Abstracts

Rationale: To describe initial presentation characteristics and seizure frequency as well as response to treatment in pediatric patients with new onset epilepsy. Methods: Retrospective descriptive study of consecutive new onset epilepsy patients who were diagnosed and followed at Boston Children's Hospital (BCH) over a 2 year period. Patients with a clinical diagnosis of epilepsy as supported by history, EEG or syndrome diagnosis were included. Patients diagnosed at a different institution, not followed at BCH or not treated with any antiepileptic drugs (AED) were excluded. Results: Three hundred-fifty-three patients (185 (52.4%) males, 168 (47.6%) females) were followed for a median of 14 months (range: 7-27 months). Median age at onset was 7 years (range: 0-20 years). Seventy-eight (22.1%) patients had pre or perinatal complications and 63 (17.8%) had prior history of provoked or febrile seizures. Ninety-nine (28%) patients had a family history of epilepsy. The etiology was mostly idiopathic followed by structural in both seizure free patients and in patients who had persistent seizures (Table 1). Among 353 patients, 204 (57.7%) patients became seizure free after their diagnosis or first available clinical visit, 147 (41.6%) patients continued to have seizures and the remaining 2 (0.7%) patients had seizures due to noncompliance and missed doses. Among those 147 patients who continued to have seizures, 76 (51.8%) patients had more than 50% seizure frequency decrease, 66 (44.8%) patients had less than 50 % decrease, 1(0.6%) patient had no change and 4 (2.8%) patients had a slightly increase in their seizure frequency compared to the initial presentation. All 204 seizure free patients were treated with a single AED; 178 patients' seizures were controlled with the first treatment choice and 26 patients' seizures were controlled with the second AED (Table 2). 26 patients discontinued the first treatment due to adverse effects in 16 and continuing seizures in 10 patients. Among 76 patients who had more than 50% decrease in their seizure frequency; 58 patients were treated with a single drug, 15 patients with 2 drugs and 3 patients with 3 drugs. Among 58 patients who were treated with a single drug; 40 patients' seizures were treated with the first treatment choice and 18 patients' seizures were treated with the second AED choice. 18 patients discontinued the first treatment due to adverse effects in 10 and continuing seizures in 8 patients. Conclusions: We describe initial presentation characteristics and treatment choices in patients with new onset pediatric epilepsy and differences in the etiologies based on response to treatment. Most patients became seizure free on a single AED and remained on this treatment at a median follow up of 14 months. Funding: The authors received no financial support for this abstract.