Haddad Naim, Grant Irish, Eswaran Hari
Weill Cornell Medical College in Qatar, Education City, PO Box 24144, Doha, Qatar.
University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205, USA.
Epilepsy Behav. 2015 Mar;44:1-4. doi: 10.1016/j.yebeh.2014.11.033. Epub 2015 Jan 21.
We aimed to describe our preliminary experience with the telemedicine (TM) seizure clinic. A retrospective database analysis for the TM seizure visits between January 2009 and January 2012 was performed. Each subject's age, gender, epilepsy syndrome, seizure types, and outcome were identified. The antiepileptic drug (AED) regimen at each visit was noted, as well as instances where surgical therapies and admission for monitoring were discussed. We identified a total of 74 encounters with 24 patients. Fifteen subjects (62.5%) had focal epilepsy, whereas seven (29%) had generalized epilepsy. Seven patients (29%) experienced one seizure type, 14 (58.5%) had two seizure types, and five (12.5%) had three or more seizure types. Thirty-two out of the 74 encounters (43%) resulted in some change in the AED regimen. Surgical therapeutic options were discussed in 35% of the visits. Two-thirds of subjects were either seizure-free or improved by the last encounter. The no-show rate was only 11%. We were able to deliver follow-up care through a TM model to patients with epilepsy with a wide spectrum of syndromes and severity. We believe that TM improves access to specialized care for patients with epilepsy living in rural areas.
我们旨在描述我们在远程医疗癫痫门诊的初步经验。对2009年1月至2012年1月期间的远程医疗癫痫门诊就诊情况进行了回顾性数据库分析。确定了每个受试者的年龄、性别、癫痫综合征、癫痫发作类型和治疗结果。记录每次就诊时的抗癫痫药物(AED)治疗方案,以及讨论手术治疗和住院监测的情况。我们共确定了24例患者的74次就诊。15名受试者(62.5%)患有局灶性癫痫,而7名(29%)患有全身性癫痫。7例患者(29%)经历一种癫痫发作类型,14例(58.5%)有两种癫痫发作类型,5例(12.5%)有三种或更多癫痫发作类型。74次就诊中有32次(43%)导致AED治疗方案发生了一些变化。35%的就诊讨论了手术治疗方案。三分之二的受试者在最后一次就诊时无癫痫发作或病情有所改善。失约率仅为11%。我们能够通过远程医疗模式为患有各种综合征和严重程度的癫痫患者提供后续护理。我们认为,远程医疗改善了农村地区癫痫患者获得专科护理的机会。