July 12, 2021

Factors Associated with Patients Not Proceeding with Proposed Resective Epilepsy Surgery

Study, published in Seizure

This study was intended to explore the relationship between eligible patients not proceeding with resective epilepsy surgery and various demographic, disease-specific, and epilepsy-evaluation variables. Researchers designed a retrospective case-control study including patients identified as candidates for resective epilepsy surgery at the Montefiore Medical Center between January 1, 2009, and June 30, 2017. They used Chi-squared, two-tailed, independent sample t-test and logistic regression to distinguish variables associated with patients not proceeding with surgery. Only 53 ultimately proceeded with surgery (33%), among the 159 potential surgical candidates reviewed over the 8.5-year study period. There is a relationship between employment status and whether the patient had epilepsy surgery: employed patients were 4.2 times more likely to not proceed with surgery compared to unemployed patients. It has been reported that patients with a temporal lobe lesion on MRI, temporal lobe EEG ictal onsets, and/or a temporal epileptogenic zone were more likely to proceed with surgery. There is a need for future study to assess these findings prospectively, determine if they generalize to other patient populations, explore the decision whether or not to proceed with epilepsy surgery from a patient-centered perspective, and imply strategies to reduce barriers to this underutilized treatment.

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