Abstracts

Rationale: Patients with seizures may have a diminished quality of life from activity restrictions put in place by physicians concerned that seizure-related injury may occur. Some literature suggests that seizure-related injury is uncommon. Care should be taken to not recommend excessive restriction of activities. Our aim was to determine how resident physicians counsel patients with seizures on driving, dangerous work conditions, recreation, and activities of daily living (ADL). Methods: Investigators recruited internal medicine, neurology, neurosurgery, and pediatrics resident physicians to complete a pilot survey. In the survey, patients experienced complex partial seizures and controlled seizures were defined as being seizure-free for 6 months. Survey participants received the Florida Department of Highway Safety and Motor Vehicles (F-DOHSM) guidelines for applicants with seizures after survey completion for driving recommendation education. Results: A total of 28 residents completed the survey, including 4 internal medicine, 11 neurology, 4 neurosurgery, and 9 pediatric residents. Level of training ranged from post-graduate year one to five. Most residents n=22 (78.6%) reported driving precautions counseling. Twenty one (75.0%) residents knew that, in Florida, patients should be seizure-free for 6 months before requesting reinstatement of driving privileges from the F-DOHSM. Seventeen residents (60.7%) reported counseling on dangerous work conditions including standing at a height, operating heavy equipment or power tools, or lifting heavy objects. Nineteen (67.9%) residents felt patients should be compliant with anti-epileptic medication and have controlled seizures before working under these conditions. Seventeen (60.7%) felt safety equipment and supervision should be in place, and 9 (32.1%) thought the patients employer should be aware of the seizure diagnosis. Most residents, n=22 (78.6%) reported counseling on sports and recreation. Twenty six (92.8%) residents felt patients with controlled seizures can swim with supervision. However, for patients with uncontrolled seizures, 19 (67.9%) residents recommended no swimming regardless of supervision. When asked about specific sports, residents allowed greater participation for those with controlled versus uncontrolled seizures (Table 1 and 2). Golf and tennis were most commonly allowed. Gymnastics, hockey, and speed skating were least commonly allowed. Twenty two (78.6%) residents reported ADL counseling. Fifteen residents (53.6%) recommended no bathing restrictions for controlled seizure patients. Bathing with supervision was most commonly recommend n= 19 (67.9%) for uncontrolled seizure. Showering only was recommended by 8 (28.5%) for uncontrolled seizures, and 5 (17.9%) for controlled seizures. Conclusions: Resident physicians play an important role in activity counseling for patients with seizures. Education on activity recommendations would likely be beneficial for resident physicians and patients with seizures, and further research to develop recommendation guidelines is needed.