Abstracts

Rationale: Seizure severity is a multi-factorial construct, despite continued debate over the contributing clinical variables. Research into seizure severity has focused on adult populations with epilepsy but similar measures have not been well delineated in a pediatric population. Because the caregiver serves as the main informant for children with epilepsy it is crucial to understand how caregivers conceptualize their child's seizure severity, which is commonly interpreted as synonymous with disease severity. We elucidated the factors that influence a caregiver's assessment of seizure severity. Methods: As part of a larger epidemiological study, Seizures and Outcomes Study in Children, caregivers were asked in a survey to rate the child's seizure severity on a 6 point scale, ranging from mild to very severe. Caregivers answered questions about the clinical presentation of the child's seizures: seizure frequency, seizure duration, age of onset, events of status epilepticus, number of medications, seizure length, frequency of nocturnal seizures, and length of postictal recovery period. Caregivers rated factors related to the child's seizure burden and quality of life including number of seizure related injuries, seizure related Emergency Room trips, how often the child was late to/missed school due to a seizure, and how much epilepsy affects various areas of the child's life. Pearson's correlation coefficients were computed to express association between seizure severity to clinical and quality of life scales obtained from caregiver. Results: Mean age was 8 years and mean seizure duration was 4 years. Of those caregivers who completed the survey (n=114), the most predictive factors of higher seizure severity were seizure length (r=.48, p≤.001), Emergency Room visits (r=.40, p<.001), number of medications (r=.32, p≤.001), episodes of status (r=.31, p≤.001), nocturnal seizure frequency (r=-.25, p≤.01), and seizures in the past 6 months (r=.25, p<.01). Conclusions: These findings indicate both clinical variables as well as interferences to daily living as notable factors for formulating seizure severity. These efforts will be helpful in guiding future work to create a standardized pediatric epilepsy severity rating scale, aimed to contribute to the systematic characterization of pediatric epilepsy and the care of children with epilepsy.