Abstracts

Rationale: Few recent studies have analyzed population-based data to estimate the burden and to describe the characteristics of U.S. children with epilepsy. We updated these studies using recent claims data to estimate epilepsy prevalence and incidence among U.S. children and to describe their characteristics. Methods: Truven Health Analytics MarketScan Data include inpatient, outpatient, and prescription drug claims from commercial health insurance companies, Medicare, and Medicaid. We used Jan 1, 2010 through July 31, 2016 data for analysis. We identified epilepsy or seizure disorder (“epilepsy”) cases among children 0-17 years old as those with at least one International Classification of Disease, 9th version (ICD-9) diagnostic code of 345.XX ("epilepsy"), 780.33 ("post-traumatic seizures"), or 780.39 ("other convulsions") and the use of at least one anti-seizure drug from the 2016 Marketscan Redbook. All unique epilepsy cases from Jan 1, 2010 through Jan 31, 2016 constituted prevalent cases. New cases identified each year (2011-2015) from the previously epilepsy-free population constituted incident cases. We stratified epilepsy prevalent cases by age, sex, urban versus rural residency, region, insurance type, and examined epilepsy types. Results: The 2010-2016 data included 21,950,428 children, of whom 109,179 were classified as having epilepsy yielding an overall epilepsy prevalence of 0.497% (5 per 1000 children). The average incidence rate was 1 per 1,000 children per year. Epilepsy was identified for 0.049% (95% Confidence Interval: 0.047-0.052%) of children ages < 1 year; 0.386% (0.383-0.389%) of ages 1 to 5 years ; 0.505% (0.503-0.508%)of ages 6 to 12 years; and 0.611% (0.609-0.615%)of ages 13 to 17 years. Epilepsy prevalence among girls, 0.506% (0.505-0.508%) significantly exceeded that of boys, 0.487% 0.486-0.488%). Epilepsy prevalence in rural children, 0.506% (0.504-0.508%), significantly exceeded that in urban children, 0.496% (0.494-0.498%). Epilepsy prevalence in those with government health insurance 0.426% (0.425-0.428%) was significantly less than that of those with employer-based insurance, 0.577% (0.576-0.578%). Epilepsy prevalence in the East Central Region, 1.728% (1.716-1.740%) significantly exceeded that in the Mountain Region, 0.420% (0.415-0.428%). Unspecified epilepsy was more common (35.0%) than focal localized epilepsy (25.3%), generalized convulsive epilepsy (18.5%), generalized non-convulsive epilepsy (10.7%), other forms of epilepsy (6.2%), status epilepticus (3.1%), infantile spasm (0.7%), and epilepsia partialis continua (0.4%). Conclusions: Use of administrative data supplements surveillance-based estimates of epilepsy prevalence and incidence with the use of clinical case ascertainment criteria. But, administrative data exclude those who lack health insurance coverage and may misidentify cases from ICD-9 diagnostic codes. Researchers should continue to examine and to refine claims data to enhance knowledge about epilepsy burden and to evaluate programs and care. Funding: No funding received.