Abstracts

Rationale: Studies exploring length of time to a diagnosis of epilepsy and the existence of previously unrecognized seizures are few. One study noted that 33% of children referred to a first seizure clinic already qualified for a diagnosis of epilepsy. We examined associations between the existence of prior unrecognized seizures and seizure type in a sample of children participating in a larger study of first recognized seizures.Methods: The sample consisted of 126 children of normal intelligence who enrolled in the larger study. Data describing the seizure condition were collected from notes of parent interviews and medical records obtained with parent permission. Author DWD evaluated information pertaining to history of the seizure disorder from both parent and physician sources and categorized each as having or not having prior unrecognized seizures. Author DWD also evaluated seizure type(s). Main seizure type was utilized in this analysis. Data were also collected regarding child IQ and family demographics by trained nurse interviewers. Descriptive statistics and chi square analysis were calculated using SPSS 14.0. Results: Occurrence of prior unrecognized seizures was significantly associated with seizure type Χ²(5, N = 120) = 11.71, p = .04. Generalized tonic/clonic seizures and complex partial seizures with secondary generalization were more common in the group with no prior unrecognized seizures. The opposite was true for absence seizures in our sample; those children who experienced the onset of recognized absence seizures as their main seizure type were more likely to have prior unrecognized seizures. Those children with elementary partial, complex partial without generalization, and elementary partial with secondary generalization were equally represented in both groups. Demographics did not significantly differ by group, but our sample was homogeneous with the majority being Caucasian, married and insured.Conclusions: Findings from this study are congruent with those from our previous work of delay to diagnosis in a sample of children with epilepsy and learning problems. Children with absence seizures are most likely to have prior unrecognized seizures, and those with generalized tonic/clonic seizures appear least likely to have had previous seizures. However, prior unrecognized seizures cannot be ruled out for any seizure type. Further study is indicated with a more diverse sample. (Source of funding: NINDS R01 NS 22416).