Epilepsy & Behavior最新文献

{"title":"Psychiatric comorbidities before and after cannabidiol treatment in adult patients with drug resistant focal epilepsy","authors":"Julián Lamonarca,&nbsp;Inés Mintz,&nbsp;Liliana Bayarres,&nbsp;Silvia Kochen,&nbsp;Silvia Oddo","doi":"10.1016/j.yebeh.2024.110032","DOIUrl":"10.1016/j.yebeh.2024.110032","url":null,"abstract":"<div><div>Cannabidiol oil (CBD) has been approved as an antiseizure medication for the treatment of drug −resistant epilepsy in pediatric patients in 2018 for some special types of epilepsy. Since this time its use was extended to other forms of epilepsy. However, to date, there are few publications on the use of CBD in adult patients with drug-resistant focal epilepsy and psychiatric comorbidities.</div><div>We conducted a prospective, observational, open cohort study, with a before-after design, in adult patients, we assessed the effectiveness, dosage, and tolerance of adjunctive CBD treatment. Our study concluded that CBD was effective and safe.Our study in line with others examining CBD use in adult patients with drug-resistant epilepsy, omits consideration of psychiatric aspects.</div><div>The aim of this study was to evaluate, in the same patient population that was part of a previous observational study, depression, quality of life, anxious symptoms and daytime sleepiness before and after CBD treatment.</div></div><div><h3>Results</h3><div>Forty-four patients were enrolled in the study. Prior to CBD treatment, 50 % of participants exhibited symptoms of depression. Following CBD treatment, 95.4 % of these individuals demonstrated a marked improvement (p = 0.001). Among this cohort, 71.5 % of patients reported minimal or no depressive symptoms post-treatment. Moreover, 68 % of patients experienced an enhancement in their overall quality of life.</div><div>Comparative analysis of BDI-II and QOLIE-10 scores before and after CBD treatment revealed a statistically significant positive correlation (p &lt; 0.036 and &lt; 0.001, respectively). Improvements in depressive symptoms were found to correspond with enhancements in quality of life. In terms of anxiety symptoms, 54.5 % of patients exhibited such symptoms prior to CBD treatment, with 71 % showing improvement post-treatment.</div><div>Adjunctive CBD treatment in adult patients with drug-resistant focal epilepsy was effective, safe, well tolerated and associated with significant improvement in depressive symptoms, anxiety and quality of life.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive digital mental health screening tool for people with epilepsy: A feasibility study in UK outpatients","authors":"Andrea Biondi ,&nbsp;Alice A. Winsor ,&nbsp;Candice Ebelthite ,&nbsp;Jemima Onih ,&nbsp;Susannah Pick ,&nbsp;Timothy R. Nicholson ,&nbsp;Deb K. Pal ,&nbsp;Mark P. Richardson","doi":"10.1016/j.yebeh.2024.110103","DOIUrl":"10.1016/j.yebeh.2024.110103","url":null,"abstract":"<div><h3>Background</h3><div>Mental health symptoms are common in people with epilepsy, impacting medication adherence, quality of life, and mortality. Early detection and timely interventions for mental health symptoms will be crucial for improved outcomes but the absence of standardized screening procedures and time constraints hinder regular assessment and management.</div></div><div><h3>Purpose</h3><div>To evaluate feasibility, acceptability and, value of a digital tool for identifying mental health symptoms in adult and paediatric epilepsy outpatients using electronic Patient-Reported Outcome Measures (ePROMs).</div></div><div><h3>Methods and materials</h3><div>The study used an established local platform (IMPARTS − Integrating Mental and Physical Healthcare: Research Training and Services) to develop an online tool using e-PROMS for a comprehensive mental health screen (psychiatric symptoms, neurodevelopmental traits, and psychosocial/behavioural risk factors) of people with epilepsy. Prior to attending the outpatient clinical epilepsy services at King’s College Hospital, participants were invited to complete the online screening tool through an SMS appointment link.