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dc.contributor.authorYang, Mengjiazhi-
dc.contributor.authorTan, K Meng-
dc.contributor.authorCarney, Patrick W-
dc.contributor.authorKwan, Patrick-
dc.contributor.authorO'Brien, Terence J-
dc.contributor.authorBerkovic, Samuel F-
dc.contributor.authorPerucca, Piero-
dc.contributor.authorMcIntosh, Anne M-
dc.identifier.citationSeizure 2022; 96: 121-127en
dc.description.abstractBetween 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.en
dc.subjectDiagnostic delayen
dc.subjectTraumatic brain injuryen
dc.titleDiagnostic delay in focal epilepsy: Association with brain pathology and age.en
dc.typeJournal Articleen
dc.identifier.affiliationThe Melbourne Brain Centre, The Department of Medicine, The University of Melbourne, Melbourne, Australia..en
dc.identifier.affiliationEastern Health, Australia..en
dc.identifier.affiliationThe Florey Institute of Neuroscience and Mental Healthen
dc.identifier.affiliationEpilepsy Research Centreen
dc.identifier.affiliationMedicine (University of Melbourne)en
dc.identifier.affiliationThe Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia..en
dc.identifier.affiliationGold Coast University Medical Centre, QLD, Australia..en
dc.identifier.affiliationDepartment of Neuroscience, Central Clinical School, Monash University, Australia..en
dc.identifier.affiliationDepartment of Neurology, Alfred Health, Melbourne, Australia.en
dc.identifier.affiliationDepartment of Medicine, Monash University, Australia..en
dc.identifier.affiliationComprehensive Epilepsy Programen
dc.identifier.pubmedid35202928-, Samuel F
item.fulltextNo Fulltext-
item.openairetypeJournal Article- Research Centre- Epilepsy Program- Research Centre-
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