ATLANTA ― A specialized First Seizure Clinic (FSC) model can dramatically shorten the time it takes children to see a neurologist epilepsy specialist, speeding up diagnosis and treatment and improving long-term outcomes, according to research presented at the American Epilepsy Society Annual Meeting.
“Speedy access to epilepsy specialists can change the course of a child’s care and life,” said Howard P. Goodkin, MD PhD, FAES, president of the American Epilepsy Society. “First Seizure Clinics help close treatment gaps, aligning with the American Epilepsy Society’s commitment to improving timely, expert care for all children.”
While children often wait weeks or months after having a seizure to see a specialist, those referred to the FSC at Dayton Children’s Hospital in Ohio were typically evaluated within one week during the study period.
“The saying ‘time is brain’ usually refers to stroke, but it also applies to epilepsy. The longer seizures go unaddressed, the greater the adverse impact on the patient’s cognitive function, seizure outcomes and overall health,” said Gogi Kumar, MD, FAES, senior author of the study and attending physician at Dayton Children’s Hospital. “For children, even a one-month delay in diagnosis and treatment can cause long-term developmental problems. Timely treatment can reduce the risk of injury and sudden unexpected death in epilepsy (SUDEP) and help children live healthier lives.”
An FSC is a specialized outpatient clinic that rapidly assesses, diagnoses and manages people after their first seizure to determine the cause and risk of recurrence, initiating appropriate care promptly. While previous research has shown that FSC models improve outcomes in adults, this is the first study to focus on access to care and early diagnosis for children after a first-time seizure.
Researchers determined that between Jan. 1, 2017, and April 30, 2025, 1,622 children were seen a median of six days after being referred to the Dayton Children’s Hospital FSC. After the first visit, more than one in five (21.6%) were diagnosed with epilepsy, generalized epilepsy, febrile seizures, absence epilepsy/syndrome, benign childhood epilepsy, Jeavons syndrome or juvenile absence epilepsy.
Overall, 1,021 children (62.9%) underwent diagnostic procedures, including long-term electroencephalogram (EEG) monitoring (77.2%) and brain magnetic resonance imaging (MRI) (44.5%). Other common diagnoses included seizure-like activity (21.6%) and convulsions (15.8%). Based on long-term EEG testing or recurring seizures, some of those children may ultimately have been diagnosed with epilepsy, although that information was not part of the study.
All children referred to the Dayton Children’s Hospital FSC have an EEG during the first appointment, and social workers are available to meet with the family to identify and address any barriers to care, which makes this model unique.
Some major medical centers and epilepsy centers have FSCs, but they may operate differently from the one at Dayton Children’s Hospital, said Dr. Kumar. Approximately 30% of epilepsy centers affiliated with the Pediatric Epilepsy Research Consortium have an FSC, according to a 2021 survey.
“Evaluating children who have a first seizure in a timely manner reduces the uncertainty and anxiety for parents and families, improving outcomes,” said Yash Agarwal, BS, lead author, research assistant at Dayton Children's Hospital and a student at Washington University in St. Louis. “We hope our model serves as a blueprint for other hospitals to replicate.”
*** AES 2025 news releases may contain updated data that does not match what is reported in the abstract.
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