BMJ Awards 2019: Education Team of the Year

Epilepsy safety education

There are around 600 sudden unexpected deaths in epilepsy (SUDEP) in the UK every year. National Institute for Health and Care Excellence guidelines since 2004 suggest that doctors should have a discussion about SUDEP with patients who are newly diagnosed with epilepsy, but evidence suggests it is carried out in less than 40% of cases, says Rohit Shankar, consultant in adult developmental neuropsychiatry at Cornwall Partnership NHS Foundation Trust.

In 2012 a team from the trust, sponsored by the charity SUDEP Action, reviewed the evidence for risk factors of SUDEP and developed a seizure safety checklist. This checklist is now used routinely in epilepsy clinics throughout the UK.

“Then we thought, why not also empower people to monitor their own risk?” says Shankar. The team worked with SUDEP Action, Royal Cornwall Hospitals, and Plymouth University to produce an epilepsy risk self monitoring app.

The free app, EpSMon (https://sudep.org/epilepsy-self-monitor), asks the patient a series of questions about medication, comorbidities, seizures, mental health, and social factors such as alcohol intake and sleep disturbances. It helps the patient assess their risk factors and encourages them to contact their doctor if their risk is high.

A recent evaluation of 2483 patients who had used the app found that 21% reported they had had no contact with a GP or epilepsy specialist in the previous 12 months. Within this subgroup, there was a high prevalence of epilepsy risk symptoms including tonic clonic seizures, nocturnal seizures, and change in seizures.

Focused Acute Medicine Ultrasound

When acute patients come into hospital there are limitations to what we can find out with a chest x ray and a stethoscope, says Martin Daschel, acute medical consultant …