Assessment of the knowledge levels and attitudes of physicians regarding the management of acute seizures in pediatric patients

INTRODUCTION: To evaluate the knowledge levels and attitudes of physicians regarding acute management of seizures in pediatric patients.
METHODS: A self-administered questionnaire was distributed electronically to physicians. The participants were divided into 3 groups according to the estimated number of patients managed by the physician due to acute seizures per year; i) group-1: ≤10, ii) group-2: 11-50, iii) group-3: ≥51. Also, the participants were categorized whether they were pediatricians or not. Demographical features, and administration details regarding first- and second-line therapy were questioned. Rates of correct answers were compared between the groups.
RESULTS: A total of 400 physicians responded to the questionnaire. Precisely, 74.5% of participants were pediatricians. The time point t1 for tonic-clonic SE and focal SE with impaired consciousness were the least known details. Rates of correct answers to questions of the maximum number of benzodiazepines in case of ongoing seizures (p<0.001), intravenous diazepam dose (p=0.017), and diazepam infusion time (p=0.034) were significantly higher in group-3. Also, there was a tendency to administer lower doses of levetiracetam (p=0.003) and phenytoin (p>0.001), and prefer longer durations for phenytoin (p=0.003) in group-1 and group-2. Rates of correct answers to questions regarding the approach to patients who presented during the postictal period (p<0.001), the time point t1 for tonic-clonic SE (p=0.07), the maximum number of benzodiazepines in case of ongoing seizures (p<0.001), diazepam infusion time (p<0.001), and co-administered liquid for phenytoin (p=0.043) were higher in pediatricians. Additionally, there was a significant tendency to administer lower doses of levetiracetam (p<0.001) and phenytoin (p<0.001), and prefer longer durations for levetiracetam (p<0.001) and phenytoin (p<0.001) in physicians other pediatricians.
DISCUSSION AND CONCLUSION: There is a wide variation in knowledge levels and attitudes among physicians. Post-graduation education programs focusing on the least-known and important details are needed.