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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...

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Autores principales: Parviainen, Laura, Kälviäinen, Reetta, Jutila, Leena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
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.
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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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