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Purpose: To compare epilepsy-related injuries in untreated or inadequately treated patients and patients on adequate treatment., Methods: In a cross-sectional case-control study, seizure-related injuries in patients who were either on no treatment or inadequate treatment were compared with another group of patients receiving appropriate evidence-based epilepsy treatment. The inadequately treated patients or 'cases' were drawn from an outreach epilepsy clinic while the adequately treated patients or 'controls' were recruited from a tertiary care facility providing comprehensive epilepsy management., Results: The odds of injury were eight times higher in inadequately treated patients or cases compared to the adequately treated patients or controls. After adjusting for gender, epilepsy duration, seizure frequency, current medication, and number of AEDs, the odds of injury were 15. 8 times higher in the cases. Major injuries such as burns, fractures, and tooth injuries were also higher in the cases., Conclusion: Untreated or inadequately treated epilepsy patients have a significantly higher risk of injuries. With adequate treatment, some of the risks of injury can be mitigated., (Copyright © 2020 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)

Purpose: The aim of this study was to analyze pre-hospital seizure rescue medication (RM) use in a pediatric epilepsy population, caregiver knowledge and comfort, and prescription patterns., Method: Cross-sectional observational study based on surveys to families of pediatric patients with epilepsy and based on medical chart review., Results: One hundred (88%) out of 114 families answered the questionnaire. Fifty-five patients were females (55%), with a median (IQR) age of 11 (6-14) years. Eighty-seven (87%) patients had RM prescribed, and 37 (42.5%) used it in the past. In univariate analysis, patients were more likely to have a RM when they had a history of SE (p<0.001), or had seizures ≥30seconds (p=0.001). Patients were not more likely to be prescribed a RM if they were diagnosed at <2years of age, had ≥3 anti-seizure medications (ASM), had a history of seizure clusters or uncontrolled epilepsy, or were currently not on ASMs. In multivariate analysis a history of SE (p=0.02) and seizure duration ≥30seconds (p=0.04) remained significant. Out of 91 families, 68 (75%) prefer a non-rectal RM; this was higher for patients with normal development, and not associated with age or sex. Fifty-three (61%) families reported that they received RM training. Ten (12%) parents did not know the RM name, and 31 (36%) did not know the administration timing. Forty-five (45%) families had a seizure action plan (SAP), and this was a predictor for knowing the RM name (p=0.04), the administration timing (p=0.004), availability of RM at school (p=0.02), and knowing what to do if the RM fails (p=0.008)., Conclusions: Most patients with epilepsy had a RM, but only 61% reported receiving training. Patients were more likely to have a RM if they had prior SE and longer seizure duration. Families with a SAP were more knowledgeable, and schools were more involved., (Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)