Abstracts

Rationale: Earning a post-secondary, or college degree, is more than ever an important prerequisite for employment.  It has been documented that patients with epilepsy  (PWE) have higher college drop out rates than the general population but matriculation rates for patients with epilepsy has been unknown.  It has also been suggested that seizure frequencies worsen for PWE in college which may be a consideration for increased drop-out rates but we had been unable to find data to support this suggestion.  This study was undertaken to evaluate 4-year college matriculation rates of patients with epilepsy seen at the University of Virginia Epilepsy program and to evaluate seizure control in the first year of college.  We hypothesized that matriculation rates would be lower than the Virginia state average of 44% (Virginia Department of Education Report) and that patients would be likely to experience seizure exacerbation in the first year of college. Methods: Retrospective database review was performed of all PWE aged 17-19 years old seen at the University of Virginia Comprehensive Epilepsy Program from 1/2011-1/2016 using primary and secondary ICD9 codes 345 and 780.39.   Determination of college attendance was based on medical record review.  Patients with seizure onset at least one year prior to college matriculation were included in final analysis.  Results: 719 charts were screened and of these, 432 patients with epilepsy were identified, of these 89 patients (21%) attended some college, with 56 (13%) attending a 4-year college.   Of the 329 patients who did not attend some college, over 50% did not because of significant cognitive dysfunction.  43 patients with seizure onset at least 1 year prior to college matriculation were included in final analysis. Of these 43 patients, 11 (26%) graduated, 3 dropped out (7%), and 29 (67%) were still enrolled as of data analysis in 2017.  58% were female and all but one patient lived in college housing away from home.  40% had seizures in the year prior to matriculation and 44% had seizures in the first year of college.  There was no statistically significant difference in the presence of generalized tonic-clonic seizures, absence, complex partial seizures, myoclonus, or simple partial seizures in the baseline period compared with the first year of college.  33 (77%) patients experienced no change in presence or absence of seizures during first year of college with 4 patients (9%) experiencing seizure improvement and 6 (14%) experiencing seizure exacerbation.  Further subgroup analysis is ongoing. Conclusions: The bad: 4-year college matriculation rates in adolescents with epilepsy is low (13%).  The good: Contrary to common belief, seizure control is unlikely to change during the first year of college compared to a 1 year pre-college baseline.  Further study is needed to understand why matriculation rates are low in this population to consider potential interventions. Funding: None