{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T01:26:58Z","timestamp":1792200418888,"version":"4.4.0"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,12,6]],"date-time":"2013-12-06T00:00:00Z","timestamp":1386288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke (NINDS)","doi-asserted-by":"crossref","award":["R37-NS31146"],"award-info":[{"award-number":["R37-NS31146"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100010621","name":"Pediatric Epilepsy Research Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100010621","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["1R21NS076859-01"],"award-info":[{"award-number":["1R21NS076859-01"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Harvard Medical School and Boston Children's Hospital"},{"name":"Payer Provider Quality Initiative"},{"name":"The Epilepsy Foundation of America","award":["EF-213882"],"award-info":[{"award-number":["EF-213882"]}]},{"name":"The Epilepsy Foundation of America","award":["EF-213583"],"award-info":[{"award-number":["EF-213583"]}]},{"DOI":"10.13039\/100008503","name":"Center for Integration of Medicine and Innovative Technology","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008503","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100001454","name":"American Epilepsy Society","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100001454","id-type":"DOI","asserted-by":"crossref"}]},{"name":"CURE"},{"DOI":"10.13039\/501100013327","name":"Lundbeck","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100013327","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003769","name":"Eisai","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003769","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Delayed diagnosis of early onset epilepsy is a potentially important and avoidable complication in epilepsy care. We examined the frequency of diagnostic delays in young children with newly presenting epilepsy, their developmental impact, and reasons for delays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Children who developed epilepsy before their third birthday were identified in a prospective community\u2010based cohort. An interval \u22651\u00a0month from second seizure to diagnosis was considered a delay. Testing of development at baseline and for up to 3\u00a0years after and of intelligence quotient (\n                      <jats:styled-content style=\"fixed-case\">IQ<\/jats:styled-content>\n                      ) 8\u20139\u00a0years later was performed. Detailed parental baseline interview accounts and medical records were reviewed to identify potential reasons for delays. Factors associated with delays included the parent, child, pediatrician, neurologist, and scheduling.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Diagnostic delays occurred in 70 (41%) of 172 children. Delays occurred less often if children had received medical attention for the first seizure (p\u00a0&lt;\u00a00.0001), previously had neonatal or febrile seizures (p\u00a0=\u00a00.02), had only convulsions before diagnosis (p\u00a0=\u00a00.005), or had a college\u2010educated parent (p\u00a0=\u00a00.01). A \u22651\u00a0month diagnostic delay was associated with an average 7.4 point drop (p\u00a0=\u00a00.02) in the Vineland Scales of Adaptive Behavior motor score. The effect was present at diagnosis, persisted for at least 3\u00a0years, and was also apparent in\n                      <jats:styled-content style=\"fixed-case\">IQ<\/jats:styled-content>\n                      scores 8\u20139\u00a0years later, which were lower in association with a diagnostic delay by 8.4 points (p\u00a0=\u00a00.06) for processing speed up to 14.5 points (p\u00a0=\u00a00.004) for full scale\n                      <jats:styled-content style=\"fixed-case\">IQ<\/jats:styled-content>\n                      , after adjustment for parental education and other epilepsy\u2010related clinical factors. Factors associated with delayed diagnosis included parents not recognizing events as seizures (N\u00a0=\u00a047), pediatricians missing or deferring diagnosis (N\u00a0=\u00a015), neurologists deferring diagnosis (N\u00a0=\u00a07), and scheduling problems (N\u00a0=\u00a011).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>\n                      Diagnostic delays occur in many young children with epilepsy. They are associated with substantial decrements in development and\n                      <jats:styled-content style=\"fixed-case\">IQ<\/jats:styled-content>\n                      later in childhood. Several factors influence diagnostic delays and may represent opportunities for intervention and improved care.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.12479","type":"journal-article","created":{"date-parts":[[2013,12,6]],"date-time":"2013-12-06T18:50:47Z","timestamp":1386355847000},"page":"123-132","source":"Crossref","is-referenced-by-count":98,"title":["Diagnostic delays in children with early onset epilepsy: Impact, reasons, and opportunities to improve care"],"prefix":"10.1111","volume":"55","author":[{"given":"Anne T.","family":"Berg","sequence":"first","affiliation":[{"name":"Department of Pediatrics Epilepsy Center, and Northwestern Memorial Feinberg School of Medicine Ann &amp; Robert H. 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