Seizures are a common symptom encountered in emergency departments regularly. Seizures may represent a diagnosis of epilepsy but can also be a symptom of a wide range of medical illnesses,…
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Seizures are a common symptom that can be caused by a variety of other medical problems. Management of a person after their first seizure should be dictated by their risk to develop further seizures. Adequate investigation and access to care for these patients is essential to help determine this risk and treat them appropriately. Although Taranaki does a fair job, a number of issues could be improved on.
Management of first seizure should be based on treating the underlying cause and tailoring investigations to identify those patients at high risk of recurrence.
To establish the incidence of first seizure presentation to Taranaki Base Hospital and investigate the management of these patients.
A retrospective audit was performed identifying patients presenting to Taranaki Base Hospital from 1 January 2015 to 31 December 2015 with a first seizure.
Thirty-seven patients presented with their first seizure with 50% found to have an easily reversible precipitant. Forty-three percent had a history of previous brain insult and 52% had an abnormality identified on neuroimaging. Only 14% received formal neurology follow-up and only 8% had electroencephalography. Forty-three percent received chronic antiepileptic drug therapy and 27% had a recurrent seizure within 12 months. Only 43% had documented driving advice.
The incidence of first seizure presentation to Taranaki Base Hospital is similar to worldwide data. In general, patients receive basic investigations in keeping with international guidelines. This audit has helped to identify a number of areas to address with the current service provision, including ways to improve access to important investigations and ways to develop a guideline to standardise care.