Abstracts

Rationale: The Seizures and Outcomes Study in Children (SOS-KIDS) identifies risk factors, etiologies, and comorbidities in a pediatric epilepsy population in a major city with diversity and differences in socioeconomic levels. A thorough understanding of the range of issues impacting children with epilepsy is critical to establishing treatment that will produce better health outcomes such as better seizure control as well as identification and treatment of comorbidities. Methods: SOS-KIDS is a cross-sectional cohort study of pediatric epilepsy patients who live in Washington DC and are evaluated at Children’s National Health System. Families were recruited at the time of the child’s routine clinic appointment or inpatient visit. Information was extracted from participants’ electronic medical records (EMR) including seizure risk factors, etiology, characteristics, and comorbidities. Results: Data were collected from 289 participants (47% female, 53% male) and mean age was 7.8 years (2 months to 17 years). There was a diverse participant population: 80% were African American, 11% Caucasian, and 9% Hispanic. There are several perinatal risk factors for epilepsy: extreme prematurity (10%), intraventricular hemorrhage (6.9%), and neonatal seizures (6.9%). Other risk factors include febrile seizures (16.3%), malformation of cortical development (13.5%), known genetic disorders (8.6%), presumed genetic disorders (10.7%), head injury (5.2%), and CNS infections (1.7%). Approximately half had an unknown etiology. Numerous participants had documented comorbidities including headaches (14.9%), ADHD (14.2%), intellectual disability (12.8%), autism (8.0%), depression (1.7%), and anxiety (3.5%). Conclusions: We identified a wide variety of risk factors and etiologies among pediatric epilepsy patients; genetic, structural, or acquired components were similar to previous studies. The several documented comorbid medical and psychiatric conditions appear underreported compared to other studies involving active assessments. This may in part derive from underreporting by patients and under-diagnosis by clinicians especially in cases of psychiatric conditions including depression. Future studies will compare EMR documentation and active parental and patient screening to identify comorbidities necessary to optimize treatment and reduce the long-term healthcare burden from epilepsy and its associated conditions. Funding: This study is supported by the Centers for Disease Control and Prevention.