Long-Term Survival in Children With Drug-Resistant Epilepsy

The long-term survival rates in children with drug-resistant epilepsy (DRE) have been discussed in a recent study published in The Lancet Child and Adolescent Health. It compares different treatment modalities. The findings reveal that cranial epilepsy surgery significantly improves survival rates compared to medication-only therapy, while vagus nerve stimulation shows a moderate improvement. This article delves into the details of the study's findings and emphasizes the importance of early referral and comprehensive evaluation for pediatric epilepsy patients (1^✔ ✔Trusted Source
Comparison of long-term survival with continued medical therapy, vagus nerve stimulation, and cranial epilepsy surgery in paediatric patients with drug-resistant epilepsy in the USA: an observational cohort study

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Comparing Treatment Approaches for Drug-Resistant Epilepsy (DRE)

The retrospective research examined the outcomes of children with DRE treated with medications alone, vagus nerve stimulation with medications, and cranial epilepsy surgery plus medications. The study found that the risk of early mortality was reduced by more than 80% after surgery and by 40% following vagus nerve stimulation when compared to medication-only therapy. These findings highlight the critical role of surgical interventions in improving survival rates for children with DRE.

Addressing the Underutilization of Epilepsy Surgery

Despite the proven effectiveness and safety of epilepsy surgery, fewer than 1% of patients with drug-resistant epilepsy (DRE) are referred to comprehensive epilepsy centers. This alarming underutilization leads to avoidable premature deaths in pediatric epilepsy patients each year. The study's senior author, Dr. Sandi Lam, emphasizes the need for early referral and comprehensive evaluation to limit the harmful effects of ongoing seizures on the developing brain. The study also highlights the disparities in access to epilepsy surgery, with white and privately insured children being more likely to receive surgical treatment.

The study included a comprehensive analysis of 18,292 pediatric patients with DRE, utilizing data from the Pediatric Health Information System (PHIS). Disparities in access to epilepsy surgery were identified, indicating the need for further investigation to understand the multifactorial reasons behind these disparities and work towards improving healthcare delivery and health equity in the treatment of pediatric epilepsy.

The study's findings emphasize the significant impact of treatment approaches on long-term survival rates in children with drug-resistant epilepsy. Cranial epilepsy surgery proves to be a game-changer, significantly reducing the risk of early mortality. Vagus nerve stimulation also shows promise in improving survival rates. The underutilization of epilepsy surgery and disparities in access call for urgent action to improve early referral and comprehensive evaluation for pediatric epilepsy patients. By addressing these challenges, we can strive towards better outcomes and improved quality of life for children with drug-resistant epilepsy.

Reference:

1. Comparison of long-term survival with continued medical therapy, vagus nerve stimulation, and cranial epilepsy surgery in paediatric patients with drug-resistant epilepsy in the USA: an observational cohort study - (https://pubmed.ncbi.nlm.nih.gov/37276875/)

Source-Medindia