Epileptic Disord. 2026 Feb 27. doi: 10.1002/epd2.70200. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze the current state of primary pediatric epilepsy care, providing evidence for regional capacity-building strategies.

METHODS: The cross-sectional survey design was adopted to assess the epilepsy diagnostic and therapeutic capabilities of pediatric physicians from 37 medical institutions in the nine main urban districts and surrounding counties of Chongqing.

RESULTS: Tertiary (56.8%, 21/37) and general hospitals (75.7%, 28/37) dominated healthcare, yet pediatric neurology lagged: only 48.7% (18/37) had dedicated teams. Key technologies like Video-EEG (43.2%) and genetic testing (54.1%) were underutilized; novel therapies (ketogenic diet 13.5%, neuromodulation 8.1%) were rarely applied. The median annual outpatient volume was 50 cases, and 33.3% of hospitals achieved >50% seizure freedom rate, yet 20.8% had >15% treatment inefficacy. Evident deficiencies of physician training: 52.4% (87/166) lacked systematic epilepsy training, and only 1.2% (2/166) had passed advanced EEG certification, resulting in only 19.3% (32/166) fully mastering epilepsy classification systems, while 31.9% demonstrated medication selection errors. Significant discrepancies in clinical decision-making: 18.7% (31/166) of physicians inappropriately selected carbamazepine for juvenile absence epilepsy, while 3.6% (6/166) adopted a high-risk immediate medication switching strategy. Fragmented patient management: 8.4% of physicians did not provide health education, and 59.0% (98/166) cited poor family adherence due to insufficient disease awareness. The regional referral rates varied widely (median: 17.5%, IQR: 35-5%).

SIGNIFICANCE: Tertiary hospitals undertake the main clinical burden but lack the construction of specialized infrastructure; lagging staff training leads to undermining the standardization of diagnosis and management; and the problem of the lack of systematic solutions in patient management persists. To enhance the overall service delivery, there are some proposed solutions including establishing hierarchical diagnosis and treatment networks, enhancing specialist training, and implementing regional quality control systems.

PMID:41757792 | DOI:10.1002/epd2.70200

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