Deciphering the surgical treatment gap for drug‐resistant epilepsy (DRE): A literature review
| Autor: | Rebecca Houston, Elena Solli, Anmol Singh Johal, Luke Tomycz, Nicole A. Colwell, Jayoung Pak, Irene Say |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Drug Resistant Epilepsy Health Knowledge Attitudes Practice medicine.medical_specialty 03 medical and health sciences Epilepsy 0302 clinical medicine Preoperative Care medicine Humans Epilepsy surgery Healthcare Disparities Surgical treatment Intensive care medicine Socioeconomic status business.industry Seizure freedom medicine.disease Clinical trial Treatment Outcome 030104 developmental biology Socioeconomic Factors Neurology Neurology (clinical) business 030217 neurology & neurosurgery Intractable seizures |
| Zdroj: | Epilepsia. 61:1352-1364 |
| ISSN: | 1528-1167 0013-9580 |
| DOI: | 10.1111/epi.16572 |
| Popis: | Patients with drug-resistant epilepsy (DRE) rarely achieve seizure freedom with medical therapy alone. Despite being safe and effective for select patients with DRE, epilepsy surgery remains heavily underutilized. Multiple studies have indicated that the overall rates of surgery in patients with DRE have stagnated in recent years and may be decreasing, even when hospitalizations for epilepsy-related problems are on the rise. Ultimately, many patients with DRE who might otherwise benefit from surgery continue to have intractable seizures, lacking access to the full spectrum of available treatment options. In this article, we review the various factors accounting for the persistent underutilization of epilepsy surgery and uncover several key themes, including the persistent knowledge gap among physicians in identifying potential surgical candidates, lack of coordinated patient care, patient misconceptions of surgery, and socioeconomic disparities impeding access to care. Moreover, factors such as the cost and complexity of the preoperative evaluation, a lack of federal resource allocation for the research of surgical therapies for epilepsy, and difficulties recruiting patients to clinical trials all contribute to this multifaceted dilemma. |
| Databáze: | OpenAIRE |
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