Abstracts

Rationale: Lack of Neurological personnel and paucity of adequate investigative tools have negatively impacted care of adults and children with Epilepsy in many English speaking Caribbean Island countries. Neurologists in Jamaica, Barbados and Trinidad afford their populations these services, however lack of knowledge, stigma, finances, the necessity of travel and other logistical barriers have impeded continuous inter-island Neurological services. Physicians in Antigua, St. Lucia and Tobago requested visiting epilepsy clinical which would provide care and Education. An EEG was later donated and volunteer EEG services organized and provided by 3 rotating EEG Technologists, two Epileptologists and a Developmental Pediatrician and Pediatrician based in their respective Caribbean Islands.Methods: Clinics are held quarterly. The inaugural clinic was held in Antigua in 2010 and St. Lucia and Tobago were added to the clinical roster in 2012. One to two day clinics are held at each site, and the entire inter-island trip lasting approximately one week. Results: 340 patient visits have been documented (251 in Antigua, 73 in Tobago, 18 in Tobago). EEG s have been done in 116 patients (age range 17 months to 78 years). 83 children (49 girls and 34 boys) and 33 adults (24 women and 9 men) received studies. Abnormalities were documented in two thirds of studies read. Management decisions were discussed with patients and their physicians and changes made when necessary. Conclusions: Dedicated Epilepsy clinics can significantly impact the overall care of individuals with epilepsy. Lack of expertise and resource limitations can be temporarily addressed with visiting clinics. Longevity in care however necessitates transfer of clinical knowledge, mutual respect and corporation and dedication.