Abstracts

Rationale: The comprehensive care of children with epilepsy involves not only the treatment of seizures, but also enhancement of their quality of life. Summer camps for children can promote self-esteem and improve social interactions. However, children with developmental disabilities are often unable to attend traditional camps due to safety concerns: The prevalence of epilepsy is higher in children with developmental disabilities than the general population, and their epilepsy tends to be more refractory, with higher rates of status epilepticus. Camp CAMP (Children s Association for Maximum Potential), is a nonprofit summer camp for children with developmental disabilities and special heath care needs, to include epilepsy. Safety is promoted with 1:1 counselor to camper ratios for high risk campers, modified but traditional camp activities, climate controlled cabins, on-site medical staff, available abortive seizure medications, and an on-site helicopter landing pad. We seek to provide a descriptive summary of the epilepsy experience and safety at this specialized medical camp.Methods: A retrospective chart review of all children (ages 5 to 21-year-old) attending summer sessions between 2008-2010 was performed. No child was turned away due to the seizure severity. Primary data points included camper age, sex, comorbid conditions, seizure type and frequency, number of antiepileptic drugs (AEDs), use of vagal nerve stimulator (VNS) or ketogenic diet, history of status epilepticus (SE), and camp infirmary visits related to seizures. Descriptive statistics were utilized.Results: Of 818 campers (mean age 13.7-years-old), 1526 total camp sessions were attended. 264 (32.3%) campers had a history of epilepsy. The most common seizure type was generalized tonic-clonic (37%), with 12.1% reporting multiple seizure types. Seizure frequency ranged from several daily to rare (less than once every few months). Rare seizures was reported most commonly (60.7%) but 21.8% of campers with epilepsy had seizures at least once a week, and 13.5% at least daily. The number of AEDs per camper with epilepsy ranged from 0 to 4, with a mean of 1.5 AEDs. 5.3% had a VNS, 1.1% were on the ketogenic diet, and 34.9% of campers with epilepsy had a prior history of SE. 46.6% had cerebral palsy, 57.6% intellectual deficits, and 28.8% autism spectrum disorders. There were only 7 total camp infirmary visits due to seizures, an incidence of 1.4%: 4 for seizure clustering, 2 for status epilepticus, and 1 for a single seizure. Both episodes of status epilepticus were aborted with Diastat, but 1 was transported to a local emergency department for observation. Conclusions: There is a high prevalence of epilepsy in those participants attending camps for children with developmental disorders. They often have refractory seizures and a prior history of status epilepticus. However, in the setting of appropriate safety precautions and supervision at a specialized medical camp, a safe and positive experience can be provided, as seizure-related complications are rare.