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Do patients presenting to accident and emergency departments have low serum anticonvulsant concentrations?
  1. D G Snow,
  2. S H Jackson,
  3. D Skinner,
  4. R M Burton,
  5. A H Williams
  1. Accident and Emergency Department, St Bartholomew's Hospital, London, U.K.


    It is often felt that poorly controlled epileptic patients, who are taking anticonvulsant medication, are over represented in A&E departments compared to the general population. This A&E based study set out to determine whether such patients do have inadequate serum anticonvulsant levels, when they present following a seizure, to A&E departments. All epileptic patients, taking medication, who presented to the A&E departments of St. Bartholomew's and Hackney Hospitals, London, over a 4-month period were studied. Serum anticonvulsant concentrations were measured on their arrival in the departments. Forty-six patients were studied. Only 21% of anticonvulsant drug concentrations were within 'therapeutic' ranges. A total of 66% were below 'therapeutic' ranges and 13% were potentially toxic. The implication of these findings is discussed.

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