Conceptualization and implementation of an interdisciplinary clinic for children with drug-resistant epilepsy during the COVID-19 pandemic

Samanta, Debopam; Elumalai, Vimala; Desai, Vidya C.; Hoyt, Megan Leigh

doi:10.1016/j.yebeh.2021.108403

Cited by 8 publications

(5 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Their ASMs should be adjusted more precisely by checking side effects routinely and by monitoring EEG. However, problems in accessing health system for epilepsy treatment including changing of ASMs regimen and restricted access to EEG or monitoring units might have played a role in worsening seizure control in our study, in accordance with data published previously regardless of ethics or national income [24]. According to previous studies, more than 90% of pediatric neurological health care service have been affected by difficulty accessing epilepsy professionals and medicine, decreased access to EEG, restricted outpatient or admission in epilepsy units, and cancellations [17,24] that might have contributed to their worsening seizure control and exacerbated their comorbidities.…”

Section: A B C Time From Diagnosi Viruses Comorbiditisupporting

confidence: 91%

“…Our findings showed that risks of seizures during the pandemic were significantly increased for children who were diagnosed with epilepsy less than 1 year, those who were having cerebral palsy or having a tracheostomy or a PEG, and those who were infected with other viruses (respiratory syncytial virus, influenza virus A, influenza virus B). Some similar factors such as poor access to healthcare and difficulties to obtain ASMs have been reported from separate literatures [24]. Children with shorter duration of epilepsy (diagnosed for less than 1 year) might have variable seizure frequency at baseline.…”

Section: A B C Time From Diagnosi Viruses Comorbiditimentioning

confidence: 73%

See 1 more Smart Citation

Impacts of COVID-19 Pandemic on Seizure Control in Children with Epilepsy

Moon¹,

Yoon²,

Jung³

2023

Preprint

View full text Add to dashboard Cite

The coronavirus disease 2019 (COVID-19) pandemic has disrupted health care worldwide. As the pandemic has been prolonged, quarantine restrictions have been lightened gradu-ally, which can influence outcomes of pediatric patients with chronic disease such as epi-lepsy by increase of susceptibility of the COVID-19 infection. The aim of this study was to determine impacts of COVID-19 pandemic on seizure control and identify potential risk factors that might worsen seizure attacks during the pandemic in children with epilepsy. We performed a retrospective chart review of 48 pediatric patients with epilepsy during the COVID-19 pandemic from January 2016 to July 2022. During the COVID-19 pandemic period, 25% of pediatric patients experienced sei-zure worsening, showing an increase in seizure frequency or duration or both. Factors associated with worsening seizures during pandemic were: diagnosis of epi-lepsy less than one year, comorbid conditions with cerebral palsy or having a tracheosto-my or a PEG, and infection with other viruses (respiratory syncytial virus, influenza virus A, influenza virus B) rather than COVID-19 infection. Our finding highlights the need to proactively monitor and regularly follow up (es-pecially short period of time) patients after they are diagnosed with epilepsy. It is also important to properly manage those who are susceptible to serious illness and keep sea-sonal viral infections under surveillance to manage exacerbated seizure in children with epilepsy. Furthermore, pediatric physicians should not overlook surveillance of seasonal respiratory viruses since quarantine restrictions are getting eased.

show abstract

Section: A B C Time From Diagnosi Viruses Comorbiditisupporting

confidence: 91%

Section: A B C Time From Diagnosi Viruses Comorbiditimentioning

confidence: 73%

Impacts of COVID-19 Pandemic on Seizure Control in Children with Epilepsy

Moon¹,

Yoon²,

Jung³

2023

Preprint

View full text Add to dashboard Cite

show abstract

“…52 Lastly, a formal team-based presurgical counseling approach(involving nurses, care coordinators, and social workers), with or without the use of telehealth services, may be more time-sensitive and sustainable in a busy clinical practice without causing clinician burnout. 53,54…”

