Anna L. Firkin|David Marco|Sibel Saya|Mark R. Newton|Terence J. O’Brien|Samuel F. Berkovic|Anne M. McIntosh
Mind the gap: Multiple events and lengthy delays before presentation with a “first seizure”
Royal Melbourne Hospital|University of Melbourne|Austin Health|University of Melbourne|Austin Health|University of Melbourne|Austin Health|Royal Melbourne Hospital|University of Melbourne|Austin Health|University of Melbourne|Royal Melbourne Hospital|University of Melbourne|Austin Health
half patients assessed suspected newonset epileptic seizures report previous undiagnosed events suggests delay timely expert assessment major issue little known degree delay nature undiagnosed events impacting understanding newonset epilepsy study aimed examine events occur presentation well extent risk factors delay assessmentincluded retrospective study 220 patients diagnosed first seizure clinic austin health australia 2003 2006 epileptic index seizure patients prior diagnosis epileptic seizures excluded chart review undertaken including detailed interviews conducted epileptologist first assessment logistic regression assessed risk factors delay first event presentation including event characteristics socioeconomic disadvantage employment distance medical facilityfortyone percent n 90 patients one event index seizure 50 multiple five prior events 28 experienced one convulsive event index seizure total 220 patients 36 delayed presentation 4 weeks 21 delayed 6 months 14 delayed 2 years first events without convulsions features likely disrupt behaviour strongly associated delay p 0001 relative socioeconomic disadvantage also associated delay presentation p 004our findings suggest gap early diagnosis care sizable proportion newonset cases despite first world urban environment availability free basic medical care delay appears particularly likely events nonconvulsive lowimpact suggesting seizure types may underrepresented studies newonset epilepsy implications understanding incidence evolution impact treatment response newonset epilepsy