Clin Med
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Epilepsy is common and has a variety of causes and associated pathologies. Increased understanding of the pathophysiology underlying the epilepsies and advances in classification, diagnostic imaging and drug treatments have led to a reduction in stigma and growing demand for services to be improved for patients. A number of important reports and guidelines have emerged in the UK in recent years, which are summarised here. Diagnosis, classification, management and models of care are discussed as well as the management of drug intractable seizures, status epilepticus, and approaches to special patient groups: women in the fertile years, the elderly and those with learning difficulties.
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ABSTRACT - The scale of pain intensity (SPIN)-screen is a simple visual tool for the screening and measurement of pain intensity, which is designed to be accessible by patients with cognitive and communication problems. It was applied prospectively in a consecutive cohort of 79 patients admitted to a tertiary specialist neurorehabilitation unit, of which 86% had significant cognitive/communicative disabilities. In all, 71 patients (90%) responded to the SPIN. ⋯ Repeat testing after 24 hours provided preliminary evidence for the stability and responsiveness of the SPIN-screen, but these require further evaluation. Of those who expressed a preference for one tool over the other, 70% preferred the SPIN. The study provides support for application of the SPIN-screen as a routine screening tool in this group of patients.