Abstracts

Rationale: To identify whether Children with Epilepsy (CWE) are at higher risk of injury. This information can help us individualize injury prevention advice given, promoting safety, while minimizing restrictions which can affect the child s physical and psychosocial development. Methods: Prospective cohort study of CWE and their nearest aged sibling. CWE were eligible for study if they (a) were age 3-17 years, (b) had a confirmed diagnosis of epilepsy and were either on AEDs and/or had one or more afebrile seizures in past six months, (c) had no major motor or sensory deficits and (d) had a sibling control in similar age group. Sibling controls had no history of afebrile seizures, a developmental quotient above 70 and no major motor or sensory deficit. Parents were asked to complete several screening tools at study onset (Parenting scale and Symptom Inventory for ADHD). Additionally, they were asked to complete monthly injury logs for both the CWE and their sibling and a seizure log for the CWE for 12 months. Additionally, they completed an Activity log for two 2-week periods (study onset and 6 months) for both the CWE and their sibling. Results: While 150 CWE-Sib pairs were enrolled in the study, only 47/150 (31%) completed some or all of the Injury and Seizure Logs, with 25 pairs completing 6 months or more .Overall, 257 months of data collection was available. CWE did not have significant more injuries than their siblings (271 vs 218, p=NS). Most injuries were minor (e.g. bumps, scrapes, minor burns from deep fryers at jobs) and all injuries requiring medical attention were sports-related. Injuries were most common in CWE in males under age nine (47% of injuries) and in sib controls in females over age ten (46% of injuries). While 1485 seizures were recorded over the study period in the cohort with epilepsy, the majority of these (98%) occurred in only 10/47 (21%) patients. Only 12/271 (4.4%) injuries in the epilepsy cohort were related to seizures. Additionally, we found no correlation between seizure frequency or number of AEDs taken and injury risk. Conclusions: CWE are not at significantly greater risk of injury compared to their non-epileptic siblings. Most injuries in the epilepsy cohort were not seizure-related. Surprisingly, the most complex and poorly controlled patients did not have higher risks of injury. While families should be routinely cautioned about potential risks around water, excessive restriction of activities does not seem warranted for most CWE. Our results are limited by the low response rate in this study and need to be confirmed in larger studies.