Related Experiment Videos
Audit on first seizure presentation to Taranaki Base Hospital: a secondary centre experience
1Medical Registrar, Taranaki Base Hospital, New Plymouth.
Insights
First seizure management at Taranaki Base Hospital shows similar incidence to global data. Investigations are basic, with opportunities to improve follow-up and guideline standardization for better patient care.
Area of Science:
- Neurology
- Epidemiology
- Clinical Audit
Background:
- Effective first seizure management requires addressing underlying causes and identifying high-risk patients.
- Tailored investigations are crucial for predicting seizure recurrence.
Purpose of the Study:
- To determine the incidence of first seizure presentations at Taranaki Base Hospital.
- To evaluate the current management practices for these patients.
Main Methods:
- A retrospective audit was conducted.
- Data was collected for patients presenting with a first seizure between January 1, 2015, and December 31, 2015.
Main Results:
- Fifty percent of first seizures had a reversible cause; 43% had prior brain insult; 52% showed neuroimaging abnormalities.
- Neurology follow-up (14%) and electroencephalography (8%) were underutilized.
- Recurrent seizures occurred in 27% within 12 months; only 43% received driving advice.
Conclusions:
- First seizure incidence aligns with international figures.
- Current investigations are generally basic but highlight areas for service improvement.
- Enhanced access to investigations and standardized care guidelines are recommended.
Background:
Management of first seizure should be based on treating the underlying cause and tailoring investigations to identify those patients at high risk of recurrence.
Aim:
To establish the incidence of first seizure presentation to Taranaki Base Hospital and investigate the management of these patients.
Method:
A retrospective audit was performed identifying patients presenting to Taranaki Base Hospital from 1 January 2015 to 31 December 2015 with a first seizure.
Results:
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.
Conclusions:
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.