Abstracts

Rationale: The study aimed to assess the impact of individualized seizure action plans (ISAP) on reducing emergency room visits in pediatric patients with drug-resistant epilepsy.


Methods: We developed ISAP templates within our Electronic Health Record (HER), using the Seizure Action Plan forms provided by the American Epilepsy Foundation as a reference. Based on this information and the availability of specific medications and formulations, an ISAP is created and documented within the HER. After six months of ISAP implementation, we conducted a post-intervention survey to assess caregivers' comfort and knowledge in managing breakthrough seizures at home and during illness


Results: The study data shows that the mean age of patients was 9 years (range;2-16), the mean disease duration was 7 years (range;1-13), and the average number of anti-seizure medications was 3 (range: 1-7). In our cohort, there was a male predominance (60.49%), where genetic and structural etiologies account for the majority of epilepsy cases (35% and 33%, respectively). Abnormal MRI brain was present in 60 % of the cases, and abnormal EEG was documented in 99%. Whole exome sequencing revealed notable genetic findings in 72% of cases (figure 1). The introduction of ISAP demonstrated a trend in reducing emergency room visits occurring once a month or more from 55% to 23% for the whole group (p-value = 0.08), as well as when epilepsy etiologies were considered (figure 2). After implementing this protocol for up to 6 months, we surveyed the parents and found that 95% of them considered SAP convenient. ER visits were reported to be reduced in 72% of the cases.


Conclusions: Although ISAP increased caregiver comfort, it didn't significantly reduce ER visits in this study. Further research is required to assess its effectiveness in managing pediatric patients with refractory epilepsy.


Funding: None