longer in the ECPC group (p = 0.008). An early epileptologist-driven protocol is associated with clinical benefit in terms of diagnostic accuracy, follow-up adherence and recurrence. This study highlights the need for epilepsy experts in the early assessment of a first epileptic seizure, starting already in the ED.
Keywords
Adolescent, Adult, Aged, Brain/diagnostic imaging/physiopathology, Costs and Cost Analysis, *Disease Management, Electrocardiography, Electroencephalography, Epilepsy/*diagnosis/economics/psychology/*therapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neuroimaging, Retrospective Studies, Young Adult, *Brain imaging, *Cost analysis, *eeg, *Follow-up, *Seizure recurrence
Pubmed
Create date
10/02/2021 12:32
Last modification date
11/02/2021 7:26
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