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Diagnostic Delay in Epilepsy: the Scope of the Problem

  • Epilepsy (C. Elder, Section Editor)
  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Diagnostic delay is an increasingly recognized issue in epilepsy. At the same time, there is a clear disparity between public awareness of epilepsy and that of other public health issues. A contributing factor for this seems to be a lack of studies testing interventions designed to improve seizure recognition. In this review, we summarize the main findings from recent studies investigating diagnostic delay in epilepsy, highlighting causes, consequences, and potential interventions in future research that may improve quality of care in this population.

Recent Findings

Building on prior evidence, diagnostic delay in patients with new-onset focal epilepsy has been identified as an important problem for patients with epilepsy. Such delay in diagnosis can lead to delayed treatment and potentially preventable morbidity and mortality including motor vehicle accidents. Nonmotor seizure semiology appears to be a major contributor for delay; such seizures are largely unrecognized when patients present to emergency departments for care. Improving recognition and diagnosis of recurrent nonmotor seizures in emergency departments represents a significant opportunity for improving time to diagnosis, particularly when patients present following a first lifetime motor seizure and meet diagnostic criteria for epilepsy.

Summary

Diagnostic delay in epilepsy is a significant public health issue and recent studies have highlighted potential areas for intervention.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Author information

Authors and Affiliations

  1. Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA

    Jacob Pellinen

  2. Comprehensive Epilepsy Center, New York University School of Medicine, New York, NY, USA

    Jaqueline French

  3. Departments of Pediatrics and Neurology, University of Colorado School of Medicine, Aurora, CO, USA

    Kelly G. Knupp

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Contributions

Jacob Pellinen was responsible for concept, design, and drafting of the manuscript. Jaqueline French and Kelly Knupp were responsible for drafting and critical revision of the manuscript.

Corresponding author

Correspondence to Jacob Pellinen.

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Conflict of Interest

Jacob Pellinen has no conflicts of interest to disclose.

Jaqueline French receives NYU salary support from the Epilepsy Foundation and for consulting work and/or attending Scientific Advisory Boards on behalf of the Epilepsy Study Consortium for Adamas, Aeonian/Aeovian, Alterity Therapeutics Limited, Anavex, Arkin Holdings, Arvelle Therapeutics, Inc., Athenen Therapeutics/Carnot Pharma, Axovant, Baergic Bio, Biogen, Biomotiv/Koutif, BioXcel Therapeutics, Blackfynn, Bloom Science, Bridge Valley Ventures, Cavion, Cerebral Therapeutics, Cerevel, Corlieve Therapeutics, Crossject, CuroNZ, Eisai, Eliem Therapeutics, Encoded Therapeutics, Engage Therapeutics, Engrail, Epalex, Epihunter, Epiminder, Epitel, Equilibre BioPharmaceuticals, Fortress Biotech, Greenwich Biosciences, GW Pharma, Idorsia, Ionis, Janssen Pharmaceutica, Knopp Biosciences, LivaNova, Longboard Pharmaceuticals, Lundbeck, Marinus, Mend Neuroscience, Merck, NeuCyte, Inc., Neurelis, Neurocrine, Neuropace, Otsuka Pharmaceutical Development, Ovid Therapeutics Inc., Passage Bio, Pfizer, Praxis, PureTech LTY Inc., Redpin, Sage, Shire, SK Life Sciences, Sofinnova, Springworks, Stoke, Sunovion, Supernus, Synergia Medical, Takeda, UCB Inc., West Therapeutic Development, Xenon, Xeris, Zogenix, Zynerba. She has also received research support from the Epilepsy Foundation, Epilepsy Study Consortium (funded by Andrews Foundation, Eisai, Engage, Lundbeck, Pfizer, SK Life Science, Sunovion, UCB, Vogelstein Foundation) Epilepsy Study Consortium/Epilepsy Foundation (funded by UCB), GW/FACES and NINDS. She is on the editorial board of Lancet Neurology and Neurology Today. She is Chief Medical/Innovation Officer for the Epilepsy Foundation for which NYU receives salary support. She has received travel reimbursement related to research, advisory meetings, or presentation of results at scientific meetings from the Epilepsy Study Consortium, the Epilepsy Foundation, Arvelle Therapeutics, Inc., Axovant, Biogen, Blackfynn, Cerevel, Crossject, CuroNZ, Eisai, Engage, Idorsia, Lundbeck, NeuCyte, Inc., Otsuka, Ovid, Pfizer, Redpin, Sage, SK Life Science, UCB, Xenon, Zogenix.

Kelly Knupp has received consulting funding from Zogenix, West Therapeutics, Encoded, Biocodex, Longboard pharmaceuticals, Eisai, Stoke.

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Pellinen, J., French, J. & Knupp, K.G. Diagnostic Delay in Epilepsy: the Scope of the Problem. Curr Neurol Neurosci Rep 21, 71 (2021). https://doi.org/10.1007/s11910-021-01161-8

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