According to a study that was published in The Lancet Child and Adolescent Health, children with drug-resistant epilepsy (DRE) had the highest survival rate after cranial epilepsy surgery and the lowest survival rate when only treated with antiseizure medications.
In this massive retrospective study, the first comparison of long-term survival in children with DRE between cohorts treated with medications alone, vagus nerve stimulation plus medications, and cranial epilepsy surgery plus medications was made. When compared to medication-only treatment, the risk of early death was reduced by over 80% with surgery and by 40% with vagus nerve stimulation.
When compared to the general population of the same age, epileptic individuals have higher rates of mortality. One of the most prevalent neurological conditions, epilepsy, affects at least 3.4 million Americans. An estimated 20% of children with epilepsy also have DRE.
“Our findings also emphasize the importance of a multidisciplinary team approach to epilepsy treatment, such as that provided at a comprehensive epilepsy center, which includes tailored evaluation and deployment of medical and surgical treatment options for patients with this difficult disease.”
Sandi Lam, MD, Division Head of Neurosurgery at Ann & Robert H. Lurie Children’s Hospital of Chicago .
Senior author Sandi Lam, MD, Division Head of Neurosurgery at Ann & Robert H. Lurie Children’s Hospital of Chicago and Professor of Neurological Surgery at Northwestern University Feinberg School of Medicine, stated, “We provide critical evidence for healthcare decision-making for pediatric patients with drug-resistant epilepsy.” Our findings also emphasize the significance of a multidisciplinary team approach to treating epilepsy, such as the one provided by a comprehensive epilepsy center, which includes individualized evaluation and implementation of medical and surgical treatment options for patients with this difficult condition.
However, comprehensive epilepsy centers are only referred to less than 1% of DRE patients of any age. The Centers for Disease Control and Prevention (CDC) and Institute of Medicine estimate that between 100,000 and 200,000 people who should have epilepsy surgery do not get it.
Dr. Lam stated, “In light of the findings of our study, the catastrophic underutilization of epilepsy surgery may directly lead to the avoidable premature deaths of pediatric epilepsy patients.” Even for infants under the age of three months, epilepsy surgery has been proven to be a safe and effective treatment option. In order to shorten the time it takes to undergo surgery and reduce the negative effects of ongoing seizures on the developing brain, we need to improve early referral for comprehensive epilepsy evaluation. We demonstrate that children’s lives may be at stake.
Additionally, Dr. Lam and his associates discovered disparities in access to epilepsy surgery. White, secretly safeguarded kids were bound to get careful treatment.
Dr. Lam stated, “Our finding of disparities in access to epilepsy surgery needs to be further explored to identify multifactorial reasons and aim to improve healthcare delivery and health equity in the treatment of pediatric epilepsy.”
18,292 children with DRE from the ages of 0 to 17 were part of the study. The inpatient, emergency department, ambulatory, and observation encounter level data from 44 children’s hospitals in the United States can be found in the administrative database known as the Pediatric Health Information System (PHIS) maintained by the Children’s Hospital Association.
“Youngsters with drug-safe epilepsy ought to go through assessment for all treatment choices, with expanded thought of nomination for cranial epilepsy medical procedures or neurostimulation, for example, vagus nerve feeling,” focused on Dr. Lam, who additionally holds the Yeager Residency in Pediatric Neurosurgery.
More information: The Lancet Child and Adolescent Health (2023). www.thelancet.com/journals/lan … (23)00082-2/fulltext
