Abstracts

Rationale:
Although the effects of the COVID-19 pandemic on persons with epilepsy have been documented in major outbreak areas, little is known about their experiences in areas with relatively low disease prevalence but with similar ‘stay-at-home’ government orders. We sought to assess the outpatient experience of persons with epilepsy in the state of Hawaii, which imposed strict lockdown orders early in the course of the pandemic despite having one of the lowest numbers of COVID-19 cases in the United States.
Method:
A telephone survey was conducted on neurological patients seen at Hawaii Pacific Neuroscience between April 22 and May 18, 2020, assessing four topics of interest: access to care, mental and general health changes, experience with telemedicine, and symptom-related changes. Responses from persons with epilepsy were compared to those from persons with other neurological conditions to investigate any disproportionate impacts of the pandemic.
Results:
Sixty-seven persons with epilepsy and 300 with other neurological conditions were identified. Those with epilepsy, in large part, did not report having difficulties accessing care and had positive experiences with telemedicine. Nearly half would not have sought care if telemedicine were not an option, and 42.3% would prefer telemedicine over in-person appointments even after the pandemic. Alarmingly, 46.2% reported experiencing new or worsening depression, anxiety, or sleep problems—all of which are associated with worse outcomes in epilepsy patients. Loss of employment due to mandatory non-essential business closures affected 21.3% of respondents with epilepsy who were previously employed. The responses in this study between persons with epilepsy versus other neurological conditions were not significantly different. Seventeen out of 48 respondents with epilepsy reported having one or more seizures since the start of the pandemic, five of which required emergency services.
Conclusion:
The impact of the COVID-19 pandemic was substantial both in persons with epilepsy and in those with other neurological conditions. Seizure triggers including stress-induced depression and anxiety as well as sleep problems should be a major point of concern for patients with epilepsy, their caregivers, and their providers. Telemedicine has been important for maintaining regular consultations for patients with epilepsy during stay-at-home orders at little to no sacrifice in patient satisfaction. Overall, these findings suggest that psychological distress resulting from the COVID-19 pandemic has not only affected pandemic hotspots but has also greatly affected areas like Hawaii, where the incidence is relatively low.
Funding:
:No funding was received for this research.