Perceptions of epilepsy surgery: a systematic review and an explanatory model of decision-making

Epilepsy & Behavior : E&B
Sandra R Dewar, Huibrie C Pieters

Abstract

Clear evidence supports the benefits of surgery over medical therapy for patients with refractory focal epilepsy. Surgical procedures meet the needs of fewer than 2% of those eligible. Referral to a tertiary epilepsy center early in the course of disease is recommended; however, patients live with disabling and life-threatening seizures for an average of 22years before considering surgical treatment. Reasons for this treatment gap are unclear. A critical analysis of the literature addressing perceptions of surgical treatment for epilepsy is placed in the context of a brief history and current treatment guidelines. Common conceptual themes shaping perceptions of epilepsy surgery are identified. Data sources used for this study were PubMed-MEDLINE and PsycINFO from 2003 to December 2013; hand searches of reference lists. Nine papers that addressed patient perceptions of surgery for epilepsy and three papers addressing physician attitudes were reviewed. Treatment misperceptions held by both patients and physicians lead to undertreatment and serious health consequences. Fear of surgery, ignorance of treatment options, and tolerance of symptoms emerge as a triad of responses central to weighing treatment risks and benefits and, ulti...Continue Reading

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Citations

Aug 2, 2016·Lancet Neurology·Nathalie JettéMark R Keezer
Sep 24, 2016·European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society·Allana AustinTamsin Owen
May 30, 2017·Epilepsy & Behavior : E&B·Ying MengJames T Rutka
Feb 12, 2017·Der Nervenarzt·C HoppeC E Elger
Oct 29, 2020·Journal of Child Neurology·Patrick J McDonaldJudy Illes
Sep 29, 2019·Neuropharmacology·Mubeen JanmohamedPatrick Kwan
Apr 23, 2020·Epilepsy & Behavior : E&B·Quynh BachSabine Müller
Feb 19, 2021·Seizure : the Journal of the British Epilepsy Association·Wesley T KerrJohn M Stern
Mar 9, 2021·Epilepsy & Behavior : E&B·Debopam SamantaRavindra Arya
Jul 25, 2021·Seizure : the Journal of the British Epilepsy Association·Vishal MandgeSheryl R Haut

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