Research Details Why Patients Opt For or Against Epilepsy Surgery

In selected cases, epilepsy surgery is safe, effective and often curative.

Although candidates for epilepsy surgery in the United States are estimated between 100,000 and 200,000, fewer than 5,000 such surgeries are conducted each year. The cause of this disparity is multi-factorial, including an unexplained low level of referrals by physicians and choices made by patients themselves. Two studies investigating why patients choose to defer or forego epilepsy surgery were presented today at the American Epilepsy Society''s 65th annual meeting and scientific conference.

Fits | Epilepsy | Convulsions - Causes Symptoms Diagnosis Treatment FAQs
Fits or convulsions or Epilepsy is characterized by recurrent, involuntary seizures and is described as a chronic neurological disorder

Investigators at New York University''s Langone Medical Center looked into potential medical and social barriers to resective epilepsy surgery in patients following pre-surgical evaluations that showed a high likelihood of achieving seizure freedom. (Abstract 1.317) A similar study conducted by investigators at the University of Pennsylvania explored the socio-cultural, medical, personal, and neuropsychological factors affecting patient decision-making for or against epilepsy surgery. (Abstract 1.307)

In a retrospective analysis of patients admitted to the epilepsy monitoring unit at their medical center between January 2007 and July 2008, the NYU team identified 110 patients who were good candidates for resective surgery based upon neuroimaging, electroencephalography, clinical semiology and IQ. Only 45 patients (41%) out of this group underwent surgery. Of the 65 (59%) that did not undergo invasive monitoring or resective surgery within the follow-up period, 14 (22%) were seizure free at last follow-up. Surgery was clearly declined by 10 patients (15%) and another 12 patients had no further discussion of surgery after the initial evaluation.

"Multiple factors can contribute to patients failing to pursue epilepsy surgery," says lead author Chad Carlson. "Over one-half of patients in our study declined surgery due to seizure freedom, perceived adequate seizure control, or having no desire to pursue surgery despite continued seizures."

Neurocysticercosis / Cysticercosis of Brain / Pork Tapeworm - Causes Symptoms Diagnosis Treatment FAQs
Neurocysticercosis or Cysticercosis of brain is the most common cause of epilepsy and the most common parasitic infection of the brain. Neurocysticercosis is more common in the developing countries.

To gain insight into patient attitudes toward epilepsy surgery, investigators at the University of Pennsylvania Penn Epilepsy Center developed a questionnaire to survey both post-surgery patients and surgery refusers, and also reviewed their medical charts and pre-surgical test results. Among core factors they found to affect patient decisions for or against surgery are frequency and severity of seizures, length of time with seizures, the stigma of having epilepsy, embarrassment of seizures in public, the need/desire to be seizure free, and general comfort with and fears concerning surgery.

The chance of surgical success quoted by the doctor, and having a personal belief that surgery would work were also found to be significant.

Epilepsy and Slides
Epilepsy is a medical condition where the brain cells fire abnormal electrical signals that physically manifests as a ‘Seizure’. There should be two or more seizures before the term epilepsy should be used.

"Our study has documented differences between surgical candidates who choose to have epilepsy surgery and those who opt against a proposed procedure," says Christopher Todd Anderson, the primary investigator. "The results could aid in focusing on specific issues with patients who could benefit from epilepsy surgery, and, importantly, prevent unnecessary pre-surgical evaluations of patients who are adamantly opposed to surgery regardless of medical opinion."

Editors Note: Authors of these studies will be available at a press briefing at 11:00 am, Sunday,
December 4, in the onsite press room, Room 336, of the Baltimore Convention Center. Briefing call-in number: Dial in on 1-866-740-1260; PIN 5867508#

About the American Epilepsy Society (AES)
The American Epilepsy Society, based in West Hartford, CT, seeks to advance and improve the treatment of epilepsy through the promotion of research and education for healthcare professionals. Society membership includes epileptologists and other medical professionals, allied healthcare professionals, and scientists concerned with the care of people who have seizure disorders.

Source-Newswise