The Humanistic and Economic Burden of Pediatric Focal Seizures in the United States

Abstract

Objective: To better understand the humanistic and economic burden of focal seizures in children 2-12 years old. Methods: We conducted a targeted literature review by searching MEDLINE for English-language publications reporting on children 2-12 years old with focal seizures published in the United States since 2008. Results: Thirty-five publications were included. Incidence of focal seizures was 23.2 to 47.1 per 100,000 children per year; prevalence was 2.0 per 1,000 children, and ranged from 1.6 - 2.6 per 1,000 in patients of any age. Life expectancy was 47.3-61.8 years among children 3-12 years old. Patients took several antiepileptic drugs and experienced frequent seizures, sleep disorders, mood disorders, migraine, and seizure-related injuries (eg, bone fractures, sprains, open wounds). Children with focal seizures scored below average on cognitive assessments and up to 42%, 16%, and 19% had depression, anxiety, and attention-deficit disorder, respectively. Patients of any age had about 10 outpatient visits (2 epilepsy-related), 2 inpatient visits (less than 1 epilepsy-related), and 24 procedures (1 epilepsy-related) per year. Medication adherence was low: only half of pediatric patients maintained ≥90% adherence over 6 months. Annual total health care costs among patients of any age ranged from $18,369 - 38,549; first-year total health care costs for children were $19,883. Conclusions: Incidence and prevalence of focal seizures is high and the humanistic and economic burdens are significant. Future studies focused exclusively on children with focal seizures are needed to more precisely describe the burden. We also suggest further research and implementation of methods to improve medication adherence as an approach to lessen burden on these young patients.

START-Play Physical Therapy Intervention Impacts Motor and Cognitive Outcomes in Infants With Neuromotor Disorders: A Multisite Randomized Clinical Trial

“…However, in some cases, exclusion could only be determined from post-intervention questionnaires. Based on the outtake information, 14 infants were deemed ineligible due to neurodegenerative diagnoses and/or seizure disorder that became uncontrolled during the study period, 22 1 infant was ineligible due to a neurodegenerative diagnosis at baseline, 1 infant was ineligible due to inadequate sitting at baseline, and 6 infants were ineligible due to Bayley gross motor scores ≤1.0 SD below the mean at baseline. The latter 7 infants did not meet our original inclusion criteria and were thus excluded prior to analysis for final outcomes.…”