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.
Read the full article on Seizure - European Journal of Epilepsy.