Abstract Details

Title Current Practice Habits and �鶹��ýӳ��al Opportunities in the Evaluation and Management of Pediatric Seizures in Guatemala

Topic Global Health and Neuroepidemiology

Presentation(s) P9 - Poster Session 9 (12:00 PM-1:00 PM)

Poster/Presentation
Number 13-011

Objective

To evaluate current practice habits and identify topics of education for optimizing the care of pediatric patients presenting with seizure to National Hospital Juan Jose Ortega (NHJJO)

Background

NHJJO is a regional hospital located in Coatepeque, Guatemala. Anecdotally, the evaluation and management of pediatric seizures has been identified as a potential topic for quality improvement; however, a systematic investigation of current practice habits had not previously been implemented.

Design/Methods A retrospective chart review of pediatric patients presenting to NHJJO with seizure from 2016-2018 was performed. A retrospective clinical diagnosis (RCD) based on initial history and examination was created for each patient, to allow determination of appropriateness of subsequent diagnostic and management strategies. RCDs of interest included first time unprovoked seizure (FTUS), simple febrile seizure (SFS), complex febrile seizure, and single febrile seizure with age <6 months.

Results A total of 127 pediatric patients presented with seizure during the study interval. 8% of patients in status epilepticus received a benzodiazepine. 60% of patients presenting with a single seizure received an acute anti-seizure medication (ASM). The concordance of a RCD with the given diagnosis ranged from 53% to 65%. Early EEG was obtained in 14% and 47% of patients with an RCD of SFS and FTUS, respectively. A head CT was obtained in 6% and 18% of patients with an RCD of SFS and FTUS, respectively. Four patients with a febrile seizure at <2 months old did not receive a lumbar puncture. 35% of patients presenting with an RCD of FTUS were prescribed a daily ASM, with phenytoin most commonly prescribed.

Conclusions Using this study of practice habits, a curriculum was developed focusing on common seizure presentations, yield of various diagnostic/management strategies, and indications for prescribing daily ASMs. The RCD framework will be used to determine effectiveness of the intervention on future practice habits.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Alicia Henriquez, MD (Seattle Children's Hospital)	Dr. Henriquez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Italfarmaco. Dr. Henriquez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Scholar Rock. Dr. Henriquez has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Henriquez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Catalyst. Dr. Henriquez has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sarepta. Dr. Henriquez has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen.
Ryan Kammeyer, MD (Childrens Hospital Colorado)	The institution of Dr. Kammeyer has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amgen. The institution of Dr. Kammeyer has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Kammeyer has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Ogborn-Mihm Trial Lawyers. The institution of Dr. Kammeyer has received research support from Rocky Mountain Multiple Sclerosis Center.
Diana J. Walleigh, MD (Children's Hospital of Colorado)	The institution of Dr. Walleigh has received research support from Angelman Syndrome Foundation.