Ballast, Jorn (2025) ‘First-seizure’ spreekuur leidt tot verbeterde diagnostische efficiëntie bij kinderen met een eerste voor epilepsie verdachte aanval Een zorgevaluatieonderzoek naar de impact van een specialistisch spreekuur op het zorgpad bij kinderepilepsie. thesis, Medicine.
Full text available on request.Abstract
Background: In the Netherlands, 2,300 children are diagnosed with epilepsy each year. The diagnostic process is challenging, with the risk of burdensome overdiagnosis and unnecessary treatment. To prevent this, the multidisciplinary 'first-seizure' consultation hour (FS-consultation hour) was set up at Isala. This study evaluates the effect of the FS-consultation hour on diagnostic and therapeutic strategies in the care of children with a first seizure suspected of epilepsy. Methods: This observational comparative cohort study compares a prospective cohort that was seen within the FS-consultation hour design (2020 to 2024) with a retrospective cohort that was seen before this design (2016 to 2019) at Isala. The groups were compared on the number of requested and abnormal additional imaging (EEG and MRI) and prescribed anti-epileptics. Results: 554 children were included (247 prospective, 307 retrospective). In the prospective cohort, significantly less additional imaging was performed: the number of 24-hour EEGs (5.3% vs. 13.7%) and standard EEGs (0.4% vs. 5.2%) was lower, as was the number of MRIs (20.2% vs. 42.3%). Anti-epileptics were also prescribed less often after the first consultation (26.7% vs. 36.8%). After correction for confounders, the difference in additional imaging remained significant, but not for the prescription of medication. No significant difference was found in the percentage of abnormal EEGs or MRIs. Conclusion: The FS-consultation hour leads to a more efficient use of additional imaging and possibly a more cautious prescribing policy for anti-epileptics, without loss of diagnostic accuracy. This patient-oriented, multidisciplinary approach can contribute to more effective and less burdensome care for children with a first seizure suspected of epilepsy.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Schoenmaker, Drs. Niels |
| Faculty: | Medical Sciences |
| Date Deposited: | 14 Jan 2026 14:57 |
| Last Modified: | 14 Jan 2026 14:57 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3878 |
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