PND43 THE BURDEN OF PEDIATRIC PARTIAL ONSET SEIZURES: A REVIEW OF THE LITERATURE

Abstract

To better understand the burden of epilepsy among 2- to 12-year-olds, we conducted a targeted literature review summarizing incidence, prevalence, healthcare costs, utilization, and quality of life (QOL). We searched PubMed for English-language publications reporting on children 2-12 years with either partial onset seizures (POS) or primary generalized tonic-clonic seizures, published in the United States since 2008. Data on incidence, prevalence, healthcare costs, utilization, and QOL outcomes were extracted. Findings on POS are presented here. 3,020 studies were found; 48 were included in this review. Incidence of POS was 23.2-47.1 per 100,000 children per year; prevalence was 2.0 per 1,000 children, and ranged from 1.6 to 2.6 per 1,000 in patients of any age. Annual total healthcare costs among patients of any age with POS ranged from $18,369-38,549, and were approximately two times higher in refractory POS. First-year total healthcare costs for children with POS were $19,883. Patients of any age with POS had about 10 outpatient visits, 24 procedures, 2 hospitalization days (less than 1 epilepsy-related) and 30 medication dispensing events (7 epilepsy-related) per year. Eight studies reported on QOL burden; 6 on cognitive difficulties (language, visuospatial, and memory development delays) and 4 on behavioral disorders (anxiety, depression, and attention-deficit disorder). Children with POS scored below average on cognitive assessments, and up to 42%, 16%, and 19% had depression, anxiety, and attention-deficit disorder, respectively. Incidence and prevalence of POS in children are high, similar to that of childhood type 1 diabetes; further, healthcare cost, utilization, and QOL burdens facing patients with POS are significant, especially among the group with refractory seizures. Most studies did not report outcomes aggregated by age groups or did not stratify by POS, which was true for utilization. Future studies focused exclusively on children with POS would be useful to more precisely describe the burden.