Barriers to the management of patients with surgically remediable intractable epilepsy.
It is estimated that only a small proportion of patients with surgically remediable intractable epilepsy receive surgical treatment. There are multiple reasons why this is the case. Patients with intractable epilepsy are sometimes severely disabled and disability can create barriers to getting recommended care. Patients with epilepsy are not well informed about their condition and the available treatments. The incidence of epilepsy is similar in minority populations, and surgically remediable epilepsy frequently presents in adolescence. Nevertheless, these vulnerable populations have specific barriers to receiving epilepsy care, which are often not addressed. In addition, despite scientific evidence for the benefits of the surgical treatment of epilepsy, many healthcare providers do not recommend or adequately discuss surgery with patients. Solutions to these barriers will require interventions that result in informed and capable patients who actively participate in their care and healthcare providers who practice culturally sensitive, recommended care.
Department of Neurology, Oregon Health Sciences University, and Health Services Research, Parkinson's Disease Research Education and Clinical Center, Portland Veterans Affairs Medical Center, Portland, Oregon, USA. swarztra@ohsu.edu
Kari
K
Swarztrauber
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002648:Child; D004827:Epilepsy / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006297:Health Services Accessibility; D006801:Humans; D010353:Patient Education as Topic; D018579:Patient Selection; D011612:Psychosurgery; D016032:Randomized Controlled Trials as Topic; D017211:Treatment Failure
D000927:Anticonvulsants