Background and aims Epilepsy is a common neurological disorder. We are developing services for children with epilepsy (CWE) at Al-Ain hospital. Aiming to improve services we conducted an audit to evaluate the assessment of all CWE against NICE guidelines.
Methods Cases were identified from the hospital database. Retrospectively, electronic case notes of children presented with a diagnosis of seizure (s) between 1/7/2011 and 31/3/2014 were reviewed. Each note of all children meeting inclusion criteria was evaluated, twice independently, using modified Epilepsy 12 performance indicators.
Results 395 children were identified with a diagnosis of seizure(s). 91 fulfilled entry criteria.
1. 70/91 were referred to epilepsy-expert paediatricians.
2. 58/70 were seen within 2 weeks.
3. None seen by epilepsy nurse (Unavailable).
4. 91/91 had full history and examination.
5. 91/91 with a diagnosis of epilepsy were on AED(s).
6. 20/91 had discussion (s) regarding AED adverse effects.
7. 40/91 had seizure type classified.
8. 11% had syndrome classification.
9. 15 had EEG after first afebrile seizure.
10. 31/39 MRIs done were indicated.
11. 8/91 had ECG.
12. 31/91 had documented rescue plan and 14/37 had Rescue-AED(s) when indicated.
Conclusion(s) 1. Inadequate discussion(s) of AED side effect, rescue plan(s) and prescribing home Rescue-AED.
2. Suboptimal use of EEG and ECG.
3. Low evidence of seizure(s) and syndrome classification.
We recommend 1. Appointment of a paediatric epilepsy specialist nurse.
2. Promotion of awareness of indications of EEG and ECG in children with seizure(s).
3. Promotion of attendance to epilepsy training (Dubai PET1 and PET2) courses.