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Svein Ivar Bekkelund

Publications and source records attributed to Svein Ivar Bekkelund.

12 recordsLinked to original sources
PubMed2006

[Patient satisfaction with assessment of headache by specialist consultation].

BACKGROUND: Headache is a common cause for referral of patients from a general practitioner to a neurologist. We have investigated patient satisfaction with neurological consultations for headache in Northern Norway. MATERIAL AND METHODS: We sent a postal questionnaire to all patients referred for headache from general practice to departments of neurology in Northern Norway from 1998 to 2000. RESULTS: Of 1403 patients, 942 (67%) responded to all relevant items in the questionnaire.160 of the patients were seen in Vefsn, 191 in Bodø and 591 in Tromsø. About 54% (510/942) of the patients were satisfied with the specialist consultation. Patients examined at the department in Bodø were significantly more satisfied (62 %) than patients examined in Tromsø (54%) or Vefsn (44%). Patients investigated in Tromsø reported improvement after treatment significantly more often than those seen in Vefsn. There was no difference in satisfaction between the three locations in the subgroup of patients with migraine. Patients who received a diagnosis or were given some kind of therapy were more content than others. INTERPRETATION: Almost half of the patients were not satisfied with the consultation. The degree of satisfaction varied between departments. More investigations are needed to clarify which patients with headache will benefit from a specialist consultation.

Adult↗
PubMed2005

[Idiopathic intracranial hypertension].

BACKGROUND: Idiopathic intracranial hypertension is a rare syndrome of increased intracranial pressure without a massive lesion or abnormal cerebrospinal fluid. Common symptoms include headache and visual disturbances such as transient visual obscurations or visual loss. Treatment may alleviate symptoms and prevent serious complications. In this study, we present 10 cases illustrating aspects of the disease including causes and treatment options. We also evaluated the effect of treatment and compared the incidence with other studies. MATERIAL AND METHODS: We registered all patients and reviewed the medical notes on patients with intracranial hypertension treated at Tromsø University Hospital over a five-year period (1999-2003). RESULTS AND INTERPRETATION: We identified 10 patients with intracranial hypertension; 6 of them fulfilled the criteria of the International Headache Society for idiopathic intracranial hypertension while 4 had secondary intracranial hypertension caused by medication such as oral contraceptives or tetracycline, or by surgical therapy. Idiopathic or secondary intracranial hypertension should be considered in patients with unexplained chronic headache.

Adolescent↗
PubMed2004

[What do general practitioners expect from the department of neurology?].

BACKGROUND: In the only department of neurology for the two northernmost counties of Norway, activities are organised to minimize waiting time for examination. In order to improve provision of services, we asked general practitioners (GPs) for advice in a questionnaire survey. MATERIAL AND METHODS: A postal questionnaire was sent to all general practitioners in the two northernmost counties of Norway. They were asked to suggest order of priority that might improve care for patients referred for headache and point out patient groups who need better services. RESULTS: A total of 177 out of 269 GPs returned the questionnaire (66%). The highest rated suggested activities were telephone meetings with a specialist and written information with criteria for the selection of patients who need a specialist consultation for headache. Responders were of the opinion that higher priority should be given to primary degenerative disorders of the brain such as Parkinson's disease and dementia disorders. INTERPRETATION: The study showed that better communication between specialists and GPs may improve services for those with headache. Increased knowledge about groups of patients who need improved care could be achieved by asking GPs working in the community for advice.

Family Practice↗
PubMed2003

Prevalence of head trauma in patients with difficult headache: the North Norway Headache Study.

OBJECTIVE: To test whether chronic headache (>3 days/week) is more prevalent than episodic headache (<3 days/week) in patients with a previous history of significant head trauma. METHOD: We included 903 consecutive patients referred to a specialist center for headache during a period of 2 years. As the main parameter, we selected self-reported history of previous significant head trauma defined as loss of consciousness or hospitalization due to head trauma. RESULTS: One hundred eighty-nine out of 903 patients with difficult headache referred to a neurologist had a previous history of head trauma (21%). We identified 297 patients with headache 3 days or more per week (33%). Of these patients with chronic headache, 68 (23%) reported previous significant head trauma compared with 121/714 (17%) in other patients with headache (P =.18). Shorter length of education was associated with chronic headache; however, age, sex, or specific headache syndromes such as migraine or tension headache were not related to chronicity. CONCLUSION: Although the incidence of previous head trauma was prevalent in this highly selected group of patients with headache, such a history was not a predictor of chronicity.

Chronic Disease↗
PubMed2003

Magnetic resonance assessment of the double-crush phenomenon in patients with carpal tunnel syndrome: a bilateral quantitative study.

