NEW
YORK, May 1, 2024 /PRNewswire/ -- A subtle type
of seizure goes undetected two thirds of the time in pediatric
emergency departments, a new study shows.
The work focuses on "nonmotor" seizures, which cause children to
"zone out" and stare into space or fidget. They may also feel
sudden changes in emotions, thoughts, or sensations, as opposed to
motor seizures, which cause muscles to move in abrupt, jerking
motions.
According to the authors, improving recognition of nonmotor
seizures may speed up the diagnosis and treatment of epilepsy in
children, who often struggle to describe their symptoms to
physicians or are not asked to do so. Brief nonmotor episodes may
happen for years before motor convulsions or other, more severe and
obvious symptoms appear.
Led by researchers at NYU Langone Health, the analysis involved
83 preteens and teens in treatment for epilepsy, a chronic
neurological disorder in which groups of brain cells send out
excessive bursts of electrical signals and trigger seizures. To be
diagnosed with the condition, a patient must have experienced a
minimum of two seizures with no apparent cause. Because they are
easy to overlook or confuse for anxiety and panic attacks, the
authors say it is critical that healthcare providers screen for
signs of nonmotor seizures.
To better understand how well such nonconvulsive episodes are
spotted by physicians and patients alike, the researchers first
explored how likely a child was to seek medical attention for their
symptoms before they were aware that they had epilepsy. According
to the findings, only four children went to the emergency
department specifically for symptoms of a nonmotor seizure,
although the study team later determined that 44 had a history of
such issues. By contrast, 21 children visited the hospital for
their first-ever motor seizure, out of 39 total.
Even when treatment was sought, however, it was unlikely that
their symptoms were properly diagnosed, the study authors report.
Their analysis showed that emergency department physicians
correctly identified only 33% of first-time nonmotor seizures,
compared with 81% of first-time motor seizures.
"Our findings highlight the need for better recognition of
epilepsy in adolescents," said study lead author Nora Jandhyala, BS. "Clearly, there is a large
gap in emergency department screening that may be delaying
lifesaving treatment," added Jandhyala, a medical student at NYU
Grossman School of Medicine.
Notably, the findings further revealed that while almost 40% of
the teens turned out to have a history of nonmotor seizures, none
were asked about them during their hospital visit. As a result,
they were no more likely to be diagnosed and treated for epilepsy
than those experiencing a motor seizure for the first time.
A report on the findings is publishing online May 1 in the journal Neurology.
According to the United States Centers for Disease Control and
Prevention, epilepsy is one of the most common brain disorders in
children, affecting 470,000 under age 17. Untreated seizures can
cause permanent brain injury, memory loss, and even death, and
delays in diagnosis have been shown to increase risk for these
concerns, the authors say. Past research had already revealed that
nonmotor seizures are less likely to be noticed by physicians than
their more overt counterparts. However, how often this specifically
occurs in young people had until now remained unclear.
For the research, the team analyzed medical records of boys and
girls between the ages of 12 and 18 who had begun treatment for
epilepsy within four months of the study. Fifty-eight had visited
either a pediatric or general emergency department prior to their
diagnosis. This data was collected as part of the Human Epilepsy
Project, a multicenter partnership of 34 hospitals throughout
the United States, Europe, and Australia designed to better understand the
disorder and improve its treatment.
In the current study, researchers evaluated the children's
seizure history, traced their epilepsy diagnosis, and uncovered if
or when they were admitted to the hospital and referred to a
neurologist.
"Encouraging healthcare workers to routinely ask patients about
signs of nonmotor seizures may offer a simple way to spot epilepsy
before it worsens," said study senior author and neurologist
Jacqueline French, MD.
French, a professor in the Department of Neurology at NYU
Grossman School of Medicine, adds that the team is now exploring
ways to boost epilepsy recognition among members of the public as
well, and hopes that symptoms become common knowledge, similarly to
those of heart attack and stroke.
French, who is also a member of NYU Langone's Comprehensive
Epilepsy Center, notes that since the study data did not include
young children, who may face even greater difficulties in
communicating their experiences, nonmotor seizures may be even more
common than reported in the current study.
Study funding was provided by NYU Langone.
In addition to Jandhyala and French, other NYU Langone
investigators involved in the study are Monica Ferrer, MD, and Hadley Greenwood, BS. Other study authors
include Jacob Pellinen, MD, at the
University of Colorado in Denver;
Dennis Dlugos, MD, at the Children's
Hospital of Philadelphia;
Kristen Park, MD, at the Children's
Hospital of Colorado in Aurora;
and Kwee Liu Lin Thio, MD, PhD, at Washington University in St. Louis.
Media Inquiries:
Shira Polan
Phone: 212-404-4279
shira.polan@nyulangone.org
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SOURCE NYU Langone Health