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Treatment of physicians with epilepsy

From the Departments of Neurology (J.W.A., O.D.), Radiology (J.W.A), Neurosurgery (O.D.), and Psychiatry (O.D.), New York University School of Medicine, NY.

Address correspondence and reprint requests to Dr. O. Devinsky, Comprehensive Epilepsy Center, New York University Medical Center, 403 E. 34 St., New York, NY 10016 od4{at}nyu.edu

Background: Physicians with epilepsy (physician–patients) are an understudied, unique patient population due to the potential adverse outcomes that seizures or medication side effects might have on patients under their care, as well as their ability to modify treatments without consulting treating physicians. We examine the effect epilepsy has upon physician–patients as well as surveying epileptologists on their views and experiences in treating physician–patients.

Methods: We reviewed charts to assess the clinical course of all physician–patients treated and distributed a questionnaire to active physician–patients at our epilepsy center. We surveyed epileptologists throughout the United States on their experience and views on treating physician–patients.

Results: Seventy-three percent of responding physician–patients experienced seizures while in a medical setting, 55% while interacting with patients, and 18% during invasive procedures. Eighteen percent of physician–patients felt seizures impacted their work and 9% were on disability secondary to epilepsy. Among epileptologists surveyed, 35% would counsel and manage physician–patients differently than other patients and 26% favored establishing guidelines or regulations governing physician–patients. The majority of physician–-patients and one-third of epileptologists felt that physician–patients were most analogous to professions that are currently regulated by the federal government.

Conclusion: This study highlights the diverse ways that epilepsy can affect physician–patients and the challenges that arise in treating this unique patient population.

GLOSSARY: AED = antiepileptic drug; CPS = complex partial seizure.

Supplementary data at www.neurology.org

Disclosure: The authors report no conflicts of interest.

Received July 18, 2006. Accepted in final form February 20, 2007.