Abstracts

Developing a seizure emergency treatment plan enables efficient management of seizure emergencies and decreases the potential for seizure-related complications. Individualized treatment plans provide for more patient and caregiver control in seizure emergencies, minimize the effect seizures have in the workplace or at school, and may reduce the need for access to emergency medical care. Recent emphasis has been placed on seizure emergency treatment plans for school-aged children; however, adults who experience seizures would also benefit from a predetermined course of action for seizure emergencies. A comprehensive review of the components associated with seizure emergency treatment plans for school-aged children, along with a literature review and clinical experience with adult patients with seizures, revealed that a seizure emergency treatment plan for adults would be a practical and comprehensive adjunctive treatment approach. The unique needs of adult patients were taken into consideration to develop a protocol for designing seizure emergency treatment plans for an adult population. A 5-phase protocol to develop seizure emergency treatment plans for adult patients with seizures was created. In Phase I, patients who would benefit from plan development are identified; patients who require emergency medical transport for prolonged seizure episodes, patients whose antiepileptic drug regimen is being changed, and patients who are severely affected by their seizure activity are candidates. In Phase II, key plan components are identified, including seizure presentation and history, recognition of seizure emergencies, seizure first aid, and caretaker designation. If emergency seizure treatment includes seizure rescue medication, diazepam rectal gel (Diastat^[reg]) information (eg, administration instructions, time to stop seizures, instructions regarding repeat dosing, patient care) is delineated. In Phase III, specific steps needed to implement the plan are addressed, including caregiver education, use in patient-specific environments (eg, at work, while traveling), and removal of perceived obstacles to success. In Phase IV, efficacy, safety, ease of implementation, and patient and caregiver satisfaction with the plan are evaluated. Phase V allows for plan modification based on the evaluation as well as changes in seizure presentation and patient physical characteristics. Adult patients who experience seizures have unique treatment needs that warrant the development and implementation of individualized seizure emergency treatment plans for optimal management of seizure activity. (Supported by Valeant Pharmaceuticals.)