Narrowing the Treatment Gap and Raising Awareness of Surgical Options for Epilepsy: Patricia C. Dugan, MD


The associate professor of neurology at NYU Grossman School of Medicine talked about the need for increased awareness in the medical community to address the underutilization of surgical interventions for refractory focal epilepsy. [WATCH TIME: 4 minutes]

WATCH TIME: 4 minutes

“I think that a lot of epileptologists have different ideas about what is causing that treatment gap. It takes a lot of effort to refer somebody and to embark on a comprehensive epilepsy surgery evaluation. It's to dedicate a lot of time and effort into ordering these tests, interpreting them and counseling the patient. It's not a single conversation that you have with the patient and their families, but it can be worthwhile. You can really make a life changing difference.”

Approximately between 30% and 40% of patients with epilepsy who have seizures are not controlled by medication.1 If seizures continue despite 2 attempts of antiseizure treatments, patients are considered to have refractory epilepsy. Drug-resistant epilepsy can be caused by a variety of events such as noncompliance, misdiagnosis, misuse of medication, and issues with lifestyle.

Research shows that surgical treatment typically offers the best opportunity for complete freedom from seizures for patients who have drug-resistant epilepsy.1 Those who are not surgical candidates, or not unwilling to consider surgery, have a variety of other alternative options for therapies that may be considered. These include peripheral or central neurostimulation, ketogenic diet, and other approaches. The patient’s quality of life can still be enhanced even if alternative treatments are not effective through psychological and social support services offered by the multidisciplinary epilepsy centers. Despite these options, research shows that only a small amount of patients with refractory epilepsy are referred to these centers for care.

At the 2023 International Congress on the Future of Neurology (IFN) Annual Meeting, held September 22-23, in Jersey City, New Jersey, Patricia C. Dugan, MD, director of the epilepsy fellowship program at NYU Langone Health, sat down in an interview with NeurologyLive® to discuss challenges neurologists face in referring patients for comprehensive epilepsy surgery evaluations. She also talked about how the medical community can enhance awareness about epilepsy surgery candidacy and close the treatment gap. Dugan, who also serves as the associate professor of neurology at NYU Grossman School of Medicine, spoke about developments and studies on the horizon in epilepsy management, and how neurologists can actively contribute to potential groundbreaking discoveries.

Click here for more coverage on IFN 2023.

1. Engel J Jr. Approaches to refractory epilepsy. Ann Indian Acad Neurol. 2014;17(Suppl 1):S12-S17. doi:10.4103/0972-2327.128644
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