Yogarajah Mahinda, Child Ruth, Agrawal Niruj, Cope Sarah, Edwards Mark, Mula Marco
Atkinson Morley Regional Neuroscience Centre St George's University Hospitals NHS Foundation Trust London UK.
Institute of Molecular and Clinical Sciences St George's University of London London UK.
Epilepsia Open. 2018 Dec 19;4(1):54-62. doi: 10.1002/epi4.12283. eCollection 2019 Mar.
Functional seizures are a common functional neurologic disorder. Given their chronic nature, and the biopsychosocial factors involved in their etiology, general practitioners (GPs) play a crucial role in the care of these patients. However, little is known about the attitudes of GPs toward, and knowledge of, functional seizures.
The Atkinson Morley Regional Neuroscience Centre in London provides a comprehensive service to patients with functional seizures. As part of a service evaluation we conducted an online survey among local GPs over a 1-month period assessing their attitudes toward, and knowledge of, functional seizures.
One hundred twenty of 974 surveyed GPs replied to the survey (12.3%). Approximately 75% of GPs readily use the term "pseudoseizures," and over 50% were not sure or did not think that functional seizures were involuntary. Nearly 30% believed, or were unsure as to whether, functional seizures occur only when patients are stressed. Despite approximately 50% of GPs expressing interest in getting involved in the management of these patients, a similar proportion do not feel confident in dealing with queries from patients with functional seizures. Although most GPs felt that neurology and psychiatry should be the primary caregivers in the diagnosis and management, respectively, of functional seizures, 50% were also of the opinion that neurology should be involved in the management of these patients.
This survey highlights the attitudes of, and descriptive terms used by, GPs toward patients with functional seizures. Our findings suggest a need for better and clearer provision of information to GPs about this condition.
功能性癫痫是一种常见的功能性神经障碍。鉴于其慢性性质以及病因中涉及的生物心理社会因素,全科医生(GPs)在这些患者的护理中起着至关重要的作用。然而,对于全科医生对功能性癫痫的态度和了解程度知之甚少。
伦敦的阿特金森·莫利地区神经科学中心为功能性癫痫患者提供全面服务。作为服务评估的一部分,我们在1个月的时间内对当地全科医生进行了一项在线调查,评估他们对功能性癫痫的态度和了解程度。
974名接受调查的全科医生中有120人回复了调查(12.3%)。约75%的全科医生经常使用“假性癫痫发作”一词,超过50%的人不确定或不认为功能性癫痫发作是不自主的。近30%的人认为或不确定功能性癫痫发作是否仅在患者压力大时发生。尽管约50%的全科医生表示有兴趣参与这些患者的管理,但同样比例的人对处理功能性癫痫患者的咨询没有信心。尽管大多数全科医生认为神经科和精神科应分别在功能性癫痫的诊断和管理中担任主要护理人员,但50%的人也认为神经科应参与这些患者的管理。
这项调查突出了全科医生对功能性癫痫患者的态度以及使用的描述性术语。我们的研究结果表明,需要向全科医生更好、更清晰地提供有关这种疾病的信息。