Abstracts

Rationale: Access to Epilepsy care especially Level 3 or 4 Epilepsy centers is challenging for many persons with epilepsy (PWE), particularly in rural and medically underserved areas. Epilepsy centers offering advanced diagnostics and therapies have long wait times and are often geographically inaccessible, leading to additional delays in care. There is variability in the diagnostic resources and medical expertise available at individual epilepsy centers, which can impact management. For instance, advanced neuroimaging such as 7Tesla (7T) MRI or Source localization and dipole modeling are not available at every center. The University of Southern California Epilepsy Care Consortium (USC-ECC) seeks to bring together epilepsy programs across southern and central California to share resources in order to reduce disparities in access to Epilepsy care and improve patient outcomes.

Methods: The USC-ECC was formally established in 2019 to connect local and regional Epilepsy programs across southern and central California, to share individual institutional resources and expertise across multiple centers, with a goal to provide high level epilepsy opinions to patients, and improve patient care. The USC-ECC consists of 7 Adult Epilepsy and 3 Pediatric Epilepsy programs, ranging from Level 2 to Level 4 Epilepsy Centers (Table1). These span a geographical distance of 250 miles from Fresno in central California to Orange County in southern California. The USC-ECC convenes weekly via Zoom. Each Epilepsy center provides program updates (clinical, administrative, practice based, academic, educational). This is followed by case presentations from ECC members using a standardized format. Presentations are largely, but not limited to presurgical cases. Some centers discuss cases at their own (local) Epilepsy Case conferences, and then bring complex cases to the ECC for added input. All centers have the option of presenting cases directly at the USC-ECC. Data presented includes clinical history, EEG (Phases 1 and 2), multimodal imaging, and other relevant studies. One week is dedicated for Pediatric Epilepsy Case presentations, one week is dedicated for presentations from invited speakers spanning diverse academic topics.

Results: Between 1/1/2021 and 5/29/2024, 281 Epilepsy cases have been presented at the USC-ECC (256 Adult cases and 25 Pediatric cases), with 75% cases presented by adult centers other than USC Keck Medical Center. Four cases were non-surgical discussions, the remainder were presurgical. The scope of presentations included phase 1 data, imaging, Neuropsychological testing, phase 2 data. Presentation of cases at the USC-ECC has resulted in referral to select Epilepsy programs for specific testing not available to all such as: 7T MRI (USC), Source Localization via Curry (CHLA), Ictal SPECT, WADA testing, Neuropsychological testing in Spanish (USC)


Conclusions: The USC-ECC provides seamless resource sharing and integration of care for PWE across several regional institutions. It allows PWE across age and socioeconomic spectra access to the combined resources of partner centers, thereby receiving the highest level of epilepsy care possible while staying close to home.

Funding: None