Does treatment in an epilepsy clinic affect epilepsy-related admissions?

Background: Epilepsy-related emergency hospitalizations are associated with risks to patients. Neurologist ambulatory care can improve seizure control and decrease the rates of ED visits and emergency hospitalizations.

Aims: To evaluate the etiologies for emergency epilepsy-related admissions in patients with and without prior epilepsy clinic follow-up, and to identify possible factors that may influence admission rates.

Methods: A retrospective review of the computerized database and the medical records of all the people with epilepsy who presented to our outpatient epilepsy clinic following an epilepsy-related admission during a 10-year period (2012 - 2021).

Results: The study group included 134 patients with epilepsy aged 18- 85 years who presented to our outpatient epilepsy clinic following an epilepsy-related admission. Patients with pre-admission follow up in the epilepsy clinic (n = 67) were less likely to have epilepsy-related admissions during subsequent post-admission follow-up (p = 0.024), had fewer prior admissions related to antiseizure medication (ASM) discontinuation, ASM nonadherence or sub-therapeutic ASM serum levels (p = 0.038), were more likely to continue epilepsy clinic follow-up (p = 0.036), and received more ASMs before admission (p = 0.0001), at the first post-admission visit (p = 0.0001) and at last follow-up (p = 0.015).

Conclusions: Epilepsy clinic follow-up may affect the rate of epilepsy and ASM related admissions. Further studies are needed to evaluate the effects of ASM polytherapy and possibly higher doses of ASMs on the rates of epilepsy-related admissions.