This retrospective chart review evaluated the effect of limited English proficiency (LEP) in Spanish-speaking people with epilepsy (PWE) and its impact on factors such as ER visits and missed clinic appointments.

Since 20% of Americans speak languages other than English, many PWE are at risk for the harmful effects of language discordance. While healthcare inequalities have been examined for common diseases, the effect of language discordance between English and Spanish with respect to epilepsy outcomes has not been investigated.

This single-center retrospective chart review analyzed data from patients who established care in the outpatient Epilepsy clinic between 1/1/2021 and 1/1/2023. Demographic and clinical factors including preferred language, were gathered from the medical record. We performed t-test analyses controlling for age and sex to determine statistically significant differences in the number of seizure-related ER visits, missed epilepsy clinic appointments, telephone encounters, and MyChart messages between English-speaking PWE and Spanish-speaking PWE.

70 participants were enrolled: 37 English-speaking PWE and 33 Spanish-speaking PWE. Spanish-speaking PWE were more likely to miss at least one epilepsy appointment (p=0.004) and less likely to send more than 3 MyChart messages (p=0.01) compared to the English-speaking PWE. Also, a higher proportion of Spanish-speaking PWE had seizure-related ER visits (21%) within 6 months of establishing care with an Epileptologist compared to English-speaking PWE (5%), but this did not reach statistical significance (p=0.07).

We found evidence of worse outcomes (missed epilepsy appointments) and underutilization of communication services (fewer MyChart messages) in Spanish-speaking PWE. These data suggest the need for larger studies and further research into what factors may influence the observed outcomes. Gaining a better understanding of possible risk factors could have a profound effect on the treatment of PWE with LEP.