Abstracts

Rationale: There is a striking deficiency of research in Epilepsy Transition. The objective of this work is to describe patients from a pediatric tertiary center referred to our Epilepsy Transition Program and to compare them with patients referred from community to our Adult Epilepsy Clinic. Additionally, we identified the level of confidence among neurologists receiving these challenging patients. Methods: A cohort of age-matched patients (18-25y) from our Adult Epilepsy Clinic was retrospectively studied. Patients from our Epilepsy Transition Program (Group 1) were compared with the group referred directly from community physicians (Group 2). As well, we used a survey to evaluate neurologists dealing with childhood-onset epilepsies. Results: Group 1 was comprised of 170 patients while Group 2 had 132 patients. Patients in Group 1 had earlier seizures onset, longer epilepsy duration (p<0.001), more patients with symptomatic etiologies, epileptic encephalopathy and cognitive delay (p<0.001). Group 1 patients required more referrals to other specialties (p=0.001). Treatment with polytherapy (p=0.003), epilepsy-surgery (p<0.001), ketogenic diet (p<0.001), and vagus nerve stimulator were more common in Group 1 (p<0.001). Additionally, our survey applied to adult (n=86) and pediatric (n=29) neurologists indicated that adult neurologists have lower levels of confidence to diagnose and treat severe forms of childhood-onset epilepsies (p<0.001), as well as epilepsy associated with cognitive delay (p<0.001). Conclusions: These findings suggest that: patients from tertiary centers present more complex healthcare needs and require more resources than age-matched patients from the community; and adult neurologists may not feel prepared to diagnose and treat adult patients with some childhood-onset epilepsies.