- CIAP Newsletters
March 2016 Issue 3
Focus on... Neurology
CIAP provides a wide range of resources to support NSW Health staff caring for patients with disorders of the nerves and nervous
system, including epilepsy, stroke, dementia, Alzheimer's disease, neuromuscular disorders, multiple sclerosis, vestibular disorders,
neurological pain, neurodegenerative diseases and more.
The Neurology Specialty Guide, located by selecting
'Specialty Guides & Links' from CIAP's left menu is a good place to browse the resources that are currently available. The guide
contains recommended CIAP resources, a selection of online journals and books along with NSW Health and other recommended guidelines
and websites, including Epilepsy Australia which promotes epilepsy
awareness month in March each year. The Rehabilitation
Specialty Guide may also be of interest, particularly for occupational therapists, nurses, psychologists and other staff working
in rehabilitation settings in hospitals and the community.
A useful resource providing a dedicated topic area for neurology is the Cochrane Library.
Found through 'Evidence-Based Practice' in CIAP's left menu, Cochrane provides a comprehensive database of systematic reviews. On the Cochrane
homepage, scroll down the page to find the Browse by Topic section. Select 'Neurology' to find systematic reviews and/or
protocols in 24 sub-categories including stroke (220 documents in 9 categories), multiple sclerosis (61 documents), Motor neurone
disorders (27 documents) and fibromyalgia (30 documents).
The Cochrane Library also provides access to the Cochrane Journal Club,
where you can access podcasts, downloadable PowerPoint slides, discussion points and clinical scenario presentations on a range of
systematic review topics for discussion in the clinical setting. Of particular interest may be
#54 Treatment for
epilepsy in pregnancy: neurodevelopmental outcomes in the child, #52 Thrombolysis for acute ischaemic stroke and #39 Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery. You can find the Journal Club by
selecting 'More Resources' on Cochrane's homepage.
Other CIAP resources that provide topic areas for neurology include BMJ Clinical Evidence and the Therapeutic Guidelines (eTG). Simply select the neurology topic on the selected resource homepage
to view the information available.
CIAP's left menu provides access to a number of eBooks via 'Books & Dictionaries' including:
- Adams and Victor's Principles of Neurology, 10e (2014) Allan H. Ropper, Martin A. Samuels, Joshua P. Klein.
Chapter 16: Epilepsy and Other Seizure Disorders
- Harrison's Principles of Internal Medicine, 19e (2016) Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo
Part 17: Neurological Disorders (Chapter 445: Seizures and Epilepsy)
- Clinical Neurology, 9e (2016) Michael J. Aminoff, David A. Greenberg, Roger P. Simon
- CURRENT Diagnosis & Treatment: Occupational & Environmental Medicine, 5e (2014) Joseph LaDou, Robert J. Harrison
Chapter 11 covers the topic: Neurology of pain
platform for viewing eBooks also provides links to multimedia, slides, algorithms, flow charts, videos of neurological examination
techniques, case studies and images. These can be accessed from the top menu options. Allied health topics can also be searched, as
well as a wide variety of patient education leaflets.
The New England Journal of Medicine (NEJM)
provides access not only to the latest edition of the journal itself, but also to a range of multimedia options. From the NEJM homepage, use
the top menu to select and view the 'Neurology/Neurosurgery' specialty area. This will allow you to view articles from multiple NEJM issues
about this topic, along with podcasts, videos, key research and information about related conferences and more. You can also subscribe to
receive updates on specialty topics by selecting the 'Sign Up' link located on the right of the specialty page.
To learn more about specific diseases and conditions, you can utilise the search features in
BMJ Best Practice, Harrison’s Principles of Internal Medicine, PEMsoft and eTG, to
locate information about a disorder. Try searching 'epilepsy' to see the range of evidence-based information that each resource provides.
BMJ Best Practice, for example, provides condition monographs for various types of seizures in adults and children, a patient information
leaflet, links to systematic reviews, assessment guidelines (including emergency and urgent considerations) and treatment protocols.
To learn more about the resources available through CIAP, visit the Learning
Centre for a range of workshops, user guides, elearning modules and video tutorials.
New CIAP Specialty Workshops open for registrations
Registrations are open for CIAP's new specialty workshops Emergency & Critical Care and Paediatrics.
The CIAP Emergency & Critical Care Workshop will be held on 21 April at Royal Prince Alfred Hospital and will focus on access
and navigation of CIAP resources in the emergency, critical care and ambulance contexts. Staff located statewide from Emergency,
Ambulance, ICU, NICU, Perioperative, High Dependency and Organ Transplant departments are welcomed to attend.
The CIAP Paediatrics Workshop will be held on 11 May at the Children's Hospital at Westmead and will focus on accessing CIAP
resources and evidence relevant to paediatric practice. NSW Health staff working across all NSW locations are welcomed to attend.
The programs for these and other specialty workshops are available from CIAP's
Knowledge Centre, accessible from the top menu bar. Registration is through HETI Online, where your attendance
will be logged in your learning history.
Other specialty workshops being held in 2016 include Allied Health, Evidence-Based Practice, Mental Health, CIAP Train the
Trainer and Community Health.
If you would like to register for a CIAP workshop, but don’t have a HETI Online login, please contact the
Article in Focus
Epilepsia 56(10): October 2016, p 1515-1523
The International League Against Epilepsy (ILAE) charged a Task Force to revise concepts, definition, and classification of status
epilepticus (SE). The report concluded:
The revised definition is conceptual, with two operational dimensions, t1 and t2:
- the first is the length of the seizure and the time point (t1) beyond which the seizure should be regarded as
“continuous seizure activity.”
- the second time point (t2) is the time of ongoing seizure activity after which there is a risk of long-term consequences.
Generalized convulsive SE in adults and children older than 5 years was operationally defined as “. . .≥5 min of (1) continuous
seizure or (2) two or more discrete seizures between which there is incomplete recovery of consciousness”.
Gems on CIAP
Drugs used for Parkinson's disease and ‘Parkinson plus’ disorders
Guidelines (eTG) provide clear, practical and comprehensive therapeutic information and guidelines for a range of diseases, disorders and
their treatments. Drawing on the latest international literature, interpreted by some of Australia’s most eminent and respected experts, eTG
focusses on promoting the quality use of medicines in the Australian context.
One of the many tables provided by eTG summarises the various drugs that may be used in the treatment of Parkinson's disease, and is useful
as a quick reference and comparative guide. This table can be accessed by selecting Therapeutic Guidelines and then 'Neurology' from the list
in the centre panel of the opening page. From there, select ‘List of tables, boxes and figures’ (second last option), and open Table 7.9: Drugs
used for Parkinson's disease and ‘Parkinson plus’ disorders.
Table 7.9 lists information about the class and name of drugs, the usual dose range along with comments about dosing, and adverse effects.
Note the orange ‘i’ buttons on the right-hand edge of drugs listed in the table. A drop down menu on each button details the class
of that drug for pregnancy and breastfeeding, as well as PBS information where relevant.
eTG can be accessed from the ‘Medications’ tab on the left menu of the CIAP home page.
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