P03-F Early care protocol for patients with a first epileptic seizure in the Complejo Hospitalario Toledo. Issue 7 (July 2019)

• Record Type: Journal Article
• Authors: Vera, Leonardo Torres; Azcona, Ana Teijeira; Loro, Fernando Ayuga; Brazo, Cristina Andrada; Castillo, Rosario Almansa; Cabeza Álvarez, Clara Isabel
• Is Part Of: Clinical neurophysiology. Volume 130:Issue 7(2019:Jul.)
• Page Start: e67
• Publication Date: 2019-07
• Subjects: Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2019.04.457
• Languages: English
• ISSNs: 1388-2457

Abstract

Abstract : Rationale: The early and accurate diagnosis of epilepsy is essential. After a first seizure, it is important to detect which patients are at special risk of having a second crisis. An expert assessment and an early EEG improves the diagnostic yield, increases the therapeutic compliance and reduces the adverse effects due to unnecessary treatments. Methods: The epilepsy Team of the Hospital Virgen de La Salud of Toledo, has implemented an early first seizure assessment consisting of three main steps: 1. Detection of the first unprovoked crisis in the Emergency Department, filling in a specific form and assessment and registration by the on-call Neurologist. 2. Case analysis, each morning, by the Epilepsy Team and contact with the Clinical Neurophysiologists to perform early EEG within 24–48 h. 3. Early First Seizure clinic within 1 week by the Epileptologists. Results: After six months, 60 patients have been included, with a diagnosis of epilepsy in 27. 17 were focal epilepsies and 10 generalized epilepsies. EEG was performed in all patients within 24–72 h and EEG after sleep deprivation in 63%. All patients have had a neuroimaging test, 100% CT and 60% MRI. Conclusions: In our experience, the EEG wtihin the first 48 h after a first seizure is essential for the epilepsy diagnosis.