Acceptance of epilepsy surgery in the pediatric age - What the parents think and what the doctors can do

- The study assessed how prevalent the reluctance is to undergo epilepsy surgery.
- Reluctance to undergo surgery varies with the age of the patients.
- Patient “barriers” can limit access to a potentially curative intervention.
- The amount of information patients receive has a key role in increasing acceptance.

Epilepsy surgery (ES) in pediatrics is safe and effective but can be underutilized. Possible barriers could be parental resistance and doctor inertia. We surveyed 138 parents of pediatric patients with epilepsy and found that 25.2% were opposed to this treatment. However, upon completing the questionnaire that contained factual information about ES, 50.4% of the responders stated that they had become more favorable vs. 3.3% more contrary and 46.3% unchanged. Parents of prepubescent patients were most receptive (p = 0.0343) and more likely to shift to a more favorable attitude. Thus, pediatric neurologists should not hesitate to discuss ES as soon as indicated, providing all necessary information to increase acceptance. However, among 60 child neurologists surveyed, 60% did not fully comply with guidelines or follow accepted standards of practice, indicating that they may not be apt to provide proper parental guidance.We conclude that education of both practicing neurologists and parents is needed to facilitate the process.