[P1-43] New onset seizure clinic for children (NOSC): West Australian experience.
Introduction: A NOSC was established at our hospital in 2011, with aim to provide accurate diagnosis and appropriate management to children with new onset seizures or seizure mimics.
Method: We report on the data analysis of the first 200 children seen in NOSC. A pediatric neurologist or pediatric/neurology trainee under supervision of a neurologist reviewed all the children. A detailed history and clinical examination were undertaken. . EEGs were undertaken prior to clinic review in most. Children were classified as “Epilepsy positive “ (EP+) or “epilepsy negative” (EP-) after the first consultation.
Results: 109/200 were classified as EP+: generalized epilepsy in 57/ 109, focal in 36, childhood seizure susceptibility syndrome in 26, epileptic encephalopathy in 5. EEG was available in 192: in117 it was abnormal- 23 with background abnormalities and 109 with epileptiform activity. MRI was abnormal in 38 of 98 children, relevant to the epilepsy in 28. 80/109 were commenced on AEDs: 12 were able to come off medication after seizure free period, 61 were controlled on AEDs and 7 were refractory. Children were followed up for duration of 12 to 48 months. None of children had diagnosis revised on follow up.
Conclusion; This is the first Australian study to report on a large cohort of children from a NOSC. Our study suggests a pediatric neurologist assessment and an EEG is a good combination to enable diagnostic accuracy: in the first 200 patients seen there were no revisions of the initial diagnosis on follow up.
Method: We report on the data analysis of the first 200 children seen in NOSC. A pediatric neurologist or pediatric/neurology trainee under supervision of a neurologist reviewed all the children. A detailed history and clinical examination were undertaken. . EEGs were undertaken prior to clinic review in most. Children were classified as “Epilepsy positive “ (EP+) or “epilepsy negative” (EP-) after the first consultation.
Results: 109/200 were classified as EP+: generalized epilepsy in 57/ 109, focal in 36, childhood seizure susceptibility syndrome in 26, epileptic encephalopathy in 5. EEG was available in 192: in117 it was abnormal- 23 with background abnormalities and 109 with epileptiform activity. MRI was abnormal in 38 of 98 children, relevant to the epilepsy in 28. 80/109 were commenced on AEDs: 12 were able to come off medication after seizure free period, 61 were controlled on AEDs and 7 were refractory. Children were followed up for duration of 12 to 48 months. None of children had diagnosis revised on follow up.
Conclusion; This is the first Australian study to report on a large cohort of children from a NOSC. Our study suggests a pediatric neurologist assessment and an EEG is a good combination to enable diagnostic accuracy: in the first 200 patients seen there were no revisions of the initial diagnosis on follow up.