The efficacy of a seizure assessment risk tool in predicting occurrence of tonic-clonic seizures

Dunbar, Jill (2015) The efficacy of a seizure assessment risk tool in predicting occurrence of tonic-clonic seizures. D Clin Psy thesis, University of Glasgow.

Abstract

Background: Previous research has identified that the occurrence of a Global Tonic Clonic Seizure (GTCS) is a high risk factor for serious injury or death within the epilepsy population. Fast intervention during a GTCS accompanied by EEG suppression is needed to reduce the risk of serious injury or death. Research has suggested that intervention should optimally occur within 50 seconds of EEG suppression commencing. Identifying patients who are at greatest risk of GTCS could enable targeted monitoring of patients and facilitate quicker intervention. However, at this time there are no specific guidelines for risk assessment in regards to risk of GTCS. The William Quarrier’s Scottish Epilepsy Centre (SEC) developed a Seizure Assessment Risk Score (SARS) tool for use in Video Telemetry (VT) epilepsy units based on risk factors highlighted by previous research. The SARS was implemented with all new admissions to the SEC and data was collected on seizure activity through routine clinical practice.

Aim: The aim of this study was to investigate the efficacy of the SARS tool at predicting the occurrence of GTCS activity in patients admitted to the SEC.

Methods: Seizure activity data and daily SARS scores were collected from 37 patients admitted to the SEC over an 8 month period. The data were then explored to determine if there was a predictive relationship between higher SARS scores and GTCS occurrence.

Results: Data from 37 patients indicated that there was no significant relationship between higher scores on the SARS and the incidence of GTCS. The current SARS tool does not appear to adequately differentiate between those patients who do experience a GTCS during their admission to the VT unit and those who do not.

Conclusion: The study highlights that the SARS tool requires further development to ensure that patients are adequately assessed for risk of experiencing a GTCS. While the majority of the sample was rated ‘high risk’ according to the SARS tool, the incidence of GTCS was in fact relatively low. The study also discusses the difficulties surrounding risk assessing an already specialised and clinically risky population.

• Item Type: Thesis (D Clin Psy)
• Qualification Level: Doctoral
• Keywords: Epilepsy, generalised seizure, video telemetry, risk assessment
• Subjects: B Philosophy. Psychology. Religion > BF Psychology
• Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Supervisor's Name: Evans, Professor Jonathan
• Date of Award: 2015
• Depositing User: Ms Jill Dunbar
• Unique ID: glathesis:2015-6840
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 09 Nov 2015 14:40
• Last Modified: 18 Nov 2015 16:47
• URI: https://theses.gla.ac.uk/id/eprint/6840