June 10, 2024

Emergency Departments Frequently Miss Signs of Epilepsy in Children

Article by NYU Langone Health

A subtle type of seizure goes undetected two-thirds of the time in pediatric emergency departments, a new study shows. The work focuses on “nonmotor” seizures, which cause children to ‘zone out’ and stare into space or fidget. Children may also feel sudden changes in emotions, thoughts, or sensations. According to the authors, improving recognition of nonmotor seizures may speed up the diagnosis and treatment of epilepsy in children, who often struggle to describe their symptoms to physicians, or are not asked to do so. Led by researchers at NYU Langone Health, the analysis involved 83 preteens and teens in treatment for epilepsy. Because seizures are easy to overlook or confuse for anxiety and panic attacks, the authors say it is critical that healthcare providers screen for signs of nonmotor seizures. To better understand how well such nonconvulsive episodes are spotted by physicians and patients alike, the researchers first explored how likely a child was to seek medical attention for their symptoms before they were aware that they had epilepsy. According to the findings, only 4 children went to the emergency department specifically for symptoms of a nonmotor seizure, although the study team later determined that 44 had a history of such issues. By contrast, 21 children visited the hospital for their first-ever motor seizure, out of 39 total. Even when treatment was sought, however, it was unlikely that their symptoms were properly diagnosed. The analysis showed that emergency department physicians correctly identified only 33 percent of first-time nonmotor seizures, compared with 81 percent of first-time motor seizures. Notably, the findings further revealed that while almost 40 percent of the teens turned out to have a history of nonmotor seizures, none were asked about them during their hospital visit. As a result, they were no more likely to be diagnosed and treated for epilepsy than those experiencing a motor seizure for the first time. The research team is now exploring ways to boost epilepsy recognition among members of the public as well, and hopes that symptoms become common knowledge, as the symptoms of heart attack and stroke are already.