Abstract Details

Title Recognition and Treatment of New Onset Focal Seizures in Emergency Departments

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S31 - Epilepsy/Clinical Neurophysiology (EEG) 3 (3:54 PM-4:06 PM)

Poster/Presentation
Number 003

Objective To assess factors effecting the diagnosis and treatment of new-onset focal seizures in Emergency Departments (EDs) utilizing data from The Human Epilepsy Project (HEP), which enrolled patients with newly diagnosed focal epilepsy.

Background It is common for patients with new-onset focal epilepsy to present to EDs for initial evaluation. Treatment decisions in EDs can influence likelihood of further seizure activity.

Design/Methods We analyzed data from all participants enrolled in HEP. There were 447 patients with new-onset focal epilepsy seen within four months of treatment initiation who were eligible and enrolled. Seizure diaries and medical records were collected. Based on clinical descriptions, seizures were categorized as either subtle seizures (SS; primarily motor arrest or focal aware without motor) or observable seizures (OS; primarily motor activity or verbal output, including generalized tonic-clonic seizures).

Results

Baseline characteristics were similar between the 246 (55%) patients with SS and 201 (45%) patients with OS at epilepsy onset. Among the 246 patients with SS, there were 132 presentations to an ED: 8 (6%) with a first-lifetime SS, 7 (5%) with multiple SS, and 117 (89%) with a first-lifetime OS after having prior SS. Among 201 patients with OS, there were 147 presentations to an ED: 134 (92%) with a first-lifetime OS, and 13 (9%) with multiple OS.

Subjects with OS plus a history of multiple SS were not started on medication more frequently than those with only a first lifetime OS (39% vs 43%) There were similar rates of seizure identification as the reason for presentation (85% vs 87%), and whether the patient was admitted or referred to a neurologist (87% vs 79%).

Conclusions This study contributes to evidence of diagnostic delay in focal epilepsy, specifically as it pertains to initial seizure recognition and treatment. These findings can support large-scale interventions aimed at improving recognition and treatment in ED settings.

Authors/Disclosures
Jacob Pellinen, MD (University of Colorado) PRESENTER	The institution of Dr. Pellinen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for SK Life Science. The institution of Dr. Pellinen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jazz Pharmaceuticals.
	No disclosure on file
Annie Yang, MD (YNHH)	Dr. Yang has nothing to disclose.
Dana Price, MD (New York University Langone Medical Center)	Dr. Price has nothing to disclose.
Jacqueline French, MD, FAAN (NYU Comprehensive Epilepsy Ctr)	Dr. French has received personal compensation in the range of $50,000-$99,999 for serving as an officer or member of the Board of Directors for Epilepsy Foundation. The institution of Dr. French has received research support from Epilepsy Study Consortium/ Epilepsy Foundation (Funded by UCB). The institution of Dr. French has received research support from GW/One8 Foundation/FACES. The institution of Dr. French has received research support from NINDS. The institution of Dr. French has received research support from Xenon. The institution of Dr. French has received research support from Cerevel. The institution of Dr. French has received research support from FACES. The institution of Dr. French has received research support from UCB. The institution of Dr. French has received research support from Epilepsy Study Consortium. The institution of Dr. French has received research support from UCB. The institution of Dr. French has received research support from Praxis. Dr. French has received personal compensation in the range of $100,000-$499,999 for serving as a Chief Medical/Innovation Officer with Epilepsy Foundation. Dr. French has a non-compensated relationship as a Consultant with Angelini that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consultant with Alterity Therapeutics Limited that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consultant with Bright minds Biosciences that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Cerecin Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Cognizance Biomarkers that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Arvelle that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consultant with Beacon biosignals that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant, Advisory Board with Biohaven Pharmaceuticals that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Bloom Science Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consultant, scientific advisory board with Camp4 Therapeutics Corporation that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant, Scientific Advisory Board with Cerebral Therapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Cerevel that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a SAB with Coda Biotherapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Genentech Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Crossject that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Eisai, that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Eliem Therapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Encoded Therapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with iQure Pharma that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant, SAB with Engrail that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a SAB with Epihunter that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a SAB with Epiminder that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Epitel Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Equilibre BioPharmaceuticals that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Grin Therapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with GW Pharma that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Janssen Pharmaceutica that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consultant with Jazz Pharmaceuticals that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Knopp Biosciences that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Lipocine that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with LivaNova that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Longboard Pharmaceuticals that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant, SAB with Lundbeck that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant, SAB with Marinus that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consultant with Modulight Bio that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant,SAB with Neumirna Therapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant,SAB with Neurocrine that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Neuroelectrics USA Corporation that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Neuronetics Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Ono Pharmaceutical Co that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant, SAB with Otsuka Pharmaceutical Development that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant, SAB with Ovid Therapeutics Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Paladin Labs Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Rapport Therapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Praxis that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with PureTech LTY Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consultant with SK Life Sciences that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Stoke that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Supernus that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consultant with Takeda that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant, SAB with UCB Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Ventus Therapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consulting, steering committee with Xenon that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consultant with Korro Bio Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with NeuroPro Therapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Advisory board with Receptor that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Advisory board with Sage Therpeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Advisory Board with Third Rock Ventures that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Vida Ventures Management that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consulting with Pfizer that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consulting with Agrithera, Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consulting with Autifony therapeutics, Unlimited that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consulting with Baergic Bio that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Biogen that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Biomarin Pharmaceuticals that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Axonis that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Capsida Biotherapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Access Industries that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Acuta Capital Partners that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Afaci that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Ceribell that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Clinical ��ɫ�� Alliance that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with EcoR1 Capital that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Cowen and Company LLC that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Epalex that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Iqvia RDS that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Leal Therapeutics Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Neurona Therapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Neuroventis that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Neurvati that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Neurelis that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Harmony/Epigenyx that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Neuropace that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Noema that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Rafa Laboratories that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Rivervest Venture Partners that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Taysha Gene Therapies that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Uniqure that is relevant to AAN interests or activities.

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