Abstracts

To assess epilepsy service quality in non-specialized hospitals . The study included 687 patients with seizures. Male/Female ratio was 418/271. Age distribution was as follow: 304 (44, 2%) patients were in age group 0-7 years, whereas 383 (55, 7%) pts. [ndash] in 7-25 years. In 158 (23%) patients age of onset was by 0-1 years, 146 pts. (21,3%) [ndash] by 1-3 years, 113 pts. (16,4%) - by 3-5 years, 80 pts. (11,6%) - by 5-7 years, 157 pts. (22,9%) [ndash] by 7-14 years and 11 (1,6%) - by 14-25 years. The most common seizure type was GTCS (560 pts.- 81,5%), which in 382 of cases (68,2%) was not associated with other seizure types, which may reflect low awareness of seizure types among physicians. CPS were recorded in 62 cases (9,02%), SPS [ndash] in 105 cases (15,3%), AS [ndash] in 75 cases (10,9%), M [ndash] in 26 cases (3,9%), tonic [ndash] 3 cases (0,4%), akynetic [ndash] 4 cases (0,6%), atonic [ndash] 8 cases (1,2%), IS [ndash] in 6 cases (0,9%). Most frequently (155-22,3%) predominantly seizure type occurred 1-5 times per year, in 125 cases (18,2%) they occurred daily. The etiology was defined as idiopathic in 27 cases (3,9%), symptomatic [ndash] in 217 (31,6%) and cryptogenic [ndash] in 77 cases (11,2%). The seizures considered as febrile in 97 cases (14,2%). CT investigation was performed in 23 cases- 3,3% (8 positive vs. 15 negative). 96 patients (14%) were on AEDs at the moment of receipt (62 {64,6%} monotherapy vs. 18 {18,75%} polytherapy), 246 (35,8%) did not receive any medication. 37 pts. (38,5%) had complete seizure control, 27 pts. (28,1%) experienced partial control, in 17 cases no control observed. In 29 cases (vs.14) we could define choice of AEDs as appropriate. Single EEG was performed in 615 cases {89,5%} (476 positive vs. 140 negative), in 70 cases {10,2%} it was not performed at all. High percentage of positive cases in single EEG performance expressed overinterpretation of the results obtained (namely non-specialized discharges considered as epileptiform). The anonymous term of seizure predictability had widespread distribution among neurophysiologists. The diagnosis of epilepsy was confirmed in 621 cases (90,4%). The classification of established diagnosis into focal and generalized syndromes was possible in 202 cases- 29,4% (focal 150 vs. 70 generalized), in 378 cases (55%) it was hard to classify epilepsy in generalized or focal. This study allow us to find out low epilepsy service quality in children neurological hospitals in Armenia, which include inappropriate antiepileptic drug therapy, low qulity EEG examination, which fail to reveal epileptiform discharges, limitation and/or absence of visualization methods in diagnosis of epilepsy, absence of syndromal qualification of disease. These results showed that there is a great diagnostic and treatment gap among neurologists. Our efforts are to optimize the knowledge and management of epilepsy