Are epilepsy surgery guidelines being followed?

Abstract

Most patients with epilepsy have good control of seizures using medications. However, up to 1/3 of epilepsy patients still have seizures despite trying several medications. Evidence has shown that surgery can be an effective way of treating temporal lobe epilepsy (TLE) that does not respond to medications. In 2003, this led the American Academy of Neurology (AAN) to recommend that patients with TLE whose seizures did not respond to drug treatment should consider surgery. They released a clinical practice guideline (CPG) to alert doctors to this information. The goal of the study by Haneef et al.1 was to find out if the AAN′s recommendations led to quicker referrals to epilepsy centers. The researchers collected data about epilepsy patients sent to their center (University of California, Los Angeles) between January 1995 and September 1998, and compared them to information about patients sent 10 years later (between January 2005 and September 2008). They were interested in seeing whether the guidelines resulted in earlier referrals of patients for epilepsy surgery. To focus on possible surgery candidates, they did not include patients who were referred for other reasons such as those who just recently started having seizures or those who had epilepsy surgery before. The time it took for doctors to refer epilepsy patients for surgery evaluation was defined as the length of unsuccessful drug therapy. For their report, the …