Section: Discussionmentioning

confidence: 99%

Physicians’ Perspectives on Presurgical Discussion and Shared Decision-Making in Pediatric Epilepsy Surgery

et al. 2022

Self Cite

View full text Add to dashboard Cite

Objective: To qualitatively explore the approach of pediatric epilepsy providers when counseling regarding surgical options for epilepsy, presenting risks and benefits of surgery, overcoming resistance to surgery, and fostering shared decision making with patients and families. Methods: We conducted in-depth interviews with 11 academic clinicians (5- neurologists, 5- epileptologists, 1- neurosurgeon) from a Level 4 pediatric epilepsy center to explore how physicians communicate and pursue surgical decision-making. Results: A blended inductive-deductive analysis revealed three key themes (with subthemes) of presurgical discussions: (1) Candidate selection and initial discussion about epilepsy surgery (neurologists compared to epileptologists, the timing of the discussion, reluctant families) (2) Detailed individualized counseling about epilepsy surgery (shared decision-making [enablers and barriers] and risk-benefit analysis [balancing risks and benefits, statistical benefit estimation, discussion about SUDEP, prognostication about cognitive and behavioral outcomes, risks of surgery]) (3) Tools to improve decision-making (educational interventions for patients and families and provider- and organization-specific interventions). Significance: Presurgical discussions lack uniformity among physicians who treat epilepsy. Despite general interest in collaborative decision-making, experts raised concern about lack of exposure to communication training and clinical tools for optimizing decision-making, a high number of families who do not feel equipped to share the decision making leaving the decision-making entirely to the physician, and paucity of practical resources for individualized risk-benefit counseling. Clinical practice guidelines should be developed to reduce existing practice variations in presurgical counseling. Further consensus is needed about when and how to initiate the conversation about epilepsy surgery, essential components of the discussion, and the utility of various tools to improve the utilization of epilepsy surgery.

show abstract

“…One way to address the increased mental health needs of this population is through targeted services available as part of a multidisciplinary clinic (Samanta et al, 2021), and the International League Against Epilepsy has also provided support and guidance on developing such service lines (Gandy et al, 2023). Past research has demonstrated that integration of psychosocial services into pediatric epilepsy clinics is both feasible and necessary, given psychosocial risks discussed at length above including increased risks for depression and suicidality (Guilfoyle et al, 2013(Guilfoyle et al, , 2015.…”

mentioning

confidence: 99%

Establishing a psychosocial screening program in a high-volume pediatric epilepsy clinic using the PedsQL—Epilepsy module.

Bernat,

McNally,

Ostendorf

et al. 2024

Clinical Practice in Pediatric Psychology

View full text Add to dashboard Cite

Objective: Children and adolescents with epilepsy are at increased risk for a number of comorbidities which can affect their health-related quality of life. We aimed to leverage data collected through widespread, automated distribution of the PedsQL-epilepsy module (Modi et al., 2017) to patient caregivers in order to assess the feasibility of using the PedsQL to create a formalized psychosocial screening program. Method: Our team utilized quality improvement methodology to establish a clinic workflow and trial a psychosocial screening program based on targeting specific domains of the PedsQL-epilepsy module using existing cutoff scores. Results: In our sample, 58% (n = 67) of patients screened positive on one or more of the three targets PedsQL-epilepsy module domains based on parent reports. Approximately 40% of those were seen for a consult (n = 26). Consults most often involved psychoeducation related to the special education process or brief intervention for managing behavioral or mood concerns (76.9% of children who screened positive, n = 20). Conclusion: The existing PedsQL-epilepsy module cutoff scores demonstrated utility in targeting patients for intervention in our high-volume multidisciplinary pediatric epilepsy clinic. Implications for Impact StatementThis article demonstrates the feasibility of using the PedsQL-epilepsy module in order to screen for psychosocial concerns in a busy pediatric epilepsy clinic. Valuable details including the process for developing and refining the screening process are also included.

show abstract

Conceptualization and implementation of an interdisciplinary clinic for children with drug-resistant epilepsy during the COVID-19 pandemic

Cited by 8 publications

References 52 publications

Impacts of COVID-19 Pandemic on Seizure Control in Children with Epilepsy

Impacts of COVID-19 Pandemic on Seizure Control in Children with Epilepsy

Physicians’ Perspectives on Presurgical Discussion and Shared Decision-Making in Pediatric Epilepsy Surgery

Establishing a psychosocial screening program in a high-volume pediatric epilepsy clinic using the PedsQL—Epilepsy module.

Contact Info

Product

Resources

About