Acute seizure-related hospitalizations in children with newly diagnosed epilepsy

Hospitalizations due to breakthrough seizures were studied in children with newly diagnosed epilepsy to evaluate (1) risk factors associated with such admissions, in particular the withholding of medication and subtherapeutic dose of anticonvulsants, and (2) the impact of the unscheduled hospitalization on subsequent seizure outcome. We recruited patients aged less than 18 years with newly diagnosed epilepsy who presented to the pediatric department in Tuen Mun Hospital between January 2002 and December 2003. Patients with acute seizure-related hospitalization within 1 year after diagnosis were included as cases (n = 36); patients with no such hospitalization were included as controls (n = 86). Treatment effect was analyzed at the last follow-up visit before January 2005. Significant univariate association was observed between seizure-related hospitalization and age at seizure onset (OR = 0.91, 95% CI 0.84, 1), idiopathic epilepsy (OR = 0.35, 95% CI 0.15, 0.81), no antiepileptic drug (OR = 3.67, 95% CI 1.51, 8.18), and subtherapeutic doses of antiepileptic drug (OR = 9.9, 95% CI 2.2, 43.8). Independent risk factors of such hospitalizations were etiology of epilepsy, no antiepileptic drug, subtherapeutic dose of antiepileptic drug, and history of febrile convulsion. Sixty-four percent of the cohort was seizure-free. Acute seizure-related hospitalization was associated with less favorable outcome (OR = 3.79, 95% CI 1.48, 9.26).