Our main goal was to assess the coexistence of narrowed cervical foramens and cervical canal stenosis in patients with carpal tunnel syndrome (CTS). We took magnetic resonance (MR) images of 120 wrists and 480 foramens in 60 age and sex matched subjects (30 patients with CTS and 30 controls). All patients had nerve conduction velocity tests before MR examination. We measured the volume of the carpal canal in all participants bilaterally. We also quantified the cross-sectional areas of the cervical foramens on both sides from C4 to T1 and measured the diameter of the cervical canal in all participants. We searched for the prevalence and location of cervical spondylosis and disc prolapse on the side of the symptomatic wrist(s). All patients had CTS-related neurophysiological findings. There was no correlation between the symptoms and the reduced carpal canal volume. The mean (SD) area of the foramens was 109.5 (12.8) mm2 in the patients compared with the controls 126.4 (28.7) mm2 (p = 0.007). Cervical spondylosis and disc prolapse were more common in the patients than the controls at the C5-C6 and C6-C7 levels, and their locations were on the same side as the symptoms in the wrist(s) in 50% of cases. There was no difference in the size of the cervical canal between the two groups. The higher incidence of narrowed cervical foramens in the patients and its concordance with affected nerve roots on the same side as the CTS symptoms support the hypothesis of a double-crush phenomenon.

Adult↗
PubMed2002

Patient satisfaction with a neurological specialist consultation for headache.

OBJECTIVE: To evaluate patient satisfaction with a specialist consultation for headache and thus identify subgroups of headache patients more satisfied than others. DESIGN: A survey of consecutive patients referred to a neurologist for headache. SETTING: Neurological outpatient clinics in North Norway. PATIENTS: We included 889 consecutive patients referred to a specialist centre for headache during a period of 2 years. Using a questionnaire, we recorded patients' satisfaction with the potential treatment initiated by the specialist. RESULTS: Sixty-three percent of migraine patients (95% CI, 0.58 to 0.68) were satisfied with the consultation, compared to 44% of patients with non-migrainous headache (95% CI, 0.40 to 0.70), (p = 0.01). Altogether 481 patients had some kind of measure recommended by the neurologist, and 317 of these (66%) were satisfied (95% CI, 0.62 to 0.70). Patients with tension-type headache and those who were not prescribed specific treatment modalities were less satisfied. CONCLUSION: The study confirms that patients with headache are satisfied with a neurological specialist consideration, especially in the case of migraine.

Adult↗
PubMed2002

Evaluation of referrals from general practice to a neurological department.

BACKGROUND: The presence of neurological deficits as obtained from clinical examination increases the likelihood of detecting serious underlying brain disorders. OBJECTIVES: In this study, we assessed the frequency of reported clinical neurological examination in patients referred to neurology. METHODS: We consecutively evaluated referrals to a neurological centre during a 6-month period. RESULTS: From a total of 716 patients, 377 (51%) had an examination reported in the referral letter. Clinical examinations were reported more often in patients with musculo-skeletal disorders compared with others, P = 0.0001. Examination was less likely to be reported in those with a history of disturbed consciousness. CONCLUSION: By showing that only about half of the patients had an examination reported, the study demonstrates that the process of selecting those with a high priority for a secondary neurological service can be improved.

Adolescent↗
PubMed2002

Clinical outcome and adverse effects of electroconvulsive therapy in elderly psychiatric patients.

We evaluated the short-term outcome and side effects of electroconvulsive treatment (ECT) in a population of elderly psychiatric patients. The material included patients consecutively hospitalized at a psychogeriatric department within a period of 5 years. From a total number of 239 patients, we included 52 treated with ECT (22%). Altogether, 41 patients (79%) improved clinically. Of them, 21 (40%) of the patients went home after the treatment. Twenty patients (38%) developed adverse reactions from the ECT treatment. Impaired memory (14%), confusion (6%), and hypertension (6%) represented the most commonly reported negative reactions secondary to the treatment. The findings from the study support previous assumptions that ECT is effective in the treatment of serious psychiatric disorders in elderly patients. Because of the relative high frequency of side effects, the patients should be selected

Aged↗
PubMedDate not supplied

Aspects of referral care for headache associated with improvement.

OBJECTIVE: To assess which aspects of referral care for headache are associated with improvement of pain and subjective quality of life. BACKGROUND: In managed care, referrals to a specialist are sometimes kept to a minimum. It has been questioned whether patients with headache do better after consultation with a specialist. METHODS: We mailed a questionnaire to all patients referred for headache to a neurologic center in northern Norway during a 2-year period (n = 1403). The questionnaire included items concerning diagnosis and treatment, along with simple visual analog scales to assess whether the patient's headache syndrome and self-perceived quality of life had changed after seeing the specialist. RESULTS: There were 1052 responders (75%). Headache generally decreased after consultation with a specialist; it decreased significantly more in the 527 patients who were assigned a diagnosis compared to the 344 patients who claimed they were not. Reduction of headache also was significantly more obvious in the 483 patients who had treatment prescribed, as compared to the 385 patients not receiving any therapeutic measure. Self-perceived quality of life was generally improved, significantly more when the patient was given a diagnosis, and even when the diagnosis did not lead to treatment. CONCLUSIONS: Patients referred to a neurologic center for evaluation of headache generally experience a significantly greater improvement in their headache syndrome and quality of life. This appears particularly so when they receive a diagnosis, even if no treatment is prescribed.

Headache↗