PO053 Status epilepticus – do neurologists and intensivists differ?

    loading  Checking for direct PDF access through Ovid

Abstract

Introduction

Super-refractory status epilepticus (SRSE) has high mortality; yet there is limited evidence and no nationally accepted cross-specialty guidelines.

Method

A case-based questionnaire on SRSE was distributed to all West Midlands Neurologists and to Intensivists in the tertiary referral hospital. Data collected included: clinician’s confidence, interventions, investigations and need for clinical guidance.

Results

Response rate was 57.8% (81 of 140): 15 Neurology Consultants (NC), 27 ICM Consultants (ICC), 13 Neurology Registrars (NR) and 24 ICM Registrars (ICR). Confidence fell with increasing seizure duration. NC were most confident. 22.5% of respondents (33.7% ICC) would use Levetiracetam before anaesthesia 64.3% of NC considered MRI<24 hours mandatory, but only 29.1% of ICC and 8.7% of ICR. 71.4% of NC expected autoimmune screening but only 58.3% of ICC and 30.4% of ICR. NC (64.3%) were more likely than ICC (0%) to consider immunoglobulin, methylprednisolone (64.3% and 0%) and plasma-exchange (42.9% and 4.1%); but less likely to use magnesium (28.6% and 37.5%). 97% would use continuous EEG: 53.9% immediately post-anaesthesia and 43.1% only in SRSE. 95.4% of respondents would welcome clinical guidelines.

Conclusion

Neurologists’ and Intensivists’ confidence in and management of SRSE varies. National clinical guidance based best practice would be welcomed by clinicians.

Related Topics

    loading  Loading Related Articles