@article{84372377693948bd993ccadcaba859fa,
title = "Focal nonmotor versus motor seizures: The impact on diagnostic delay in focal epilepsy",
abstract = "Objective: To test the hypothesis that people with focal epilepsy experience diagnostic delays that may be associated with preventable morbidity, particularly when seizures have only nonmotor symptoms, we compared time to diagnosis, injuries, and motor vehicle accidents (MVAs) in people with focal nonmotor versus focal seizures with motor involvement at epilepsy onset. Methods: This retrospective study analyzed the enrollment data from the Human Epilepsy Project, which enrolled participants between 2012 and 2017 across 34 sites in the USA, Canada, Europe, and Australia, within 4 months of treatment for focal epilepsy. A total of 447 participants were grouped by initial seizure semiology (focal nonmotor or focal with motor involvement) to compare time to diagnosis and prediagnostic injuries including MVAs. Results: Demographic characteristics were similar between groups. There were 246 participants (55%) with nonmotor seizures and 201 participants (45%) with motor seizures at epilepsy onset. Median time to diagnosis from first seizure was 10 times longer in patients with nonmotor seizures compared to motor seizures at onset (P <.001). The number and severity of injuries were similar between groups. However, 82.6% of MVAs occurred in patients with undiagnosed nonmotor seizures. Significance: This study identifies reasons for delayed diagnosis and consequences of delay in patients with new onset focal epilepsy, highlighting a treatment gap that is particularly significant in patients who experience nonmotor seizures at epilepsy onset.",
keywords = "clinical neurology, complex partial seizures, epilepsy semiology, epilepsy/seizures, partial seizures",
author = "{the Human Epilepsy Project Co-Investigators} and Jacob Pellinen and Erica Tafuro and Annie Yang and Dana Price and Daniel Friedman and Manisha Holmes and Sarah Barnard and Kamil Detyniecki and Manu Hegde and John Hixson and Sheryl Haut and Reetta K{\"a}lvi{\"a}inen and Jacqueline French",
note = "Funding Information: There was no targeted funding for this study. Creation of HEP was sponsored by the Epilepsy Study Consortium. Funding for HEP was received from industry, philanthropy, and foundations (UCB Pharma, Eisai, Pfizer, Lundbeck, Sunovion, the Andrews Foundation, the Vogelstein Foundation, Finding a Cure for Epilepsy and Seizures [FACES], and Friends of Faces). The funders of HEP had no role in the design or conduct of this study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. Funding Information: D.F. receives salary support for consulting and clinical trial–related activities performed on behalf of the Epilepsy Study Consortium, a nonprofit organization, and receives no personal income for these activities. New York University (NYU) receives a fixed amount from the Epilepsy Study Consortium toward D.F.{\textquoteright}s salary. Within the past year, the Epilepsy Study Consortium received payments for research services performed by D.F. from Adamas, Axcella, Biogen, Crossject, CuroNZ, Engage Pharmaceuticals, Eisai, GW Pharmaceuticals, Pfizer, SK Life Science, Takeda, Xenon, and Zynerba. D.F. has also served as a paid consultant for Eisai and Penumbra. D.F. has received honorarium from Neuropace. D.F. has received travel support from Medtronics and the Epilepsy Foundation. D.F. receives research support from the CDC, NINDS, Epilepsy Foundation, Empatica, Epitel, UCB, and Neuropace not related to the current work. D.F. serves on the scientific advisory board for Receptor Life Sciences, and holds equity interests in Neuroview Technology and Receptor Life Sciences. K.D. has received research support to Yale University for investigator‐initiated studies from Eisai, Sunovion, Acorda, and Upsher‐Smith, and has also received consultation fees from UCB. J.H. has received research support from UCB, and has received consultation and advisory board honoraria from Acorda, Neurelis, Lumetra Healthcare Solutions, and the Epilepsy Foundation. S.H. is a consultant for Alden Health. R.K. has received institutional grants from the Academy of Finland and the Saastamoinen Foundation, speaker's honoraria from Eisai, Orion, Sandoz, and UCB, and honoraria for membership on advisory boards from Eisai, GW Pharmaceuticals, Marinus Pharmaceuticals, Takeda, and UCB. J.F. 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 from Aeonian/Aeovian, Anavex, Arvelle Therapeutics, Athenen Therapeutics/Carnot Pharma, Axovant, Biogen, BioXcel Therapeutics, Blackfynn, Cerebral Therapeutics, Cerevel, Crossject, CuroNZ, Eisai, Encoded Therapeutics, Engage Therapeutics, Epiminder, Epitel, Fortress Biotech, Greenwich Biosciences, GW Pharmaceuticals, Ionis, Janssen Pharmaceutica, Knopp Biosciences, Lundbeck, Marinus, Merck, NeuCyte, Neurocrine, Otsuka Pharmaceutical Development, Ovid Therapeutics, Passage Bio, Pfizer, Praxis, Redpin, Sage, SK Life Science, Stoke, Sunovion, Supernus, Takeda, UCB, Xenon, Xeris, and Zogenix. J.F. has also received research grants from Biogen, Cavion, Eisai, Engage, GW Pharmaceuticals, Lundbeck, Neurelis, Ovid, Pfizer, SK Life Science, Sunovion, UCB, Xenon, and Zogenix as well as grants from the Epilepsy Research Foundation, Epilepsy Study Consortium, and NINDS. J.F. is on the editorial board of and . J.F. is Chief Medical/Innovation Officer for the Epilepsy Foundation, for which NYU receives salary support. J.F. 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, Biogen, Cerevel, Engage, Lundbeck, NeuCyte, Otsuka, Sage, UCB, Xenon, and Zogenix. None of the other authors has any conflict of interest to disclose. Lancet Neurology Neurology Today ",
year = "2020",
month = dec,
doi = "10.1111/epi.16707",
language = "English (US)",
volume = "61",
pages = "2643--2652",
journal = "Epilepsia",
issn = "0013-9580",
publisher = "Wiley-Blackwell",
number = "12",
}