Abstracts

Rationale: Our objective was to determine the relationship between obesity and epilepsy in chidren. The prevalence of childhood obesity presents an increasingly significant health care concern nationwide, as recent national surveys show 17% of children are obese. Obesity in childhood is defined as >95th percentile of body mass index(BMI) for age. There are few studies to show the prevalence of obesity is higher in adult patients with epilepsy than in the general population. There is little research regarding how obesity relates to pediatric epilepsy. Methods: A cross sectional chart review from a pediatric epilepsy clinic at the Medical College of Georgia was performed from November 2010-April 2011. Height and weight were recorded for each visit along with standard clinic information regarding number of antiepileptic medications, frequency of seizures, and the number of hospitalization or ER visits since the prior appointment. Body mass index (BMI) was calculated using the age and sex specific calculator published by the centers for disease control (CDC). BMI percentiles were classified into four categories: underweight(<10th percentile),healthy(10th-85th percentile),overweight(>85th percentile), and obese (>/= 95TH percentile). Medication lists were reviewed and the doses verified. Seizure frequency was self reported and divided into four divisions: seizure free, 1-5 seizures, 5-10 seizures, and >10 seizures per the prior six month period. Hospitalizations and ER visits were reviewed and verified. Generalized linear model analysis was utilized to determine the response of a higher BMI to the covariants of seizure frequency, antiepileptic medications, and the number of hospitalization or ER visits. Results: Two hundred pediatric epilepsy patients were included for review. The median age was 10 years with 111 males and 89 females. A normal BMI was found in 40% (n=81) of patients, 21% (n=42) patients were underweight, 16% (n= 31) were overweight and 23% (n=46) were obese. Covariables revealed 43% of patients reported seizure freedom in the prior six months, the remaining 57% had multiple seizures; of those, 32% had greater than ten seizures during the reporting period. 41% of patients were on monotherapy; whereas 59% were on polytherapy, suggesting a high refractory cohort. 86% did not have any hospitalizations, 14% were hospitalized or had ER visits for seizures or other comorbid illnesses. Statistical analysis did not reveal that an increased BMI predicts poorly refractory epilepsy; there were no statistically significant findings in regard to seizure frequency and the number of AEDs. There were fewer hospitalizations in those with lower BMI (p=0.02); supporting that obesity contributes to comorbid illness. Conclusions: Thirty-nine percent in this cohort of epilepsy patients were overweight or obese; which is higher than the national overall prevalence of obesity in children. More investigation is warranted to determine the etiology and prognostic influence of BMI on refractory epilepsy. This is important in contributing to medication decisions and lifestyle modifications which impact patients.