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Press Release Date: February 22, 2001
A new evidence report developed by the MetaWorks® Evidence-based Practice Center, under contract to the Agency for Healthcare Research and Quality (AHRQ), indicates that the available scientific literature supports the use of a complete history and physical examination, including neuropsychologic assessment and a standard EEG, to diagnose epilepsy, prevent delayed or missed diagnoses, and predict remission outcomes.
The report, Management of Newly Diagnosed Patient with Epilepsy: A Systematic Review of the Literature, also found that other diagnostic tests, such as CT scan or MRI, are more important in ruling out secondary causes of seizures or to resolve uncertain diagnoses. The report also says that the clinical and pharmacologic expertise of the treatment team in selecting and monitoring antiepileptic drugs (AEDs), periodic blood tests, and cognitive tests in children may help improve patient outcomes, but more research is necessary.
The topic of management of newly diagnosed epilepsy was nominated as an EPC evidence report by the Centers for Disease Control and Prevention as part of an effort to develop a framework for providing optimal care to patients with low-prevalence, chronic diseases. The EPC, which reviewed 120 studies taken from 13,128 citations, notes there are limitations in the available evidence, such as no gold standard for diagnosis, poorly defined and inconsistent patient populations, inconsistent terminology, and lack of patient-centered outcomes.
The summary is available online at http://www.ahrq.gov/clinic/epcsums/epilepsum.htm. Print copies are available from the AHRQ Publications Clearinghouse by writing to P.O. Box 8547, Silver Spring, MD 20907, or by calling (800) 358-9295. The EPC summary also is available on the National Guideline Clearinghouse™ (NGC) at http://www.guideline.gov (select NGC Resources). Copies of the full report are expected to be available in late 2001.
For additional information, please contact AHRQ Public Affairs, (301) 427-1364: Karen Migdail, (301) 427-1855 (KMigdail@ahrq.gov).