Impact of waiting time for first clinic assessment and seizure outcomes of pediatric epilepsy
Introduction: Pediatric epilepsy has increased in global incidence. Children with epilepsy require immediate healthcare evaluation and monitoring. Waiting times between first seizure onset and pediatric neurology assessment may impact seizure outcome at follow-up. Quality of medical care for children with first seizure onset will be assessed and the impact of pediatric neurology clinic waiting times on seizure outcomes will be determined. Methods: This retrospective study, based on chart review, includes patients with first seizure evaluation at the Royal University Hospital in Saskatoon between January 2012 and December 2015. The interim period before first assessment and other factors were studied in relation to seizure outcome on follow-up. Results: 1158 patients were assessed. 197 patients had epileptic events. The mean age of patient at diagnosis was 6.2 years (±5.2). The mean waiting time for assessment by a pediatric neurologist was 4.3 (±3.6) months. The mean duration of follow-up was 20.9 (±11.0) months. At the last seizure assessment, 132 patients were seizure-free and 65 patients had seizure recurrence. Factors independently associated with poor seizure outcome included waiting time, language not age-appropriate, and gait not age-appropriate. Factors collectively associated with poor seizure outcome included waiting time and gait not age-appropriate. Total number of anti-epileptic drugs was significant at 18 months in both univariate and multivariate models. Conclusion: First seizure assessment is crucial for management of children with epilepsy. Waiting time and other factors may influence seizure outcome, representing opportunities to improve standard medical care.
seizure, pediatric, epilepsy
Master of Science (M.Sc.)
Community Health and Epidemiology
Community and Population Health Science