Optimizing Nutrition Care: A Comparative Study of Nutrition Screening Tools in Children with Drug-Resistant Epilepsy

Objectives: To compare the STRONGkids and SGNA tools in identifying malnutrition risk in children with Drug Resistant Epilepsy (DRE) and to determine their validity and reliability among children with Drug Resistant Epilepsy (DRE). Methodology: A cross-sectional observational study was conducted at Sri Ramachandra Hospital, Department of Neurology, Chennai, Tamil Nadu, India. The duration of the study was four months from July 1st, 2024, to November 1st 2024, involving 30 children diagnosed with Drug Resistant Epilepsy (DRE) having either focal or generalized epilepsy, aged below five years. Nutritional risk was assessed using the STRONGkids and SGNA tools. The STRONGkids tool evaluates factors such as weight, growth, feeding difficulties, and underlying medical conditions, while the SGNA tool includes a clinical examination with a focus on weight history, appetite changes, and physical signs of malnutrition. Participants Socio Economic data were also collected and were classified as per Kuppuswamy Socio-Economic Status (SES) classification. Data were analyzed using descriptive statistics and inter-rater reliability measures. Findings: The STRONGkids tool identified 15 children (50%) at medium risk of malnutrition, while the SGNA tool identified 14 children (46.7%) as moderately malnourished. The agreement between the two tools was high, with a kappa coefficient of 0.76, indicating substantial inter-rater reliability. Both tools identified 15 (48.35%) children as having moderate malnutrition, with minor discrepancies in the number of children flagged. Novelty: Unlike previous research that broadly examines pediatric malnutrition, this study specifically targets children with DRE, a population at heightened risk for nutritional issues due to complex medical needs. The study is one of the first to directly compare the STRONGkids and SGNA tools for identifying malnutrition risk in children with DRE, particularly those under the age of 5, a group often underrepresented in nutritional research. The study identifies the strengths of both tools, STRONGkids for quick, routine screening and SGNA for comprehensive assessment offering practical guidance for clinicians managing pediatric DRE cases. Keywords: Nutritional Screening, Drug Resistant Epilepsy, STRONGkids, SGNA, Antiseizure Medications