Authors :
Presenting Author: Shwetha Menon, MD – The University of Texas Health Science Center at Houston
Venkata Tekumalla, MD – The University of Texas Health Science Center at Houston
Jay Gavvala, MD – UTHealth Houston
Rationale:
Seizures account for a significant portion of acute medical and emergency room presentations, accounting for about 3.6% of hospitalized patients. Therefore, proper diagnostic identification is vital not only for neurologists, but also for internists and emergency room physicians, as well as trainees in those subspecialties. While this is emphasized in neurology residency curriculum, less efforts are devoted to these topics in other specialties. We aim to characterize current comfort among non-neurology physicians in identification of epileptic and non-epileptic events and recognition of various semiologic features. In a secondary step, we will assess the effectiveness of a structured educational module to improve recognition of clinical features of epileptic and non-epileptic events.Methods:
An introductory video based lecture into seizure identification, diagnosis, and management was developed by authors to educate internal medicine residents. Likert surveys were utilized before the seminars to assess learner comfortability in the subject matter. The likert survey consisted of comfortability ratings ranging from 1 to 5, with 1 being not comfortable at all and 5 being very comfortable. Additionally, pre-test and post-test educational questionnaires will be completed to assess learner mastery along with the seminar.Results:
A total of 32 residents completed the pre-seminar Likert survey with 71% of non-neurology residents having encountered acute seizures in the hospital setting. Out of these residents, only 45.4% acutely managed the episode themselves without external help. Regarding comfortability levels, only 12.5% were comfortable (ratings of 4 or 5) with detection of seizures, 15.6% were comfortable identifying between epileptic seizures and seizure mimics, and 0% felt they had a mastery of the ILAE guidelines for epilepsy. Overall only 28.2% reliably felt they could identify status epilepticus with 15.6% feeling comfortable choosing an anti-seizure medication to treat seizures with. Ongoing analysis of pre and post-test educational questionnaires is currently underway.Conclusions:
The results of the Likert survey highlight a gap in education among non-neurology trainees on the identification and management of epileptic seizures, seizure mimics, and status epilepticus. Overall, residents feel uncomfortable not only with identifying seizures but also with choosing anti-seizure medications for treatment and diagnosing status epilepticus. The efficacy of ongoing educational efforts via video based didactics is currently being assessed.
Funding: None