TUESDAY, Oct. 20, 2020 — Patients with new-onset focal epilepsy with subtle seizures experience prolonged time to diagnosis, according to a study published online Oct. 20 in Epilepsia.

Jacob Pellinen, M.D., from the New York University School of Medicine in New York City, and colleagues examined the causes and consequences of delayed diagnosis in patients with focal epilepsy. Time to diagnosis, injuries, and motor vehicle accidents (MVAs) were compared in patients with subtle versus disruptive seizures at the onset of epilepsy in a cross-sectional study. Data were included for 447 patients who completed enrollment data for analysis. Patients were classified by initial seizure semiology: subtle seizure (SS) or disruptive seizure (DS).

The researchers found that demographic characteristics were similar for the 246 and 201 patients with onsets characterized by SS and DS, respectively. The median number of days to diagnosis from first reported seizure was 616 and 60 days for patients with SS and DS, respectively. Between the groups, the proportion who experienced injury prior to diagnosis was similar, as was the severity of injuries. Of the 23 MVAs, 19 occurred in patients with undiagnosed SS.

“To improve diagnoses, it is critical that physicians not overlook the possibility of a seizure, particularly during emergency room visits and after any kind of car accident,” Pellinen said in a statement. “Patients need to partner with their physicians and be honest about any recurring abnormal or unusual symptoms they experience.”

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