Abstracts

Rationale: The Human Epilepsy Project (HEP) was designed to look at treatment response, biomarkers, and psychiatric comorbidities in newly treated focal epilepsy. Patients can be included if they are within 4 months of treatment initiation, regardless of prior epilepsy duration. The research team used enrollment data to explore time to treatment after seizure onset.Methods: We used the submitted medical narrative and retrospective seizure diary to assess time from first and second seizure to initiation of treatment. Seizures were characterized using a structured interview (DISCOVER) form, to determine if they were simple partial (SPS), complex partial (CPS) or secondarily-generalized tonic clonic convulsion (SGTCC). If the exact date of a seizure was unknown, but the month and year were available, we used the 15th day. If only the year was known, we used July 1st. Patients who had more than 30 days delay between second seizure and initiation of treatment were considered to have delay of treatment initiation. Reason for delay to treatment was divided into 4 possible options: patient was unaware clinical events were seizures, never sought medical treatment (Patient Unaware, PU), patient sought medical treatment, but was not diagnosed with seizures (Doctor Unaware, DU), patient and/or doctor elected to delay treatment (Elective Delay, ED), or reason unknown (U).Results: Out of 206 enrolled patients, 86 had SGTCC as their first seizure type, 59 had CPS, and 57 had SPS. 4 had unclassifiable seizures as their first seizure type (seizure was unwitnessed, insufficient clinical information, etc). First and second seizure type was the same for 80% (n = 69) of patients with initial SGTCC, 92% (n = 54) of patients with CPS, and 90% (n = 52) of patients with SPS. Median time from first/second seizure to treatment by first seizure type was 76/3.5 days for SGTCC, 246/205 days for CPS, and 520/456 days for SPS. Mean time to treatment was 302/156 (SD = 617/454) days for SGTCC, 1063/974 (SD = 2138/2081) days for CPS, and 2099/1991 (SD = 3297/3270) days for SPS. When first seizure was a SGTCC, 33% (n = 28) of patients had a delay of treatment initiation, compared to 76% (n = 45) of patients with CPS and 86% (n = 48) with SPS. For patients with delay to treatment, reason for delay is depicted in Figure 1. 54% (63/116) of patients who had a non-GTCC as their first seizure type had a SGTCC prior to treatment initiation. Average time from first CPS/SPS to SGTCC was 1539 days, or 4.2 years.Conclusions: There is a lag in recognizing simple and complex partial seizures, which leads to occurrence of SGTCC that could be avoided. Better education of physicians and the public about non-GTCC focal seizure types is urgently needed. Supported by The Epilepsy Study Consortium (ESCI), a non-profit organization dedicated to accelerating the development of new therapies in epilepsy to improve patient care. The funding provided to ESCI to support HEP comes from industry, philanthropy and foundations (UCB Pharma, Finding A Cure for Epilepsy and Seizures, Pfizer, Lundbeck, Eisai, The Andrews Foundation, Friends of Faces and others).