<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_joepi-2017-0004_s_001"><h3>Background</h3><p>Epilepsy is among the most frequent neurological conditions and it is estimated that approximately 8% of the population experience a seizure at some time in their lives.</p></sec><sec id="j_joepi-2017-0004_s_002"><h3>Aim</h3><p>To examine the characteristics of patients referred to a First Seizure Clinic (FSC) at a University Hospital in South-West London.</p></sec><sec id="j_joepi-2017-0004_s_003"><h3>Methods</h3><p>All subjects referred to the FSC at St George’s University Hospitals between January and December 2015 were included in this audit.</p></sec><sec id="j_joepi-2017-0004_s_004"><h3>Results</h3><p>From a total of 257 patients, males 49.5%, age range 16–90, 30% referred by General Practices (GPs), 59.1% by the Accident &amp; Emergency Department (A&amp;E) and 10.9% by other hospital wards, 24.5% did not attend (DNA) the clinical appointment. Females who did not attend were significantly older than males (49.8 years old vs 39.7; p = 0.007). Among those who attended the clinical appointment, 17% were diagnosed first unprovoked seizure, 12.4% acute symptomatic seizure and 28.9% epilepsy. These patients were referred mainly by A&amp;E while GPs referred seizure mimics especially non-epileptic attack disorder (NEAD) and syncope. Patients with NEAD were significantly younger than those with seizures (29.4 years old vs 44.2; p &lt; 0.001) and had a previous psychiatric history (72.7% vs 16.8%; p &lt; 0.001). The proportion of seizure mimics was similar in the older sample group (> 65 years). Regarding acute symptomatic seizures, 33.3% were alcohol-related, 20.8% acute brain insults and 12.5% drug-related (always overdose).</p></sec><sec id="j_joepi-2017-0004_s_005"><h3>Conclusions</h3><p>1 in 4 patients referred to a FSC does not attend the clinical appointment, especially older females. More than 1 in 3 cases represent seizure mimics and are referred mainly by GPs.</p></sec></abstract>

BackgroundEpilepsy is among the most frequent neurological conditions and it is estimated that approximately 8% of the population experience a seizure at some time in their lives.AimTo examine the characteristics of patients referred to a First Seizure Clinic (FSC) at a University Hospital in South-West London.MethodsAll subjects referred to the FSC at St George’s University Hospitals between January and December 2015 were included in this audit.ResultsFrom a total of 257 patients, males 49.5%, age range 16–90, 30% referred by General Practices (GPs), 59.1% by the Accident & Emergency Department (A&E) and 10.9% by other hospital wards, 24.5% did not attend (DNA) the clinical appointment. Females who did not attend were significantly older than males (49.8 years old vs 39.7; p = 0.007). Among those who attended the clinical appointment, 17% were diagnosed first unprovoked seizure, 12.4% acute symptomatic seizure and 28.9% epilepsy. These patients were referred mainly by A&E while GPs referred seizure mimics especially non-epileptic attack disorder (NEAD) and syncope. Patients with NEAD were significantly younger than those with seizures (29.4 years old vs 44.2; p < 0.001) and had a previous psychiatric history (72.7% vs 16.8%; p < 0.001). The proportion of seizure mimics was similar in the older sample group (> 65 years). Regarding acute symptomatic seizures, 33.3% were alcohol-related, 20.8% acute brain insults and 12.5% drug-related (always overdose).Conclusions1 in 4 patients referred to a FSC does not attend the clinical appointment, especially older females. More than 1 in 3 cases represent seizure mimics and are referred mainly by GPs.

Diagnoses and referral pattern at a first seizure clinic in London

Journal of Epileptology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

{"article-title":"Diagnoses and referral pattern at a first seizure clinic in London"}

BackgroundEpilepsy is among the most frequent neurological conditions and it is estimated that approximately 8% of the population experience a seizure at some time in their lives.AimTo examine the characteristics of patients referred to a First Seizure Clinic (FSC) at a University Hospital in South-West London.MethodsAll subjects referred to the FSC at St George’s University Hospitals between January and December 2015 were included in this audit.ResultsFrom a total of 257 patients, males 49.5%, age range 16–90, 30% referred by General Practices (GPs), 59.1% by the Accident & Emergency Department (A&E) and 10.9% by other hospital wards, 24.5% did not attend (DNA) the clinical appointment. Females who did not attend were significantly older than males (49.8 years old vs 39.7; p = 0.007). Among those who attended the clinical appointment, 17% were diagnosed first unprovoked seizure, 12.4% acute symptomatic seizure and 28.9% epilepsy. These patients were referred mainly by A&E while GPs referred seizure mimics especially non-epileptic attack disorder (NEAD) and syncope. Patients with NEAD were significantly younger than those with seizures (29.4 years old vs 44.2; p  65 years). Regarding acute symptomatic seizures, 33.3% were alcohol-related, 20.8% acute brain insults and 12.5% drug-related (always overdose).Conclusions1 in 4 patients referred to a FSC does not attend the clinical appointment, especially older females. More than 1 in 3 cases represent seizure mimics and are referred mainly by GPs.

BackgroundEpilepsy is among the most frequent neurological conditions and it is estimated that approximately 8% of the population experience a seizure at some...

Diagnoses and referral pattern at a first seizure clinic in London

Published Online: Nov 14, 2017

Page range: 31 - 36

Received: Oct 10, 2017

Accepted: Oct 18, 2017

DOI: https://doi.org/10.21307/joepi-2017-0004

Keywords
epilepsy, first unprovoked seizure

© 2017 Duncan Palka et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Diagnoses and referral pattern at a first seizure clinic in London

Published Online: Nov 14, 2017

Page range: 31 - 36

Received: Oct 10, 2017

Accepted: Oct 18, 2017

DOI: https://doi.org/10.21307/joepi-2017-0004

Keywordsepilepsy, first unprovoked seizure

© 2017 Duncan Palka et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Keywords
epilepsy, first unprovoked seizure