Eva Kumlien1, Peter Mattsson. 1. Department of Neuroscience, Neurology, Uppsala University Hospital, Uppsala, Sweden. eva.kumlien@neuro.uu.se
Abstract
PURPOSE: Epilepsy surgery is safe and effective for epilepsy that is refractory to medical treatment. However, only a minority of candidates for epilepsy surgery are referred for surgical evaluation. We investigated Swedish neurologists' views on and criteria for referral for epilepsy surgery. MATERIALS AND METHODS: A survey was sent out to neurologists who treat patients with epilepsy. We received responses from 81% of referring hospitals and 57% of private practices. RESULTS: Sixty-one percent of respondents considered that epilepsy surgery reduced seizure frequency and 53% that it improved quality of life. Surgical treatment was thought to be cost-effective by 90% of respondents. Referral for surgery was considered if three or more antiepileptic drugs had failed. Seizure frequency and severity and, the patient's own wishes were regarded as the most important criteria for surgical referral. MRI and EEG findings were also important whereas duration of illness was considered less important. Age below 65 years and lack of mental retardation were important for considering referral. CONCLUSION: In general Swedish neurologists have a cautious but positive attitude towards epilepsy surgery. Uncertainties about eligibility criteria among referring clinicians may contribute to the underutilization of epilepsy surgery. Copyright 2010 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
PURPOSE:Epilepsy surgery is safe and effective for epilepsy that is refractory to medical treatment. However, only a minority of candidates for epilepsy surgery are referred for surgical evaluation. We investigated Swedish neurologists' views on and criteria for referral for epilepsy surgery. MATERIALS AND METHODS: A survey was sent out to neurologists who treat patients with epilepsy. We received responses from 81% of referring hospitals and 57% of private practices. RESULTS: Sixty-one percent of respondents considered that epilepsy surgery reduced seizure frequency and 53% that it improved quality of life. Surgical treatment was thought to be cost-effective by 90% of respondents. Referral for surgery was considered if three or more antiepileptic drugs had failed. Seizure frequency and severity and, the patient's own wishes were regarded as the most important criteria for surgical referral. MRI and EEG findings were also important whereas duration of illness was considered less important. Age below 65 years and lack of mental retardation were important for considering referral. CONCLUSION: In general Swedish neurologists have a cautious but positive attitude towards epilepsy surgery. Uncertainties about eligibility criteria among referring clinicians may contribute to the underutilization of epilepsy surgery. Copyright 2010 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
Authors: Christine B Baca; Huibrie C Pieters; Tomoko J Iwaki; Gary W Mathern; Barbara G Vickrey Journal: Epilepsia Date: 2015-04-20 Impact factor: 5.864
Authors: Lara Jehi; Daniel Friedman; Chad Carlson; Gregory Cascino; Sandra Dewar; Christian Elger; Jerome Engel; Robert Knowlton; Ruben Kuzniecky; Anne McIntosh; Terence J O'Brien; Dennis Spencer; Michael R Sperling; Gregory Worrell; Bill Bingaman; Jorge Gonzalez-Martinez; Werner Doyle; Jacqueline French Journal: Epilepsia Date: 2015-08-07 Impact factor: 5.864
Authors: Debopam Samanta; Adam P Ostendorf; Erin Willis; Rani Singh; Satyanarayana Gedela; Ravindra Arya; M Scott Perry Journal: Epilepsy Behav Date: 2021-02-18 Impact factor: 2.937