Natalie Toma,1 Kammiee-Marie Ardo,1 Jennifer McQueeny,1 Andrew Mettias,1 Matthew Kao,1,2 Janette Bow-Keola,1,2 Tyrone Sumibcay,1,2 Kore Kai Liow,1,2 Darren DuGas,1 Enrique Carrazana2
1 Comprehensive Epilepsy Center and Video-EEG Epilepsy Monitoring Unit & Epilepsy Research Unit, Hawaii Pacific Neuroscience, Honolulu, HI
2 John A. Burns School of Medicine, University of Hawaiʻi, Honolulu, HI
Background: Patients with epilepsy (PWE) from ethnically minoritized groups often face disparities in chronic disease burden and access to care. Data on epilepsy in Native Hawaiian and other Pacific Islander (NHOPI) populations remain limited. This study aimed to characterize seizure profiles, etiologies, and comorbidities among PWE in Hawaiʻi, with a focus on NHOPI patients.
Methods: We conducted a retrospective chart review of 500 PWE seen at Hawaiʻi Pacific Neuroscience between January 2019 and July 2020. Patients were categorized by self-identified race/ethnicity (White, Asian, NHOPI, or Other). Seizure type, seizure control, comorbidities, and epilepsy etiologies were compared across groups using chi-square and one-way ANOVA.
Results: Seizure type and control, gender, and age did not significantly differ between groups. However, NHOPI patients exhibited a disproportionately high comorbidity burden. Compared to other groups, NHOPI PWE had significantly higher rates of elevated BMI (p < 0.001), obesity (p < 0.001), diabetes mellitus (p = 0.038), cardiovascular comorbidities (p = 0.005), PTSD (p = 0.029), sleep disorders (p = 0.026), and current tobacco use (p < 0.001). NHOPI patients also showed a trend toward higher epilepsy-related hospitalization (p = 0.054), though this did not reach statistical significance.
Conclusion: NHOPI individuals with epilepsy experience a significantly greater burden of physical and psychiatric comorbidities despite similar seizure profiles. These findings underscore the need for culturally competent, integrated care strategies and support further research with larger NHOPI samples to explore potential disparities in epilepsy-related outcomes.