</div></div><div><h3>Results</h3><div>Out of 1081 epilepsy patients (955 adults, 126 paediatric), 38.2% of adults and 51.6% of carers of paediatric patients accessed the ePROMs, with modest completion rates of 15% and 14%, respectively. Adults reported mild to significant anxiety (37.4%), minor to major depression symptoms (29.2%), and occasionally psychotic symptoms (11.1%). Adults with self-reported psychiatric symptoms reported significantly higher number of seizures, seizure burden, insomnia, autistic and ADHD traits and lower quality of life and perceived social support. Only 21% of those reporting psychiatric symptoms were receiving any form of mental health support. A large proportion of paediatric patients presented emotional/behavioural difficulties (32%), high impulsivity (38.8%), low self-esteem (27.7%), sleep difficulties (50%), comorbid neurodevelopmental syndromes (27.7%). Both groups reported good level of perceived social support.</div></div><div><h3>Conclusion</h3><div>Our epilepsy adapted IMPARTS e-PROMS allowed remote screening for mental health symptoms, neurodevelopmental and resilience factors. Integrating these tools into electronic patient records might enhance early identification and facilitate referral to appropriate care pathways.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Results of a National Delphi consensus on the outpatient management of pediatric psychogenic nonepileptic seizures in the United States","authors":"Afsaneh Talai ,&nbsp;Daniel A Freedman ,&nbsp;Kristen Trott ,&nbsp;Maija R Steenari ,&nbsp;Sigita Plioplys ,&nbsp;Hillary Kimbley ,&nbsp;Jennifer Madan Cohen ,&nbsp;Priya Tatachar ,&nbsp;Dara V.F. Albert ,&nbsp;On behalf of the Pediatric Epilepsy Research Consortium","doi":"10.1016/j.yebeh.2024.110096","DOIUrl":"10.1016/j.yebeh.2024.110096","url":null,"abstract":"<div><h3>Background and objectives</h3><div>The purpose of this study was to develop national consensus based on expert opinion on the optimal outpatient care model of pediatric psychogenic nonepileptic seizures (PNES).</div></div><div><h3>Methods</h3><div>A core working group (CWG) within the PNES special interest group of the Pediatric Epilepsy Research Consortium was established. The CWG developed a rigorous scoring rubric to select experts in pediatric PNES within the United States of America and a three-round Delphi study was conducted to assess consensus on key components of the management of pediatric PNES in the outpatient setting.</div></div><div><h3>Results</h3><div>Eighteen experts representing neurology, psychology, psychiatry, social work and nursing participated in the study. Strong consensus was reached that the multidisciplinary clinic (MDC) model is the gold standard for the outpatient management of pediatric PNES. Consensus was obtained that a neurologist, psychologist and social worker are essential members of the MDC and in the setting of unlimited resources, psychiatry and nursing are also recommended. Further consensus was established on the roles of specific personnel, structure of the clinic, billing practices, trainee inclusion, patient inclusion and exclusion, and end of visit management. While consensus was reached that a new term should be developed for this diagnosis, consensus was not reached on the ideal term.</div></div><div><h3>Discussion</h3><div>Expert consensus was established for the multidisciplinary management of pediatric PNES in the outpatient setting. Specific recommendations were provided that can facilitate the development and implementation of MDCs in other institutions. Further prospective studies are warranted to validate this practice model.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pitfalls and unmet needs of transition in epilepsy: Understanding the adult neurologist perspective","authors":"Pietro Mattioli ,&nbsp;Maria Margherita Mancardi ,&nbsp;Alessandra Ferrari ,&nbsp;Elisa Micalizzi ,&nbsp;Dario Arnaldi ,&nbsp;Irene Pappalardo ,&nbsp;Francesca Bisulli ,&nbsp;Chiara Pastori ,&nbsp;Paola Mandich ,&nbsp;Lino Nobili ,&nbsp;Francesca Darra ,&nbsp;Flavio Villani ,&nbsp;Commission on Transition of the Lega Italiana Contro l'Epilessia (LICE)","doi":"10.1016/j.yebeh.2024.110100","DOIUrl":"10.1016/j.yebeh.2024.110100","url":null,"abstract":"<div><div>Transition from the paediatric holistic approach to the adult more individual care of epilepsy is a process that carries a high level of complexity and involves many actors. It is a mandatory step so to provide a gold-standard quality of care in young people with epilepsy. Its failure is strongly associated with a poor epilepsy, cognitive, and behavioural outcome.