Abstracts

Rationale: The COVID-19 pandemic represents a challenge to the care of patients with epilepsy (PWE). Some reports suggest COVID-19 can cause increased seizures in PWE, which may be related to psychological distress during the pandemic due to fear of infection, job loss, and financial difficulties or from the infection itself. Conversely, the pandemic may have brought about a decrease in daily demands and stressors; eliminating the stress of the daily commute and other social obligations can be a cause for decreased seizure frequency in PWE. While surveys and record reviews provide some indication of the effect of the pandemic on seizures, RNS can potentially provide more accurate counts. The objective of this study is to better understand the impact of the COVID-19 pandemic on seizure frequency in a population of patients with an RNS system implanted.

Methods: Patients with an RNS system implanted before September 2019 at Baylor College of Medicine were included in the study. We reviewed patient’s records in the online Patient Data Management System (PDMS) and analyzed the weekly number of long episodes (LE) as a proxy for seizures prior to the COVID-19 pandemic declaration (baseline period-Sep 2019-Mar 2020) and after the declaration (COVID period- Mar 2020-Sep 2020). Paired t-test was used to analyze the means of change in LE count. Additionally, telephone surveys are being conducted to assess patient mental health during the pandemic including the emergence of anxiety/depression symptoms, sleep disturbances, infection, job changes, and other stressors. The correlation between change in LE counts and reported stressors are being assessed.

Results: A total of 20 patients were included in this study. The median age was 37 years (SD=11.8). Fourteen (70%) patients were male. Seven patients (35%) had an increase in the average LE count, 12 (60%) had a decrease, and one (5%) had no change. Overall, there was no statistically significant change (p=0.2) in the average LE count between the pre-COVID period and the COVID period (see Table). Survey data collection is ongoing.

Conclusions: This study provides a better understanding of the impact of the COVID-19 pandemic on seizure frequency in PWE and the factors that affect changes in seizure frequency. This study also shows a unique way to utilize RNS data to accurately assess seizure variations during the pandemic.

Funding: Please list any funding that was received in support of this abstract.: none.