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Temporal lobe epilepsy surgery rate varies between ethnic groups

5 May, 2004

African Americans
are less than half as likely as non-Hispanic whites in the US to
undergo surgery for temporal lobe epilepsy, according to research
presented to the American Academy of Neurology Annual Meeting in San Francisco.

The difference in surgery rates is independent of other demographic,
socio-economic and clinical variables, including availability of
medical insurance, according to lead study author Jorge Burneo of the Epilepsy Center at University of Alabama at Birmingham Medical Center.

Previous
studies have documented differences in the use of treatments by African
Americans and whites in the use of different treatments for a variety
of conditions and so this new research was to assess whether the same
pattern is true in surgery for epilepsy. The researchers reviewed the
charts of 122 patients with temporal lobe epilepsy (TLE) with evidence
of mesial temporal sclerosis, a common cause of TLE.

While
African Americans constituted 25 per cent of temporal lobe epilepsy
patients at the Epilepsy Center, they accounted for only nine per cent
of surgery patients. After taking into account age, education, seizure
onset variables, and type of medical insurance, African Americans were
still 56 per cent less likely to undergo surgery than non-Hispanic
whites.

Dr Burneo commented:

"Race
appears to be an important factor related to such disparities but the
causes remain unclear, and they appear not to be related to a
difference in access to care.

"Surgery
for medically intractable temporal lobe epilepsy is no longer an
intervention of last resort and is often considered early because it
may lead to freedom from seizures."