</div><div>Although the interest of the scientific community on transition has increased, in the clinical practice it is still considered a sensitive issue, in particular for adult neurologists. In this study we aimed at exploring pitfalls and unmet needs of transition from the adult neurologists’ perspective. A short survey, aimed to adult neurologists, was designed to explore i) whether transition is considered a problematic issue for the adult neurologist, ii) how transition impact his/her clinical practice, iii) which are the major problems related to the process, and iv) how transition may be improved. The results of the survey showed that transition is felt as a complex process that needs a shared action plan between child and adult neurologists, possibly with multidisciplinary team meetings as well as a higher training on childhood epilepsies for the adult neurologist.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter on “Cognitive outcomes after fetal exposure to carbamazepine, lamotrigine, valproate or levetiracetam monotherapy: Data from the EURAP neurocognitive extension protocol”","authors":"Susanna Stjerna ,&nbsp;Yfke Huber-Mollema ,&nbsp;Torbjörn Tomson ,&nbsp;Emilio Perucca ,&nbsp;Dina Battino ,&nbsp;John Craig ,&nbsp;Anne Sabers ,&nbsp;Sanjeev Thomas ,&nbsp;Frank Vajda ,&nbsp;Eija Gaily","doi":"10.1016/j.yebeh.2024.110084","DOIUrl":"10.1016/j.yebeh.2024.110084","url":null,"abstract":"","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epilepsy in LEAT and other brain tumors: A focused review","authors":"Catrin Mann ,&nbsp;Nico Melzer ,&nbsp;Dorothea Münch","doi":"10.1016/j.yebeh.2024.110092","DOIUrl":"10.1016/j.yebeh.2024.110092","url":null,"abstract":"<div><div>Of all patients with brain tumors, about 30–50% suffer from epileptic seizures. The probability of developing epilepsy is particularly high in low-grade, epilepsy-associated brain tumors (LEAT). LEATs often show a pronounced network dysfunction with extensive EEG pathologies and cognitive deficits, and the epilepsies are often difficult to treat. In high-grade brain tumors, epileptic seizures determine morbidity and quality of life. The underlying mechanisms of epileptogenesis of brain tumors are increasingly understood and raise hope for personalized therapeutic approaches. This short, focused review provides an overview of the current understanding of brain tumor-related epilepsies.</div><div>This paper was presented at 16th International Epilepsy Course and Colloquium held in Frankfurt a.M., Germany, September 2024.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal lobe encephaloceles: Electro-clinical characteristics and seizure outcome after tailored lesionectomy","authors":"Camilo Garcia-Gracia ,&nbsp;Samer Riaz ,&nbsp;Claudia Vallin ,&nbsp;Andreas Alexopoulos ,&nbsp;Badih Adada ,&nbsp;William Bingaman ,&nbsp;Imad Najm ,&nbsp;Juan C. Bulacio","doi":"10.1016/j.yebeh.2024.110066","DOIUrl":"10.1016/j.yebeh.2024.110066","url":null,"abstract":"<div><h3>Objective</h3><div>Our study aimed to investigate the management of patients with medically refractory epilepsy related to temporal encephaloceles, focusing on the use of ancillary testing in the pre-surgical evaluation to optimize surgical outcomes.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of electronic medical records from the Cleveland Clinic, covering the period from January 2000 to May 2020. Patients with drug-resistant temporal lobe epilepsy were included if they had temporal lobe encephaloceles and required surgical intervention. We reviewed the results of ancillary studies, including invasive EEG.