Characteristics of patients with epilepsy admitted to the pediatric emergency service

Introduction and Aim: Epilepsy is one of the most common neurological diseases of childhood. Pediatric patients diagnosed with epilepsy may apply to pediatric emergency services for different reasons, apart from pediatric neurology/child health and diseases outpatient follow-up. However, very few data are available in the literature regarding the epilepsy/non-epilepsy reasons for the emergency admissions of epileptic patients and the follow-up processes in the emergency department. In our study, it was aimed to examine the characteristics of patients with epilepsy who admitted to the pediatric emergency department and the reasons for admission and the follow-up process in the pediatric emergency department. Materials and Methods: Our study is a retrospective study, and 802 emergency applications of 492 patients aged between 1 month and 18 years with a diagnosis of epilepsy who applied to the Ankara City Hospital Pediatric Emergency Service between January 01, 2020 and December 31, 2021 were included in the study. Age, gender, age at diagnosis of epilepsy, seizure frequency, seizure characteristics, used medications, presence of additional disease, reason for admittion to the pediatric emergency department, type of admitance to the pediatric emergency service (outpatient, ambulance), diagnosis/treatment/duration of stay in pediatric emergency service/ discharge information (emergency observation/hospitalization/ intensive care admission/exitus) was evaluated. Results: The mean age of our patients was 99,4±64,3 months, 59.8% were male and 40.2% were female. It was determined that the pediatric patients with epilepsy who were followed up in the pediatric neurology outpatient clinic in the last six months admitted to the pediatric emergency department more frequently. When the epilepsy etiologies of the patients admitted to the pediatric emergency department with the diagnosis of epilepsy were evaluated, 60.6% of the patients were in the group of unknown epilepsy etiology. There was an additional disease accompanying epilepsy in 34% of the patients, and it was found that those with an additional disease applied to the emergency department more frequently than those without. It was determined that the epilepsy follow-up period of the patients did not affect the frequency of admission to the pediatric emergency department. There was no statistically significant difference between the ages of patients with comorbidities and those without comorbidities. The most common reason for patients to apply to the pediatric emergency service was seizure (69.1%), while the other reasons for admission were upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), acute gastroenteritis (AGE), allergy, and psychiatric reasons. The most common cause of seizures in patients who presented to the emergency room with seizures was irregular use of antiepileptic drugs. Nine patients had hypoglycemia and four patients had hypocalcemia-related seizures. AED treatment was administered to 161 of 554 patients who applied to the emergency department with seizures, and the most common treatment was intravenous levetiracetam administration. 32.5% of the patients were hospitalized in pediatric services and 5.1% in pediatric intensive care. Conclusion: There is very few data in the literature regarding the epilepsy/non-epilepsy causes of epilepsy patients' admission to the emergency department and the follow-up processes in the emergency unit. In our study, the characteristics of the patients who applied to the pediatric emergency department with the diagnosis of epilepsy were examined. The most common reason for admission was seizures. The most common cause of seizures was the irregular use of antiepileptic drugs. It was determined that the presence of additional diseases accompanying epilepsy increased the frequency of admission to the pediatric emergency department.