Background: The International League Against
Epilepsy recommends patients with drug resistant epilepsy (DRE) be referred
for surgical evaluation, however prior literature suggests this is an
underutilized intervention. This study captures practices of North American
pediatric neurologists regarding the management of DRE and factors which may
promote or limit referrals for epilepsy surgical evaluation.
Methods: A REDCap survey distributed via the
Child Neurology Society mailing list to pediatric neurologists practicing in
North America. “R” was used to conduct data analyses. Ethics approval from
the CHEO REB was granted prior to the start of data collection.
Results: 102 pediatric neurologists responded,
77% of whom currently practice in the United States. 73% of respondents
reported they would refer a patient for surgical consultation after two
failed medications. Of all potential predictors tested in a logistic
regression model, low referral volume was the only predictor of whether
participants refer patients after more than three failed medications.
Conclusions: Pediatric neurologists demonstrate
fair knowledge of formal recommendations to refer patients for surgical
evaluation after two failed medication trials. Other modifiable factors
reported, especially family perceptions of epilepsy surgery, should be
prioritized when developing tools to enhance effective referrals and
increase utilization of epilepsy surgery in the management of pediatric
DRE.
Mobility in osteogenesis imperfecta: a multicenter North American study