</div></div><div><h3>Results</h3><div>A total of 19 patients with temporal lobe encephaloceles underwent resection for drug-resistant epilepsy treatment. Among them, 63 % reported experiencing auras commonly associated with mesial temporal lobe epilepsy, such as autonomic, psychic, and abdominal symptoms, followed by dialeptic seizures. Ictal patterns were consistently ipsilateral, with high amplitude delta or medium amplitude theta activity at onset, predominantly localized to the frontotemporal region in more than half of the cases. In 35 % of these patients, encephaloceles were only diagnosed during surgery. Stereo-EEG evaluation revealed two distinct ictal patterns: one characterized by localized low voltage fast activity in the temporal pole evolving into a 3–4 Hz high amplitude diffuse spiky activity, and the other exhibiting low amplitude rhythmic theta activity in the temporal pole with late involvement of the amygdala/hippocampus. Surgical resection strategy was based on clinical history and ancillary data analysis. At one-year follow-up after resection, 63 % of the patients attained Engel I seizure control over an average duration of 44 months (ranging from 6 months to 7.3 years). Additionally, 18 % of the patients achieved an Engel II outcome.</div></div><div><h3>Significance</h3><div>Tailored resection of the encephalocele and the surrounding temporal pole, while preserving the mesial temporal structures, can effectively control seizures in patients with temporal encephaloceles identified through MRI. Patients presenting with temporal lobe symptoms and scalp ictal patterns characterized by polymorphic high delta theta activity with frontotemporal evolution should be evaluated for temporal encephaloceles as a potential underlying cause of their seizures, especially when the MRI is otherwise unrevealing.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of spontaneous abortion and stillbirth adverse events in epilepsy patients treated with levetiracetam: A pharmacovigilance study","authors":"Qi Wang ,&nbsp;Hao Sun ,&nbsp;Jie Huang ,&nbsp;Yanjie Chen ,&nbsp;Jiameng Ni ,&nbsp;Zaixiang Tang ,&nbsp;Jingfang Liu","doi":"10.1016/j.yebeh.2024.110077","DOIUrl":"10.1016/j.yebeh.2024.110077","url":null,"abstract":"<div><h3>Background</h3><div>The prescription of levetiracetam during pregnancy has become more common due to its lower teratogenic risk profile. However, due to a lack of data about its association with stillbirth and spontaneous abortion, worries remain.</div></div><div><h3>Objective</h3><div>To investigate information on any possible association of spontaneous abortion and stillbirth adverse events with levetiracetam in women with epilepsy.</div></div><div><h3>Methods</h3><div>This retrospective pharmacovigilance study used disproportionality analysis to detect signals of adverse reaction of interest reported with Levetiracetam in FAERS, the FDA Adverse Event Reporting System. The ratio of reporting odds (ROR) and information component (IC) indices were used to undertake disproportionality analyses, and change point analyses were carried out to identify variations in the frequency of reporting of relevant adverse events. Sensitivity analyses included subgroup analyses by indication, treatment regimen, and reporting region.</div></div><div><h3>Results</h3><div>Overall, 2870 cases of spontaneous abortion and stillbirth with commonly used antiseizure medications were analyzed. A total of 65.5 % of these cases had epilepsy as the indication. In the entire dataset, we observed disproportionality signals of spontaneous abortion for 6 ASMs (levetiracetam, carbamazepine, lamotrigine, oxcarbazepine, topiramate, valproic acid) and disproportionality signals of stillbirth for 4 ASMs (levetiracetam, carbamazepine, lamotrigine, oxcarbazepine). In the epileptic population, disproportionality signals for stillbirth (ROR_0.25 = 4.60; IC_0.25 = 1.30) and spontaneous abortion (ROR_0.25 = 3.98; IC_0.25 = 1.20) in levetiracetam was identified. These disproportionality signals have been consistently robust over the past years, according to a temporal assessment of them. Sensitivity studies proved how reliable the findings were.</div></div><div><h3>Conclusion</h3><div>Using validated pharmacovigilance methods, we found significant disproportional signals for spontaneous abortion and stillbirth associated with levetiracetam. Of these, the signals for spontaneous abortion were observed after 2011 and for stillbirth after 2014, which may be related to the rise in levetiracetam prescriptions during pregnancy in recent years. The association of spontaneous abortion and stillbirth adverse events with levetiracetam and potential biases confounding this association merit further investigation.