Abstracts

Rationale: Cluster seizures are medical emergencies that require rapid treatment. Each cluster carries a risk of progression to prolonged seizures and status epilepticus that can potentially result in neuronal injury or death. There are limited data available on the prevalence, treatment, and impact of cluster seizures. The aim of this study was to understand the disposition, clinical characteristics, and current treatment patterns of patients with cluster seizures in a real-world setting. Methods: As part of a larger retrospective online chart review study, US-based neurologists were first surveyed on the demographics and clinical characteristics of epilepsy patients with cluster seizures in their clinics. Cluster seizure was defined as multiple seizures occurring within a 24-hour period, distinguishable from the usual seizure pattern. All information was collected through a Web-based survey. Results: A total of 101 neurologists treating at least one cluster seizure patient in the past 12 months responded to the survey; the largest proportion (38.6%) practiced in the single-specialty neurology group setting, followed by the multiple-specialty group setting (22.8%), and the solo practice setting (16.8%). On average, epilepsy patients accounted for 27.0% (±21.8%) of the patients they treat. Responding neurologists had an average of 37 patients experiencing cluster seizures over the past 12 months, with the majority of neurologists reporting treating 1-19 or 20-39 cluster seizure patients (46.5% and 31.7%, respectively). The majority (90.2%) of patients with cluster seizures were adults; of these, 73.5% had experienced a cluster seizure within the last 12 months, 48.1% in the last 6 months, 30.2% in the last 3 months, and 14.7% in the last month. Additionally, within the last 12 months, 22.2% had experienced 1 cluster seizure episode, 25.3% had experienced 2-3 episodes, and 24.8% had experienced 4 or more episodes. Rescue medication was prescribed to 61.4% of patients, with the most common being diazepam rectal gel (51.3%). Conclusions: This survey provides preliminary information on the clinical characteristics and treatment of cluster seizure patients. The follow-up chart review study will contribute to the development of a better understanding of the characteristics, treatment, and clinical and economic impact of cluster seizures. Supported by Acorda Therapeutics, Ardsley, NY.