Physicians' beliefs about brain surgery for drug-resistant epilepsy: A global survey

Ali A Asadi-Pooya; Francesco Brigo; Eugen Trinka; Simona Lattanzi; Ioannis Karakis; Nirmeen Adel Kishk; Kette D Valente; Asel Jusupova; Saule T Turuspekova; Anilu Daza-Restrepo; Guilca Contreras; Mansur A Kutlubaev; Alla Guekht; Abbas Rahimi-Jaberi; Ghaieb Aljandeel; Yamile Calle-Lopez; Taoufik Alsaadi; Abdulaziz Ashkanani; Lakshmi Narasimhan Ranganathan; Abdullah Al-Asmi; Samson G Khachatryan; David Gigineishvili; Boulenouar Mesraoua; Naluca Mwendaweli

doi:10.1016/j.seizure.2022.10.012

Physicians' beliefs about brain surgery for drug-resistant epilepsy: A global survey

Seizure. 2022 Dec:103:18-22. doi: 10.1016/j.seizure.2022.10.012. Epub 2022 Oct 10.

Authors

Ali A Asadi-Pooya¹, Francesco Brigo², Eugen Trinka³, Simona Lattanzi⁴, Ioannis Karakis⁵, Nirmeen Adel Kishk⁶, Kette D Valente⁷, Asel Jusupova⁸, Saule T Turuspekova⁹, Anilu Daza-Restrepo¹⁰, Guilca Contreras¹¹, Mansur A Kutlubaev¹², Alla Guekht¹³, Abbas Rahimi-Jaberi¹⁴, Ghaieb Aljandeel¹⁵, Yamile Calle-Lopez¹⁶, Taoufik Alsaadi¹⁷, Abdulaziz Ashkanani¹⁸, Lakshmi Narasimhan Ranganathan¹⁹, Abdullah Al-Asmi²⁰, Samson G Khachatryan²¹, David Gigineishvili²², Boulenouar Mesraoua²³, Naluca Mwendaweli²⁴

Affiliations

¹ Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Neurology, Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: aliasadipooya@yahoo.com.
² Department of Neurology, Hospital of Merano (SABES-ASDAA), Merano-Meran, Italy.
³ Department of Neurology, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg 5020, Austria; Institute Neuroscience Christian-Doppler Medical Centre, Paracelsus Medical University, Austria; Centre for Cognitive Neuroscience, Salzburg 5020, Austria; Department of Public Health, Health Services Research and Health Technology Assessment, Member of the European Referencenetwork EpiCARE., Medical Informatics and Technology, UMIT - University for Health Sciences, Hall in Tirol, Austria.
⁴ Department of Experimental and Clinical Medicine, Neurological Clinic, Marche Polytechnic University, Ancona, Italy.
⁵ Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
⁶ Department of Neurology, Cairo University Epilepsy Unit (CUEU), School of Medicine, Cairo University, Cairo, Egypt.
⁷ Deparment of Psychiatry, Laboratory of Clinical Neurophysiology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil.
⁸ Neurology and Clinical Genetics Department, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan.
⁹ Department of Nervous Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.
¹⁰ ENyS CONICET - Neuroscience and Epilepsy service, El Cruce Hospital "Dr. Néstor Kirchner", Buenos Aires, Argentina.
¹¹ Epilepsy Unit. La Trinidad Medical Center, Caracas, Venezuela.
¹² Department of Neurology, Bashkir State Medical University, Ufa. Russia.
¹³ Department of Neurology, Nerosurgery and Medical Genetics, Moscow Research and Clinical Center for Neurospychiatry, Pirogov Russian National Research Medical University, Moscow, Russia.
¹⁴ Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
¹⁵ Iraqi Council for Medical Specializations, Faculty of Epileptology, Medical City, Baghdad, Iraq.
¹⁶ Neurology Section, University of Antioquia, Fundación Clínica del Norte-Neuroclínica, Medellín Colombia.
¹⁷ Deptartment of Neurology, American Center for Psychiatry and Neurology, and Khalifa University, Abu Dhabi, UAE.
¹⁸ Ahmadi Hospital, Kuwait, Kuwait.
¹⁹ Madras Medical College, Institute of Neurology, Chennai, Tamil Nadu, India.
²⁰ Neurology unit, Department of Medicine, College of Medicine and Health Sceinces and Sultan Qaboos University Hospital, Sultan Qaboos University, Oman.
²¹ Department of Neurology and Neurosurgery, National Institute of Health, Yerevan, Armenia.
²² Department of Neurology & Neurosurgery, Institute of Neurology, Javakhishvili Tbilisi State University, Tbilisi, Georgia.
²³ Neurosciences Department, Hamad Medical Corporation and Weill Cornell Medical College, Doha, Qatar.
²⁴ Ministry of Health, University Teaching Hospital, Lusaka Province, Zambia.

PMID: 36252422
DOI: 10.1016/j.seizure.2022.10.012

Abstract

Purpose: To investigate the opinions of physicians about brain surgery for drug-resistant epilepsy worldwide.

Methods: Practicing neurologists, psychiatrists, and neurosurgeons from around the world were invited to participate in an online survey. The survey anonymously collected data about demographics, years in clinical practice, discipline, nation, work setting, and answers to the questions about beliefs and attitudes about brain surgery for drug-resistant epilepsy.

Results: In total, 1410 physicians from 20 countries and different world regions participated. The propensity to discuss brain surgery with patients, who have drug-resistant seizures, was higher among men (versus women) [Odds Ratio (OR) 1.67, 95% CI 1.20-2.31; p = 0.002]. In comparison to neurologists, psychiatrists were less likely (OR 0.28, 95% CI 0.17-0.47; p < 0.001) and neurosurgeons were more likely (OR 2.00, 95% CI 1.08-3.72; p = 0.028) to discuss about it. Survey participants working in Africa, Asia, the Middle East, and the Former Union of Soviet Socialist Republics showed a lower propensity to discuss epilepsy surgery with patients.

Conclusion: This study showed that on an international level, there is still a knowledge gap concerning epilepsy surgery and much needs to be done to identify and overcome barriers to epilepsy surgery for patients with drug-resistant seizures worldwide.

Keywords: Brain; Epilepsy; Seizure; Surgery; Treatment.

MeSH terms

Brain
Drug Resistant Epilepsy* / surgery
Epilepsy* / surgery
Female
Humans
Male
Physicians*
Seizures
Surveys and Questionnaires