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Epilepsia ; 65(1): 107-114, 2024 Jan.
Article in English | MEDLINE | ID: mdl-37953072

ABSTRACT

OBJECTIVE: Non-Hispanic (NH) Black children are less likely to receive a standard treatment course for infantile epileptic spasms syndrome (IESS) than White/NH children at pediatric tertiary care epilepsy centers in the United States. However, if inequities exist in time to diagnosis is unknown. Diagnostic delays as little as 1 week can be associated with worse developmental outcomes. METHODS: Diagnostic delays were evaluated in a retrospective cohort of 100 children with new onset IESS between January 2019 and May 2022. RESULTS: Children with Black, Indigenous, and People of Color (BIPOC) caregivers were more likely to experience clinically significant delays in referral from first provider to neurologist, when compared to White/NH children, even after controlling for other demographic and clinical variables (odds ratio = 4.98, confidence interval = 1.24-19.94, p = .023). SIGNIFICANCE: Disproportionate diagnostic delays place BIPOC children at risk of adverse developmental and epilepsy outcomes. Further interventional prospective and qualitative studies are needed to address inequities in care.


Subject(s)
Epilepsy , Spasms, Infantile , Humans , Child , United States , Retrospective Studies , Prospective Studies , Ethnicity , Epilepsy/diagnosis , Syndrome , Spasm , Spasms, Infantile/therapy , Spasms, Infantile/drug therapy
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