Abstracts

Rationale: There is a dearth of information regarding differences in seizure outcome after treatment in an epilepsy center vs. general neurology practice. We showed recently that a number of people who transitioned care from general neurology practices to an epilepsy center saw improvement in seizure control (Zakaria et al, Neurology 2007;68:Suppl 1:A72). The aim of this study was to examine whether similar improvements in seizure control are seen in patients residing in a residential care facility vs. other patients and whether the results of the previous study can be confirmed on a larger sample of epilepsy patients. Methods: A retrospective chart review was performed on 100 patients followed at an epilepsy center; 50 institutionalized patients versus 50 patients matched for age, gender, and duration of epilepsy. T-tests were conducted to evaluate for differences in the two groups, including treatment outcomes.Results: Mean age at the time of chart review was 42.6 ±13.3 years; mean age at the onset of epilepsy was 16.1 ±17 years. There were no significant differences between the groups of patients with regard to seizure control. The mean number of seizures per month at the time of first presentation to the epilepsy center was 34 ±107 (institutionalized patients 28, other 40; p = 0.57). At the time of the last visit, the seizure frequencies were 8 ±32 (5 vs. 11; p = 0.33). The difference in initial vs. current seizure control was significant at p = 0.003 with approximately 76% decrease in seizure frequency after management at an epilepsy center. During the first month of treatment at an epilepsy center, only 9 patients did not have any seizures vs. 44 patients in the month prior to the last visit (p < 0.001).Conclusions: Overall, treatment at an epilepsy center results in significant improvement in seizure control. No differences in seizure control between institutionalized and other patients were seen.