New Epilepsy Guidelines: Are They Necessary?

Andrew N. Wilner, MD


January 27, 2011

In This Article

Epilepsy Quality Measures

The American Academy of Neurology (AAN) recently published 8 epilepsy quality measures that were developed through the American Medical Association-convened Physician Consortium for Performance Improvement (PCPI).[1] The guidelines were derived from literature published from 1998-2008 that included 160 recommendation statements from 19 sets of guidelines and 2 consensus papers. The 40 member expert panel concluded that, "It is anticipated that implementation of these performance measures will improve care for patients with epilepsy if adopted by providers." These performance benchmarks are summarized below.

AAN and PCPI Approved Quality Measures

1. Document seizure type and frequency;

2. Document epilepsy etiology or syndrome;

3. Review EEG;

4. Review CT or MRI;

5. Discuss antiepileptic drug side effects;

6. Refer patients with drug-resistant epilepsy for surgery;

7. Counsel about safety from seizures; and

8. Counsel women of childbearing potential.

Physicians, physician assistants, nurse practitioners, nurses, and other healthcare providers, all desire the best care for their patients. What "best care" entails depends upon the provider's best judgment. The AAN, promoter of the new epilepsy quality measures, agrees. "The AAN recognizes that specific patient care decisions are the prerogative of the patient and the physician caring for the patient, based on all of the circumstances involved."[2]


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