Abstracts

Rationale: Neurobehavioral comorbidities have higher than normal prevalence among children with epilepsy, and are often present at or near the time of diagnosis. Data regarding the course of comorbidities during early phase of epilepsy are limited. In follow-up to our previous 2015 study, the current study describes cumulative data from the first 2.5 years of our multidisciplinary protocol for New Onset Pediatric Epilepsy (NOPE) Clinic. Clinic logistics, evaluation findings, and epilepsy variables are provided. Methods: The half-day NOPE clinic includes brief neuropsychological evaluation, pediatric psychology assessment, and follow up medical evaluation with patient/parent education. Inclusion criteria for study: age 3 ?" 18, first diagnosis of epilepsy, first exposure to antiepileptic drugs, no significant neurological history, FSIQ>70. Records from 91 consented participants are reviewed. 80% were seen in the NOPE clinic within 12 weeks of epilepsy diagnosis. 43 females, age 3-17 years (median 8 years). No prior significant neurological history. 83/91 had abnormal EEG. 13/91 had abnormal MRI. 48 focal seizures, 31 primary generalized, 12 unknown. Prior to NOPE visit, 26 had 1 seizure, 38 had 2-5 seizures, 26 had >6 seizures, 11 had episode of SE. 87 started on AED (78 monotherapy) (65/78 LEV monotherapy). Results: Mean FSIQ: 102 (SD: 12), VCI: 103 (SD: 12), PRI/FRI: 101 (13), WMI: 97 (13), PSI: 96 (13). Prior to NOPE visit, 6/91 had a diagnosis of ADHD or LD. During the NOPE evaluation, an additional 28/91 (31%) were found to have clinically significant symptomatology as indicated by impairment in two or more of the following aspects of the neuropsychological evaluation: history of prior diagnosis, continuous performance test (CPT), relevant Conners-3 elevation(s), behavioral observations. Academic accommodations were recommended for 23/91 (25%) participants. Compared to the group on monotherapy, participants on polytherapy performed significantly lower (p < .05) on tests of processing speed. There were no significant cognitive differences observed among the following epilepsy variables: focal versus generalized seizure onset, normal versus abnormal EEG/MRI, history of status, total number of seizures, or age at seizure onset. Conclusions: Findings incorporate multiple sources of data from baseline neuropsychological evaluation to corroborate previously documented data suggesting higher than normal prevalence of ADHD and LD among children with epilepsy, shortly after initial diagnosis. Evidence of some cognitive ramifications of polytherapy may be present within the first year after diagnosis. Information from the NOPE clinic has facilitated prompt assessment and treatment for children with epilepsy. Future research will clarify associations among epilepsy variables and clinical presentations. Funding: N/A