Racial disparities in the use of surgical treatment for intractable temporal lobe epilepsy

Abstract

To compare the use of surgical treatment for epilepsy among different ethnic and racial groups with surgically remediable temporal lobe epilepsy (TLE). The authors used multiple logistic regression analysis to model the use of anterior temporal lobectomy in a cross-sectional study of video-EEG monitoring discharge data among residents of Alabama and surrounding states discharged from the University of Alabama at Birmingham Hospital between July 1998 and January 2003 with a primary diagnosis of TLE. Of 432 patients diagnosed with TLE, 130 had evidence of mesial temporal sclerosis on MRI studies. Seventy patients underwent surgery; African Americans were less likely than non-Hispanic whites to undergo surgical treatment (odds ratio, 0.3; 95% CI, 0.2 to 0.8). After potential demographic (age, education, and sex), socioeconomic, medical insurance coverage, and clinical confounders (bitemporal seizure onset) were controlled, African Americans had a 60% less chance to receive surgery than non-Hispanic whites. There are disparities in the use of surgical treatment for temporal lobe epilepsy. Race appears to be an influential factor related to such disparities.