Abstracts

To assess increasing capability of residents by level of training to recognize and treat two distinct and important epilepsy syndromes. An observational, cross sectional study was performed among the residents of the neurology program of the University of Medicine and Dentistry of New Jersey at Newark. Two vignettes of a typical case of Juvenile Myoclonic Epilepsy (JME) and Mesial Temporal Lobe Epilepsy (MTLE) respictively were presented to the residents. A questionnaire was provided to the residents with questions regarding diagnosis, EEG features, treatment and prognosis. The questionnaire was scored by means of a self designed scoring protocol.
ANOVA of scores between groups of residents stratified by training year and combined in junior and senior groups was performed, and also versus 2 control groups of Board Certified/Board Eligible (BC/BE) neurologists with and without extra training in EEG/epilepsy. Diagnostic and therapeutic awareness of JME was significantly different between groups. Diagnostic and therapeutic awareness was significantly better in senior (PGY3-4) residents compared to junior (PGY1-2) residents. Diagnostic and therapeutic awareness was not significantly better between residents of all separate training years and neurologists without extra training in epilepsy. Diagnostic and therapeutic awareness was significantly better in neurology attendings with training in epilepsy when compared to residents and neurologists without training in epilepsy.
Diagnostic and therapeutic awareness of MTLE was significantly different between groups. Diagnostic and therapeutic awareness was significantly better for PGY4 residents compared to PGY1 residents. Diagnostic and therapeutic awareness was not significantly better between residents and neurologists without extra training in epilepsy. Diagnostic and therapeutic awareness was significantly better in neurology attendings with training in epilepsy when compared to junior and senior residents and neurologists without training in epilepsy. Diagnostic and therapeutic awareness of JME and MTLE remains poor among residents and neurologists without training in epilepsy. Syndromic diagnosis of epilepsy continues to remain suboptimal, with negative repercussions for therapeutic management. Optimal management for patients with epilepsy is with neurologists with special expertise in epilepsy.