Presurgical evaluations and epilepsy surgery are no longer limited to large medical centers
Surgery for epilepsy produces good outcomes, yet it remains an underused treatment option. This surgery requires inpatient evaluation using video electroencephalography (VEEG) to monitor brain wave activity and seizures. Another evaluation, called intracranial EEG, uses electrodes placed directly on the exposed brain to map out epileptic zones prior to surgery.
A new study of trends in presurgical evaluations for epilepsy from 1998 to 2009 found that hospitalization rates for intractable epilepsy and VEEG monitoring increased. In addition, more presurgical evaluations were being performed in nonteaching hospitals. Yet, this did not translate to more use of epilepsy surgery over time.
Data were obtained from the Nationwide Inpatient Sample to identify hospital admissions for presurgical evaluation and/or surgery in patients with epilepsy. The year of discharge was grouped into two time periods: 1998–2003 and 2004–2009. By using U.S. Census population estimates and the prevalence rate of epilepsy (7.1/1,000 persons), the researchers estimated the number of individuals with epilepsy. During the study period, more patients from older age groups underwent epilepsy surgery and pre-surgical diagnostic evaluations. An increase in surgery was also noted for patients in the 0–17 year age group. More evaluations and surgeries were performed in nonteaching hospitals.
The researchers also found a significant rise in intractable epilepsy-related discharges and VEEG monitoring. However, there were no changes in the use of intracranial EEG monitoring or epilepsy surgery overall. The study was supported in part by AHRQ (T32 HS00059).
See "Temporal trends in pre-surgical evaluations and epilepsy surgery in the U.S. from 1998 to 2009," by Nicholas K. Schiltz, Ph.D., Siran M. Koroukian, Ph.D., Samden D. Lhatoo, M.D., and Kitti Kaiboriboon, M.D., in Epilepsy Research 103, pp. 270-278, 2013.