ArticleEpilepsia2024
Delays in the diagnosis and surgical treatment of drug-resistant epilepsy: A cohort study.
Article in Epilepsia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Concentration and Specialty Pair Patterns of Interdepartmental Consultations in Hospitalized Patients Using Real-World Data: Retrospective Cohort Study.Journal of medical Internet research · 2026Article
- Epilepsy Surgery in a Resource-Limited Latin-American Center: Presurgical Evaluation Findings and Early ILAE Outcomes in a Mixed Adult-Pediatric Cohort.Brain sciences · 2026Article
- Delayed and deferred surgery associated with cenobamate use in people with drug-resistant focal epilepsy.Epilepsia · 2026Article
- Cost and clinical outcomes of epilepsy surgery in a Brazilian public hospital: a health economic evaluation.Arquivos de neuro-psiquiatria · 2026Article
- Expanding the scope of pediatric epilepsy surgery: Access, indications, and outcomes in a modern cohort.Epilepsia open · 2026Article
- Pediatric Epilepsy Surgery: The Noninvasive Presurgical Evaluation.Pediatric neurosurgery · 2026Review
- Lesionectomy as management for super-refractory status epilepticus due to focal cortical dysplasia: illustrative case.Journal of neurosurgery. Case lessons · 2025Article
- Factors Influencing the Duration From the Initiation of Surgical Evaluation to Final Intervention in Pediatric Epilepsy Surgery.Annals of the Child Neurology Society · 2025Article
- Long-term outcomes of corpus callosotomy in adult patients with drug-resistant epilepsy: Results from a single neurosurgical center in Mexico.Epilepsia open · 2025Article
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
objectiveDelay in referral for epilepsy surgery of patients with drug-resistant epilepsy (DRE) is associated with decreased quality of life, worse surgical outcomes, and increased risk of sudden unexplained death in epilepsy (SUDEP). Understanding the potential causes of delays in referral and treatment is crucial for optimizing the referral and treatment process. We evaluated the treatment intervals, demographics, and clinical characteristics of patients referred for surgical evaluation at our level 4 epilepsy center in the U.S. Intermountain West.
methodsWe retrospectively reviewed the records of patients who underwent surgery for DRE between 2012 and 2022. Data collected included patient demographics, DRE diagnosis date, clinical characteristics, insurance status, distance from epilepsy center, date of surgical evaluation, surgical procedure, and intervals between different stages of evaluation.
resultsWithin our cohort of 185 patients with epilepsy (99 female, 53.5%), the mean ± standard deviation (SD) age at surgery was 38.4 ± 11.9 years. In this cohort, 95.7% of patients had received definitive epilepsy surgery (most frequently neuromodulation procedures) and 4.3% had participated in phase 2 intracranial monitoring but had not yet received definitive surgery. The median (1st-3rd quartile) intervals observed were 10.1 (3.8-21.5) years from epilepsy diagnosis to DRE diagnosis, 16.7 (6.5-28.4) years from epilepsy diagnosis to surgery, and 1.4 (0.6-4.0) years from DRE diagnosis to surgery. We observed significantly shorter median times from epilepsy diagnosis to DRE diagnosis (p < .01) and epilepsy diagnosis to surgery (p < .05) in patients who traveled further for treatment. Patients with public health insurance had a significantly longer time from DRE diagnosis to surgery (p < .001). SIGNIFICANCE: Both shorter distance traveled to our epilepsy center and public health insurance were predictive of delays in diagnosis and treatment intervals. Timely referral of patients with DRE to specialized epilepsy centers for surgery evaluation is crucial, and identifying key factors that may delay referral is paramount to optimizing surgical outcomes.
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