Display Settings:

Format

Send to:

Choose Destination
We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Neurology. 2010 Aug 24;75(8):699-704. doi: 10.1212/WNL.0b013e3181eee457.

Referral pattern for epilepsy surgery after evidence-based recommendations: a retrospective study.

Author information

  • 1Department of Neurology, David Geffen School of Medicine at UCLA, 710 Westwood Plaza, Los Angeles, CA 90095-1769, USA.

Erratum in

  • Neurology. 2010 Nov 23;75(21):1945.

Abstract

BACKGROUND:

Class I evidence for surgical effectiveness in refractory temporal lobe epilepsy (TLE) in 2001 led to an American Academy of Neurology practice parameter in 2003 recommending "referral to a surgical epilepsy center on failing appropriate trials of first-line antiepileptic drugs." We examined whether this led to a change in referral patterns to our epilepsy center.

METHODS:

We compared referral data for patients with TLE at our center for 1995 to 1998 (group 1, n = 83) and 2005 to 2008 (group 2, n = 102) to determine whether these recommendations resulted in a change in referral patterns for surgical evaluation. Patients with brain tumors, previous epilepsy surgery evaluations, or brain surgery (including epilepsy surgery) were excluded.

RESULTS:

We did not find a difference between the groups in the duration from the diagnosis of habitual seizures to referral (17.1 +/- 10.0 vs 18.6 +/- 12.6 years, p = 0.39) or the age at the time of evaluation (34.1 +/- 10.3 vs 37.0 +/- 11.8 years, p = 0.08). However, there was a difference in the distributions of age at evaluation (p = 0.03) and the duration of pharmacotherapy (p = 0.03) between the groups, with a greater proportion of patients in group 2 with drug-resistant epilepsy both earlier and later in their treatment course. Nonepileptic seizures were referred significantly earlier than TLE in either group or when combined.

CONCLUSIONS:

Our analysis does not identify a significantly earlier referral for epilepsy surgery evaluation as recommended in the practice parameter, but suggests a hopeful trend in this direction.

Comment in

PMID:
20733145
[PubMed - indexed for MEDLINE]
PMCID:
PMC2931651
Free PMC Article

Images from this publication.See all images (3)Free text

PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for HighWire Icon for PubMed Central
    Loading ...
    Write to the Help Desk