ED visits for seizures, epilepsy decreased during pandemic, especially in young children
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Seizure- and epilepsy-related emergency department visits decreased during the COVID-19 pandemic compared with pre-pandemic levels, with the largest drop seen among young children, per a study in MMWR.
“Seizures generally account for approximately 1% of all emergency department visits,” Sanjeeb Sapkota, MBBS, MPH, of the Center for Global Health at the CDC, and colleagues wrote. “Persons of any age can experience seizures, and outcomes might range from no complications for those with a single seizure to increased risk for injury, comorbidity, impaired quality of life and early mortality for those with epilepsy.”
Seeking to examine trends in weekly seizure- or epilepsy-related ED visits in the United States before and during the COVID-19 pandemic, CDC researchers analyzed data from January 2019 to December 2021 using the National Syndromic Surveillance Program (NSSP), which collects deidentified electronic health record data from EDs and other health care settings.
Researchers used diagnostic codes from the International Classification of Diseases to identify seizure-related visits and categorized trends into six age groups (0-9, 10-19, 20-39, 40-59, 60-69 and 70 years). They then quantified change in mean weekly seizure-related ED visits from April 1 to Dec. 29, across 2019, 2020 and 2021 and stratified results by age group and sex. Researchers compared 2020 data with corresponding data from 2019 and 2021 to assess percentage change in mean weekly seizure-related ED visits.
Results showed that all ED visits, including seizure-related ones, decreased among all age groups and sexes during the pandemic period from April 1 to Dec. 29, 2020, compared with the same period in 2019. The largest decline in seizure-related ED visits, noted as early as February 2020, was observed among children aged 0 to 9 years.
During April 1 to Dec. 29, 2020, there were 19,824 weekly seizure-related ED visits, a 16% overall drop from 23,588 during the same period in 2019. Among children aged 0 to 9 years, the number of seizure-related weekly ED visits declined by 44% to 1,553, compared with 2,759 visits during the same period in 2019. Overall, ED visits among children aged 0 to 9 years declined from 162,711 visits in 2019 to 71,131 in 2020, a 56% reduction.
Researchers also found that by the first week of 2021, seizure-related ED visits among all age groups were close to respective pre-pandemic levels in 2019, excluding children aged 0 to 9 years, for whom the return to pre-pandemic levels was delayed until roughly week 25 of 2021.
“These findings reinforce the importance of understanding factors associated with ED avoidance among persons with epilepsy or seizures, and any alternative care approaches among persons with epilepsy or seizures and the need to encourage persons to seek appropriate care for seizure-related emergencies,” Sapkota and colleagues wrote.