2020 Volume 37 Issue 3 Pages 755-765
Purpose; We have to understand some differences of current clinical circumstances and social welfare works between metropolitan and local areas in Japan, when we discuss to establish a medical cooperation system for epilepsy. The Japan epilepsy society (JES) surveyed current situations and problems on cooperative relationship using a questionnaire from medical doctors who have treated patients with epilepsy at metropolitan areas. The purpose of this work is to make plan for practical clinical network on epilepsy. Methods; Target areas on this survey were Tokyo 23 district, Kanagawa, Aichi, Osaka, and Fukuoka prefectures. The JES obtained some answers from chiefs doctors whose facility had at least a full-time doctor in neurology, neurosurgery, pediatrics, psychiatry, and emergency departments, and was possible to examine MRI and EEG. The JES also asked some questions to boarded epileptologists working at the treatment and welfare center, and private clinic on epilepsy. Results; We obtained 214 answers from 1,312 doctors in five areas, and response rate was 16.3%. A characteristic of respondents in this study was accounting for 47.9% of pediatrician. Possible examinations at responders facilities were standard EEG (97.2%), therapeutic drug monitoring (96.7%), MRI (92.4%), neuropsychological test (69.7%), and video EEG monitoring (24.2%). All aged patients were acceptable by 66.7% of hospitals. Acceptance ratio of candidates for epilepsy surgery and of patients with psychiatric symptoms were 11.7% and 17.9%, respectively. The most frequent reason of unacceptance was having severe psychiatric symptom by 79.1%. Making circumstances that physicians easily ask some questions to epileptologists (59.3%) and offering some educational programs on epilepsy (57.9%) were important to make cooperation medical system for epilepsy. Discussion; The number of epilepsy center in metropolitan area is still few for population. To increase number of epilepsy center and establish a medical cooperation system for epilepsy based on educational programs are required. Make some regional medical cooperation systems within the metropolitan areas is needed for patients and family with epilepsy.
