Abstracts

RATIONALE: The duration of seizure has been identified by many investigators as associated with increased morbidity and mortality. Hence the time from onset to initial treatment is important. The objective of this study was to examine the time delay from onset to initial treatment in a database of 889 patients admitted to the greater Richmond area over a 5 year period (1988-1994). This period of study was prior to the widespread use of rectal AED[ssquote]s. Our goal was to establish feasibility of more immediate treatment by first provider personnel.
METHODS: The seizure database maintained prospectively at the Medical College of Virginia was queried to extract the time to seizure treatment of all patients (n=889) as well as the time to seizure stop. In addition, the study cohort was subdivided into age groups greater and less than 16 years.
RESULTS: The distribution of time to treatment varied over a broad range. A total of 41.5 % of all patients received first AED dose within 30 minutes, 29.4 % within 30-60 minutes, 11.00 % 60-90 minutes and 18.1 % greater than 90 minutes. 6.4 % of the study group received first AED greater than 4 hours. Children less than 16 years of age comprised 29.7 % of the study population however there were no significant differences in time to treatment as a function of age. Seizure was controlled within 1 hour in 57% of patients. 2 % of patients arrived at hospital within 1 hour. Of those patients with time to treatment exceeding 4 hours, 27% could not be controlled within 4 hours.
CONCLUSIONS: Time to treatment remains prolonged and is a major factor in the ability to control seizure both in adults and children.
Support: Elan Pharmaceuticals
Disclosure: Grant - Funded by a Research Grant by Elan Pharmaceuticals