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DIAGNOSIS IS KEY: ACUTE HOSPITAL MANAGEMENT OF NONEPILEPTIC SEIZURES
  1. Sophie Fitzsimmons,
  2. Lisa Page,
  3. Julia Aram
  1. Brighton and Sussex University Hospitals NHS Trust

Abstract

Patients presenting to the Emergency Department (ED) with non-epileptic seizures (NES) may receive inappropriate treatment. This audit aimed to determine the prevalence and management of NES patients presenting to the Royal Sussex County Hospital ED.

A list of patients presenting to the ED over 1 year with any of the keywords ‘seizure’ ‘fit’ ‘epilepsy’ in the presenting complaint was generated from electronic patient records. We identified NES patients and recorded the management they received during their admission using: electronic discharge summaries/patient records, cross-checking with neurology/neuropsychiatry services and notes review.

Of 908 patients who presented to the ED with seizures, 42 had a diagnosis of NES (4.9%), accounting for 8.7% of attendances. There were 31 admissions of NES patients, ranging from 1 to 33 days. Those with a confirmed diagnosis of NES at admission had an average length of stay of 2 days and no emergency calls; those without had an average length of stay of 6 days and 4 patients had between 1 and 4 emergency calls during their admission.

This audit demonstrated that patients with NES present frequently to hospital and that when the diagnosis of NES is established and communicated, harmful interventions and length of stay are minimised.

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