Related Experiment Video
Updated: May 17, 2026
Electrophoretic Delivery of γ-aminobutyric Acid (GABA) into Epileptic Focus Prevents Seizures in Mice
Published on: May 16, 2019
Association between sociodemographic status and antiepileptic drug prescriptions in children with epilepsy
Peter Mattsson1, Torbjörn Tomson, Karin Edebol Eeg-Olofsson
1Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden. peter.mattsson@neuro.uu.se
Insights
Sociodemographic factors influence access to expert epilepsy care and antiepileptic drug (AED) prescriptions in Swedish children. Inequalities persist despite universal healthcare, highlighting the need for equitable access to specialized pediatric neurological services.
Area of Science:
- Pediatric Neurology
- Public Health
- Health Services Research
Background:
- Epilepsy affects a significant number of children, necessitating specialized care and medication.
- Understanding sociodemographic influences on healthcare access is crucial for addressing health disparities.
Purpose of the Study:
- To investigate associations between sociodemographic factors and access to expert healthcare for children with epilepsy in Sweden.
- To examine disparities in antiepileptic drug (AED) prescriptions based on child and parental characteristics.
Main Methods:
- Nationwide cross-sectional study using Swedish national administrative registers.
- Linked data on epilepsy diagnoses, AED prescriptions, and sociodemographic variables (gender, age, parental education, residence, region of birth, income).
- Compared access to neuropediatricians and AED prescribing patterns across different sociodemographic groups.
Main Results:
- Younger children (1-5 years) and those in large cities were more likely to see a neuropediatrician.
- Specific AEDs like oxcarbazepine and levetiracetam showed differential prescription patterns based on location and parental income.
- Neuropediatricians were more likely to prescribe lamotrigine, oxcarbazepine, and levetiracetam compared to other specialists.
Conclusions:
- Universal healthcare coverage in Sweden does not eliminate inequalities in accessing specialized pediatric epilepsy care.
- Sociodemographic factors significantly impact both access to expert care and AED prescription patterns.
- Differences in AED prescribing exist between neuropediatricians and other physicians, suggesting a need for further investigation into optimal treatment strategies.
Purpose:
We investigated whether in Sweden sociodemographic differences are associated with access to expert health care and antiepileptic drug (AED) prescriptions in children with epilepsy.
Methods:
Data on epilepsy, prescription of AEDs, and sociodemographic variables were obtained from several national administrative registers. We linked individual data to examine whether access by pediatric epilepsy patients to neuropediatricians and the prescription of individual AEDs differed according to gender, age, parental education, place of residence, parental region of birth, and household income. We also assessed whether AEDs are prescribed differently to patients with epilepsy by neuropediatricians as compared to other physicians.
Key Findings:
Of 1,788,382 children aged 1-17 years in 2006, living in the country by the end of 2006, 9,935 had a diagnosis of epilepsy (0.56%). Patients with epilepsy on AED treatment (n = 3,631) comprised 0.24% of the total Swedish population aged 1-17 years. Out of 3631 patients with epilepsy on AED treatment, 2301 (63.4%) received prescriptions from a neuropediatrician. Children with epilepsy aged 1-5 years old--as opposed to older children and adolescents--and children with epilepsy residing in large cities--as opposed to children living in smaller cities and rural areas--were more likely to be treated by a neuropediatrician. Children living in large cities received oxcarbazepine to a greater extent than children living in rural areas. Levetiracetam was prescribed more extensively to children whose parents had higher incomes. Of the five most frequently used AEDs, three (lamotrigine, oxcarbazepine, and levetiracetam) were prescribed to a larger extent by a neuropediatrician rather than by other specialists, and one AED (carbamazepine) was prescribed to a lesser extent.
Significance:
The results of this nationwide cross-sectional study of children with epilepsy are important because they show that universal coverage for medical care does not eliminate inequalities of access to health care services among children and adolescents. No data are available that can guide us as to whether the density of child neurologists is of importance to access to expert health care, but this seems likely. Prescription patterns of AEDs differ between child neurologists and other specialists.
Related Concept Videos
01:24Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
01:08Antiepileptic Drugs: Sodium Channel Blockers
Sodium channel blockers modulate ion channels, particularly voltage-gated sodium channels. They block only sodium ion movement.
Among the most commonly prescribed antiepileptic drugs are...
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
01:22Epilepsy ll: Types
01:17Antiepileptic Drugs: Calcium Channel Blockers
Calcium channel blockers exert their antiepileptic effects by targeting T-type calcium channels, which are integral to transmitting nerve signals in the central nervous system. These channels allow the passage of calcium ions, which are vital for neuronal communication. By inhibiting T-type calcium channels, calcium channel blockers effectively reduce the release of neurotransmitters and...
01:20Antiepileptic Drugs: Potassium Channel Activators
Ezogabine has gained approval as an adjunctive treatment...