Biomedical subjects

Geir Bråthen

Publications and source records attributed to Geir Bråthen.

4 recordsLinked to original sources

PubMed2005

A structured, nurse-led intervention program improves quality of life in patients with epilepsy: a randomized, controlled trial.

We tested the hypothesis that structured epilepsy nursing improves quality of life (QOL). One hundred fourteen adult patients with uncontrolled epilepsy were randomly assigned to either an intervention group or a control group. The intervention group was offered an interactive, 1-day group education program followed by extended nurse follow-up and counseling. The nurse was present at as many outpatient consultations as possible and performed repeated consultations by telephone. All patients completed the QOLIE-89 before randomization and after 2 years. QOL was significantly improved from inclusion to completion of study in the intervention group (P=0.019), mainly in the subitems for Health Discouragement (P=0.01), Medication Effects (P=0.035), and Physical Role Limitations (P=0.05). To our knowledge, this is the first study to demonstrate a significant effect of a structured nurse-led intervention program in QOL of patients with epilepsy.

Adolescent↗

PubMed2004

[Disagreement about epilepsy and driving].

BACKGROUND: To find out how current regulations concerning epilepsy and driving licence are applied in clinical practice in Norway. MATERIAL AND METHODS: A questionnaire was sent to all 344 members of the Norwegian Neurological Association. RESULTS: 56% responded within 3 months, most of them (152) working in the field of clinical neurology. The majority (73%) did not see reporting a "situation-related" seizure to the authorities as obligatory, but almost all of these respondents (94%) would temporarily disallow driving. 60% did not consider it obligatory to report the exclusive occurrence of simple partial seizures with retained consciousness and motor control. A surprisingly large number (36%) would never recommend dispensation from the rule instituting a one-year driving ban. 39% generally used EEG in the assessment of driving fitness, whereas 17 % rarely did so. Only 50% instructed their patients not to drive during antiepileptic drug withdrawal. 45% did not consider seizure recurrence resulting from consented withdrawal to activate the obligation to report. CONCLUSION: There is poor consensus among neurologists on many aspects of driving and epilepsy, particularly on the assessment of risk when drugs are withdrawn. These issues should be focused on in graduate and postgraduate education in clinical neurology.

Anticonvulsants↗

PubMed2003

[Alcohol and epilepsy].

BACKGROUND: Although alcohol-related seizures have been recognized since antiquity, their pathophysiology, classification and treatment options remain unsettled. MATERIAL AND METHODS: On the basis of clinical studies experience and literature searches, a review of classification, diagnostics and treatment of alcohol-related seizures is given. RESULTS: The best-described entity is the alcohol withdrawal seizure, usually occurring within 48 hours after cessation of drinking. However, alcohol can also trigger seizures unrelated to withdrawal, impair seizure control in epilepsy, and has the potential to induce epilepsy. Approximately one third of patients being hospitalized for acute seizures have overused alcohol prior to the seizure. The clinical diagnosis is based on a thorough medical history. The Alcohol Use Disorders Identification Test (AUDIT) provides a reliable measure of drinking habits. Carbohydrate-deficient transferrin (CDT) is the best biomarker for alcohol abuse available and a good supplement to the clinical investigation. The diagnostic value of EEG is limited. INTERPRETATION: Acute seizure management does not differ from that of other seizures. After a withdrawal seizure, prophylactic medication should be restricted to the first few days: In co-existing epilepsy and alcohol abuse, anti-epileptic drugs should be used with caution. There is little evidence to support the general advice that well-controlled epilepsy patients need to abstain completely from alcohol.

Alcohol Drinking↗

PubMed2003

An easily performed group education programme for patients with uncontrolled epilepsy--a pilot study.

The factual knowledge of epilepsy is often insufficient among patients with this disorder. Compliance problems due to ignorance are common, and counselling is extremely important. We have developed a simple 1-day, low-cost group education programme for patients with epilepsy, intended to be suitable in routine care. The programme aims to help patients to achieve an improved understanding of the disorder and was carried out for a total of 54 consecutive patients with at least one seizure during the last year. This hospital-based 6-hour interactive course is organised by an epilepsy nurse and contains the following elements: basic knowledge about epilepsy, living with epilepsy, visit to the EEG lab, social security system and medical treatment. It was evaluated by means of a semi-structured interview and was found generally useful by all the participants. Sixty-five percent considered the sharing of experience with other patients to be the most valuable element. The ideal group size was found to be six to eight. Heterogeneity concerning age, sex and competence seemed to increase the interaction within the groups. This pilot study indicates that group education may be a useful approach in the clinic.

Adolescent↗