Abstract
Saipan is a United States (US) territory Western Pacific island where little recent data exists regarding epidemiology, clinical presentation, and standard of care for pediatric seizures. This paper characterizes these features in Saipan’s pediatric population with comparisons to mainland US. This is a retrospective chart review of all pediatric patients with a history of seizures at the island’s only hospital and major private neurology clinic over a 10-year period. Variables regarding demographics, presentation, diagnosis, and treatment were collected. A total of 144 patients were included, with 101 patients diagnosed with febrile seizures and 31 patients diagnosed with non-febrile seizures. Age at first presentation peaked at 1 year old overall. The most common identified etiology of epilepsy was found to be hypoxic injury (39%), hemorrhagic injury (10%), cerebral malformation (6%), and brain mass (6%). Simple versus complex classification of febrile seizures, etiologies, and first-line treatment for non-febrile seizures were comparable to the mainland US. Electroencephalogram (EEG) was not used consistently in diagnosis. The findings from this study demonstrate that clinical presentations of pediatric seizures in Saipan are comparable to those in the mainland US.
Highlights
While significant data exists describing the epidemiology of childhood seizures in the UnitedStates (US), the same cannot be said for other regions in the world
This was a retrospective chart review of all patients under the age of 18 years with the ICD−9 and ICD−10 codes corresponding to seizures and epilepsy in the electronic health record system (EHR) at Commonwealth Healthcare Corporation (CHC) and paper charts at a private neurology clinic in Saipan between 2008 to 2018
In terms of epidemiology and standards of care, we found that the population of children with febrile seizures and epilepsy in Saipan is highly comparable to that of the United States (US)
Summary
While significant data exists describing the epidemiology of childhood seizures in the UnitedStates (US), the same cannot be said for other regions in the world. Mariana Islands (CNMI) is a US territory comprised of several islands in the Western Pacific region. The capital and the largest of the CNMI islands, has a population of roughly 50,000 people, most of which are Asians and Pacific Islanders [1]. The existing data about pediatric epilepsy that can most closely be approximated to the population of Saipan comes from Guam, a neighboring Mariana. Apart from a 2004 World Health Organization publication stating that there was insufficient epidemiological data and unreliable estimates of the epilepsy burden in the Western Pacific region, little more has been published since [3]. Guam’s population is over three times that of the CNMI and includes a higher ratio of native islanders to Asian immigrants, whereas the CNMI has a roughly equal ratio of the two populations [1]. We aim to characterize the Saipanese pediatric population and compare to the mainland US
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