Abstract

Background: Epilepsy can achieve remission through accessible medications and regular follow-up. However, maintaining remission became challenging due to the barriers to care that emerged during the COVID-19 pandemic. Objective: To assess the prevalence of worsened seizure control in pediatric patients with epilepsy during the COVID-19 pandemic. Associated factors would be defined and investigated. Materials and Methods: A cross-sectional study was conducted on patients with epilepsy at the Pediatric Outpatient Unit of Bhumibol Adulyadej Hospital in Bangkok, Thailand, between January and February 2022. The present study included patients aged 1 month to 18 years at the time of diagnosis, with epilepsy diagnosed at least six months before the COVID-19 pandemic, making the diagnosis between January 2012 and October 2019, and treated with at least one antiseizure medication. Guardians were interviewed via telephone to assess demographic data, epilepsy characteristics, and their views on changes in care. Results: Among the 509 patients, 128 were included. Forty percent of guardians reported facing challenges in scheduling follow-up doctor’s appointments, primarily due to the fear of COVID-19 infection for 61.9%. The prevalence of worsened seizure control during the COVID-19 pandemic was 4.7%. Uncontrolled seizures at baseline were identified as a significant factor influencing worsened seizure control (p=0.001). Conclusion: Approximately five percent of pediatric patients with epilepsy experienced worsened seizure control during the COVID-19 pandemic. This highlights the importance of continuous care for this vulnerable group, even between limitations in travel and access to medical services. Forty percent of guardians reported difficulty in scheduling follow-up physician appointments. These findings suggest the importance of establishing efficient medication delivery and that telemedicine services for epilepsy care be considered in future planning, especially in anticipation of potential future waves of COVID-19 or other disease outbreaks. Keywords: COVID-19; Epilepsy; Seizure control; Pediatric patients

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