Importance of prompt diagnosis in pediatric epilepsy outcomes

Purpose: Recognition of childhood epilepsy has improved worldwide. Children with epilepsy require immediate healthcare evaluation and monitoring. The interval between the onset of the first seizures and pediatric neurology assessment may influence the epilepsy outcome at follow-up assessments. This study aimed to assess the quality of medical care for children with first seizure onset and determine the impact of pediatric neurology clinic waiting times on epilepsy outcomes. Methods: This was a retrospective cohort study based on chart reviews and included patients who underwent their first seizure evaluation at the Royal University Hospital in Saskatoon, Canada between January 1, 2012 and December 31, 2015. Waiting time (the time interval between seizure onset and the first clinical assessment) and baseline factors were examined in relation to epilepsy outcome on follow-up. Results: Of a total 1157 patients evaluated for epilepsy for the period 2012-2015, 197 patients had unprovoked seizures and were eligible for this study. The mean age of the patients at seizure onset was 5.6 (+/- 5.1) years. The mean waiting time was 4.33 months and the mean follow-up time was 20.9 months. Shorter waiting times in the clinic led to a more favourable seizure outcome. Of the 197 assessed at the last seizure assessment, 132 (67 %) patients had a favourable epilepsy outcome with no seizures at follow-up appointments and 65 (33 %) showed an unfavourable epilepsy outcome with persistent seizures at follow-up appointments. Conclusion: Early assessment of first seizure onset is crucial for the management of children with epilepsy. Waiting time and other factors may influence epilepsy outcome, and represent opportunities to improve standard medical care.