Med-IQ
Epilepsy and Surgery: What Providers Need to Know

Epilepsy and Surgery: What Providers Need to Know

Med-IQ Express

Developed in collaboration
Med-IQ      Duke Medicine

Online Course | Specialties: Neurology, Primary Care
Released: 11/2/2021
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Expires: 11/1/2022
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Max Credits: 0.25
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Faculty
Derek Southwell, MD, PhD
Surgical Director, Duke Comprehensive Epilepsy Center
Assistant Professor of Neurosurgery
Assistant Research Professor of Neurobiology
Duke University
Durham, NC
  
Activity Planners
Christie Avraamides, PhD
Senior Clinical Content Manager
Med-IQ
Baltimore, MD

Laura Rafferty, ELS
Senior Editorial Manager
Med-IQ
Baltimore, MD

Samantha Gordon, MS
Accreditation Manager
Med-IQ
Baltimore, MD

Amy Sison
Director of CME
Med-IQ
Baltimore, MD

Writer
Caitlin Rothermel
MedLitera
Vashon, WA
 
Learning Objective
Upon completion, participants should be able to:

  • Identify patients who should be referred for consideration of surgical treatment of epilepsy

Target Audience
This activity is intended for neurologists, primary care providers, and any clinician who manages patients with epilepsy.
 
Statement of Need
Approximately 3 million adults in the United States have epilepsy. After diagnosis, adults with epilepsy typically receive antiseizure medication as first-line treatment, with the goals of controlling seizures, avoiding or minimizing adverse events, and improving quality of life. However, 30% to 40% of people with epilepsy do not achieve seizure control with medications. Medical risks associated with poorly controlled epilepsy include physical injuries due to seizure events (such as falls), cognitive and behavioral changes, and sudden unexpected death in epilepsy. Although clinical guidelines recommend early neurosurgical referral for patients whose epilepsy is not well controlled with medication, data show that patients experience an average delay of 20 years from diagnosis to surgery. Unfortunately, real-world assessments confirm that many physicians and patients do not understand the risks and benefits associated with epilepsy surgery and instead perceive surgery as a “last resort.” Primary care clinicians and general neurologists play a key role in guiding their patients through the practical steps and testing that eventually lead to appropriate specialist care referrals and subsequent surgical treatment. Thus, these healthcare providers can benefit from education on when to consider referring their patients with epilepsy to an epilepsy center and available surgical approaches for patients with uncontrolled seizures or intolerable adverse reactions to medication.

Collaboration Statement
This activity was developed by Med-IQ in collaboration with Duke Health.

Med-IQ      Duke Medicine

Accreditation/Designation Statements
Med-IQ is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
 
Med-IQ designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurse practitioners, physician assistants, and other healthcare professionals who successfully complete the activity will receive a Statement of Participation indicating the maximum credits available.
 
Medium/Method of Participation
This CE activity consists of a 0.25-credit online publication. To receive credit, read the introductory CE material, read the publication, and complete the evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.
 
Initial Release Date: November 2, 2021
Expiration Date: November 1, 2022

Estimated Time to Complete This Activity: 15 minutes

Disclosure Policy
Med-IQ requires any person in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines “relevant financial relationships” as those in any amount occurring within the past 24 months that could create a conflict of interest (COI). Individuals who refuse to disclose will not be permitted to contribute to this CME activity in any way. Med-IQ has policies in place that will identify and resolve COIs prior to this educational activity. Med-IQ also requires faculty to disclose discussions of investigational products or unlabeled/unapproved uses of drugs or devices regulated by the US Food and Drug Administration.

Drug/Product Usage by Faculty
Off-label/unapproved drug uses or products are mentioned within this activity.

Disclosure Statement
The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been resolved through an established COI resolution process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation. 
 
Derek Southwell, MD, PhD, has indicated no real or apparent conflicts.

The peer reviewers and activity planners have no financial relationships to disclose.
 
Statement of Evidence-Based Content
Educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently are consistent with the ACCME definition of continuing medical education (CME). As an ACCME-accredited provider of CME, Med-IQ has a policy to review and ensure that all the content and any recommendations, treatments, and manners of practicing medicine in CME activities are scientifically based, valid, and relevant to the practice of medicine. Med-IQ is responsible for validating the content of the CME activities it provides. Specifically, (1) all recommendations addressing the medical care of patients must be based on evidence that is scientifically sound and recognized as such within the profession; (2) all scientific research referred to, reported, or used in CME in support or justification of a patient care recommendation must conform to generally accepted standards of experimental design, data collection, and analysis.

Med-IQ is not liable for any decision made or action taken in reliance upon the information provided through this activity. 

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For questions or comments about this activity, please contact Med-IQ. Call (toll-free) 866 858 7434 or email info@med-iq.com.

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The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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Complimentary CE
This activity is available free of charge to participants.
 
Copyright
© 2021 Duke University Health System

Abstract

Here are the key takeaways from this activity. Deeper insights and evidence, plus an opportunity to receive credit, are available at the "Continue" button below.

  • Approximately 3 million adults in the US have epilepsy
  • About 30% to 40% of people with epilepsy do not achieve seizure control with medications
  • Medical risks associated with poorly controlled epilepsy include physical injuries due to seizure events (such as falls), cognitive and behavioral changes, and sudden unexpected death in epilepsy
  • Patients who experience ongoing seizures after 2 medication trials should be referred to an epilepsy center for consideration of surgical evaluation
  • Patients who achieve seizure control with medications yet experience unwanted side effects from medications should also be considered for surgical evaluation
  • Several surgical procedures are available; the type of surgery offered depends highly on the individual patient’s condition
  • Roughly, more effective surgeries can lead to seizure freedom in 70% of cases; less effective surgeries are associated with an approximately 50% to 70% reduction in the frequency of seizures
  • Recovery time after surgery depends on several factors, but patients typically need to be hospitalized for only a few days
  • Patients are encouraged to rest and limit activity for a few weeks after surgery, but they are also encouraged to function independently throughout their recovery

View reference list.

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Unless otherwise indicated, photographed subjects who appear within the content of this activity or on artwork associated with this activity are models; they are not actual patients or doctors.

The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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