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Impact of diagnostic delay on seizure outcome in newly diagnosed focal epilepsy
OBJECTIVE: In the current study, we aimed to assess the diagnostic delay and the impact of diagnostic delay on seizure outcome in a cohort of newly diagnosed patients with focal epilepsy. METHODS: The study material was compiled from eight clinical antiseizure medication monotherapy trials conducted...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733655/ https://www.ncbi.nlm.nih.gov/pubmed/33336131 http://dx.doi.org/10.1002/epi4.12443 |
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author | Parviainen, Laura Kälviäinen, Reetta Jutila, Leena |
author_facet | Parviainen, Laura Kälviäinen, Reetta Jutila, Leena |
author_sort | Parviainen, Laura |
collection | PubMed |
description | OBJECTIVE: In the current study, we aimed to assess the diagnostic delay and the impact of diagnostic delay on seizure outcome in a cohort of newly diagnosed patients with focal epilepsy. METHODS: The study material was compiled from eight clinical antiseizure medication monotherapy trials conducted at Kuopio Epilepsy Center during 1995‐2016. We analyzed the time from first seizure to diagnosis, the number of seizures before diagnosis, and the response to treatment at five years. RESULTS: Of the 176 patients (age range 15‐75 years) in the cohort, 135 (77%) had had more than two seizures before treatment. The majority of these (79 patients, 45%) had had three to ten seizures. Median number of all seizures before diagnosis was 5 (range 2‐2000). Focal aware seizures and focal impaired awareness seizures were more frequent than focal to bilateral tonic‐clonic seizures; median number 45 (range 2‐2000), 11 (range 2‐220), and 3 (range 2‐30), respectively (P < .001). Median delay was 12 months (range 0‐362). Diagnostic delay alone did not correlate with the treatment response at five years. However, an increasing number of seizures before diagnosis indicated a worse seizure outcome (P < .001). SIGNIFICANCE: This study shows that patients with focal epilepsy experience significant delays in diagnosis even in developed countries, especially with seizure types other than tonic‐clonic seizures. In these cases, a long delay in diagnosis alone might not affect the long‐term outcome. However, when accompanied with recurrent seizures misinterpreted by the patient or healthcare providers, the effect of such delay on prognosis can be considerable. |
format | Online Article Text |
id | pubmed-7733655 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77336552020-12-16 Impact of diagnostic delay on seizure outcome in newly diagnosed focal epilepsy Parviainen, Laura Kälviäinen, Reetta Jutila, Leena Epilepsia Open Full‐length Original Research OBJECTIVE: In the current study, we aimed to assess the diagnostic delay and the impact of diagnostic delay on seizure outcome in a cohort of newly diagnosed patients with focal epilepsy. METHODS: The study material was compiled from eight clinical antiseizure medication monotherapy trials conducted at Kuopio Epilepsy Center during 1995‐2016. We analyzed the time from first seizure to diagnosis, the number of seizures before diagnosis, and the response to treatment at five years. RESULTS: Of the 176 patients (age range 15‐75 years) in the cohort, 135 (77%) had had more than two seizures before treatment. The majority of these (79 patients, 45%) had had three to ten seizures. Median number of all seizures before diagnosis was 5 (range 2‐2000). Focal aware seizures and focal impaired awareness seizures were more frequent than focal to bilateral tonic‐clonic seizures; median number 45 (range 2‐2000), 11 (range 2‐220), and 3 (range 2‐30), respectively (P < .001). Median delay was 12 months (range 0‐362). Diagnostic delay alone did not correlate with the treatment response at five years. However, an increasing number of seizures before diagnosis indicated a worse seizure outcome (P < .001). SIGNIFICANCE: This study shows that patients with focal epilepsy experience significant delays in diagnosis even in developed countries, especially with seizure types other than tonic‐clonic seizures. In these cases, a long delay in diagnosis alone might not affect the long‐term outcome. However, when accompanied with recurrent seizures misinterpreted by the patient or healthcare providers, the effect of such delay on prognosis can be considerable. John Wiley and Sons Inc. 2020-12-08 /pmc/articles/PMC7733655/ /pubmed/33336131 http://dx.doi.org/10.1002/epi4.12443 Text en © 2020 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Full‐length Original Research Parviainen, Laura Kälviäinen, Reetta Jutila, Leena Impact of diagnostic delay on seizure outcome in newly diagnosed focal epilepsy |
title | Impact of diagnostic delay on seizure outcome in newly diagnosed focal epilepsy |
title_full | Impact of diagnostic delay on seizure outcome in newly diagnosed focal epilepsy |
title_fullStr | Impact of diagnostic delay on seizure outcome in newly diagnosed focal epilepsy |
title_full_unstemmed | Impact of diagnostic delay on seizure outcome in newly diagnosed focal epilepsy |
title_short | Impact of diagnostic delay on seizure outcome in newly diagnosed focal epilepsy |
title_sort | impact of diagnostic delay on seizure outcome in newly diagnosed focal epilepsy |
topic | Full‐length Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733655/ https://www.ncbi.nlm.nih.gov/pubmed/33336131 http://dx.doi.org/10.1002/epi4.12443 |
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