Abstracts

Decades of successful empirical experience with epilepsy surgery have demonstrated the safety and efficacy of surgical intervention on selected seizure syndromes. Recently, the beneficial effect of anterior temporal lobe resection has been reaffirmed by a prospective randomized clinical trial for patients with mesial temporal sclerosis (New England Journal of Medicine 2001). Despite these findings, only a small minority of potential surgical candidates undergo epilepsy surgery in the United States. This study attempts to determine the attitudes and practice patterns of general neurologists vis-a-vis epileptologists regarding epilepsy treatment in the State of California and in the State of New York. Confidential e-mail questionnaires were sent to all neurologists in the State of California and in the State of New York. Two groups were queried as comparison cohorts: epileptologists and all other neurologists, including those who have other declared subspecialty interests in neurology. The survey covers all facets of epilepsy management, including questions regarding the definition of medical intractability, attitudes and practice patterns regarding surgical treatment of seizure disorders, the necessity and feasibility of further randomized clinical trials for other surgical procedures for epilepsy, and the perceived relative value of specialized epilepsy treatment centers. A complete analysis of the findings of this study will be presented at the December 2005 meeting of the American Epilepsy Society. The final results of this survey are unavailable at the time of the writing of this abstract. Published data demonstrate the benefit of epilepsy surgery in selected patient subgroups. However, because surgery is perceived to be invasive, it is important to determine the burden of proof that needs to be satisfied in order to allow selected surgical procedures to become primary therapy in epilepsy management as opposed to remaining as options of last resort.