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors for additional surgeries in drug-resistant epilepsy after mesial temporal laser interstitial thermal therapy","authors":"Behnaz Esmaeili ,&nbsp;Andrew L. Ko ,&nbsp;John W. Miller","doi":"10.1016/j.yebeh.2024.110074","DOIUrl":"10.1016/j.yebeh.2024.110074","url":null,"abstract":"<div><div>We aimed to identify factors predicting additional surgical interventions in patients with drug-resistant epilepsy who continue experiencing seizures after mesial temporal laser interstitial thermal therapy (LITT). In a retrospective observational study, we analyzed consecutive patients with drug-resistant temporal epilepsy treated with mesial temporal LITT at the University of Washington between 2013–2022. The primary outcome was subsequent epilepsy surgery to improve seizure control after LITT. Logistic regression was used to assess how clinical factors and travel distance within tertiary center referral regions predict subsequent surgery occurrence. We identified 145 patients treated with mesial temporal LITT. Among the patients, 25 underwent subsequent surgeries, including 17 temporal lobectomies, 5 repeat LITT, 2 responsive neurostimulation, and 1 with deep brain stimulation. Further surgery was associated with higher Engel scores and shorter travel distance to our tertiary epilepsy center. Factors like age, sex, epilepsy duration, surgery on dominant hemisphere, and frequency of convulsive seizures were not significant. Patients who continue to have seizures after LITT are potential candidates for more surgery. Patients who must travel farther are less likely to receive follow-up surgery. Healthcare inequity presents a significant barrier in accessing epilepsy surgery, limiting the potential to achieve improved outcomes for individuals with epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical presentation of young persons with epilepsy who have not transitioned to adult health care systems: A single-site retrospective cohort","authors":"Meha Joshi ,&nbsp;Laura D. Fonseca ,&nbsp;Gogi Kumar","doi":"10.1016/j.yebeh.2024.110058","DOIUrl":"10.1016/j.yebeh.2024.110058","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to determine the demographics and clinical presentation of young persons with epilepsy (YPE) 18-years and older who have not transitioned to adult health care systems (AHCS) and to investigate the number of neurology-related hospital encounters in this population before and after attaining adulthood.</div></div><div><h3>Methods</h3><div>We conducted a single-site retrospective cohort study at Dayton Children’s Hospital (DCH) between 12/01/2021 and 5/31/2022. We included epilepsy patients 18-years and older. Patient demographics, insurance, number of hospitalizations and Emergency Department (ED) visits before and after 18 years of age, clinical presentation, and comorbidities were collected.</div></div><div><h3>Results</h3><div>251 patient charts were reviewed. The median age was 20.9 years. The most common comorbidities were intellectual disability (36 %) and psychiatric illnesses (59 %). The majority had generalized epilepsy (52 %) and tonic-clonic seizures (56 %). 58 % of the patients had infrequent seizures in the past year. Documentation of transition to AHCS discussion occurred in only 3 % of patients before age 18 compared to 35 % of patients after age 18. There was a decrease in 30 % for ED visits and 15 % for neurology related hospitalizations after the age of 18.</div></div><div><h3>Conclusion</h3><div>YPE 18-years of age and older who were managed by a pediatric neurologist at DCH had significant co-morbidities. However, they were clinically stable and rarely required admission to the hospital. Most of them did not have documentation about transition discussions. At DCH, YPE who have not transitioned to AHCS are clinically stable and well managed.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}