Please use this identifier to cite or link to this item:
Title: Diagnostic delay in focal epilepsy: Association with brain pathology and age.
Austin Authors: Yang, Mengjiazhi;Tan, K Meng;Carney, Patrick W ;Kwan, Patrick;O'Brien, Terence J;Berkovic, Samuel F ;Perucca, Piero ;McIntosh, Anne M 
Affiliation: The Melbourne Brain Centre, The Department of Medicine, The University of Melbourne, Melbourne, Australia..
Eastern Health, Australia..
The Florey Institute of Neuroscience and Mental Health
Epilepsy Research Centre
Medicine (University of Melbourne)
The Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia..
Gold Coast University Medical Centre, QLD, Australia..
Department of Neuroscience, Central Clinical School, Monash University, Australia..
Department of Neurology, Alfred Health, Melbourne, Australia.
Department of Medicine, Monash University, Australia..
Comprehensive Epilepsy Program
Issue Date: Mar-2022
Date: 2022
Publication information: Seizure 2022; 96: 121-127
Abstract: Between 16-77% of patients with newly diagnosed epilepsy report seizures before diagnosis but little is known about the risk factors for diagnostic delay. Here, we examined the association between prior seizures and neuroimaging findings in newly diagnosed focal epilepsy. Adults diagnosed with focal epilepsy at First Seizure Clinics (FSC) at the Royal Melbourne Hospital or Austin Health, Melbourne, Australia, between 2000 and 2010 were included. Medical records were audited for seizure history accrued from the detailed FSC interview. Potentially epileptogenic brain abnormality type, location and extent was determined from neuroimaging. Statistical analysis comprised multivariate logistic regression. Of 735 patients, 44% reported seizure/s before the index seizure. Among the 260 individuals with a potentially epileptogenic brain imaging abnormality, 34% reported prior seizures. Of 475 individuals with no abnormality, 50% reported prior seizures (p < 0.001). Patients with post-stroke changes had lower odds of prior seizures (n = 24/95, OR 0.5, p = 0.005) compared to patients without abnormalities, as did patients with high-grade tumors (n = 1/10, OR 0.1, p = 0.04). Abnormality location or extent was not associated with seizures. Prior seizures were inversely associated with age, patients aged >50 years had lower odds compared to those 18-30 years (OR 0.5, p = 0.01). A history of prior seizures is less common in patients with newly diagnosed focal epilepsy associated with antecedent stroke or high-grade tumor than in those without a lesion, and is also less common in older individuals. These findings may be related to age, biological mechanisms or aspects of diagnosis and assessment of these events.
DOI: 10.1016/j.seizure.2022.02.004
ORCID: 0000-0003-4580-841X
Journal: Seizure
PubMed URL: 35202928
PubMed URL:
Type: Journal Article
Subjects: Diagnostic delay
Traumatic brain injury
Appears in Collections:Journal articles

Show full item record

Page view(s)

checked on May 30, 2024

Google ScholarTM


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.