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Abstract Details

Surgical Timing and Outcomes in Drug Resistant Epilepsy: A Systematic Review Through a Gender Lens
Epilepsy/Clinical Neurophysiology (EEG)
P7 - Poster Session 7 (8:00 AM-9:00 AM)
11-004

To determine how gender influences the time from diagnosis to intervention in epilepsy surgery, as well as gender-related differences in outcomes.
Despite the proven efficacy of epilepsy surgery, it is often underutilized. Studies in other fields of medicine have shown that women often experience delays in receiving specialized treatments, potentially due to differences in symptom presentation, provider bias, or systemic healthcare barriers.

A search of Embase, MEDLINE, Web of Science and PubMed (2009-present) identified studies that reported outcomes of epilepsy surgery separated by gender. Study types included RCTs, cohort studies, case-control studies, case series and systematic reviews. Studies with <10 patients or pediatric populations were excluded.

243 studies included in our analysis (total = 16,159 total patients: 7,914 women and 8,245 men).

The mean age at diagnosis was 10.9 ± 4.7 for men and 11.9 ± 5.2 for women. The average age at surgery for men was 30.1 ± 5.3 and 32.9 ± 6.0 for women. Further, the average duration of epilepsy was 18.32 ± 7.21 for men and 19.56 ± 5.97 for women.

In studies with ≤1-year follow-up, seizure freedom was achieved in 77.4 ± 1.1% of males and 73.2 ± 1.4% of females. In studies with >1-year follow-up, seizure freedom was observed in 56.6 ± 0.6% of males and 60.4 ± 0.6% of females. 

Ongoing analyses aim to further delineate outcome differences by surgical type and etiology.

We found that the time from diagnosis to intervention was greater in women than for men. Further, while men had better short-term outcomes, women tended to show more favorable outcomes at a longer term. However, a full conclusion can be better drawn with more comprehensive data.
Authors/Disclosures
Paula E. Voinescu, MD (Brigham and Women'S Hospital)
PRESENTER 		The institution of Dr. Voinescu has received research support from Epilepsy Foundation of New England. The institution of Dr. Voinescu has received research support from BWH - Connors Center. The institution of an immediate family member of Dr. Voinescu has received research support from American Epilepsy Society. Dr. Voinescu has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Phillipines League Against Epilepsy. Dr. Voinescu has received personal compensation in the range of $500-$4,999 for serving as a PhD Opponent with University of Bergen, Norway. Dr. Voinescu has a non-compensated relationship as a Board Member and Chair with My Epilepsy Story that is relevant to AAN interests or activities. Dr. Voinescu has a non-compensated relationship as a Speaker with Epilepsy Foundation that is relevant to AAN interests or activities. Dr. Voinescu has a non-compensated relationship as a Grant Reviewer with American Epilepsy Society that is relevant to AAN interests or activities. Dr. Voinescu has a non-compensated relationship as a Member of Scientific Advisory Committee with North American AED Pregnancy Registry that is relevant to AAN interests or activities.
Caroline Choi Miss Choi has nothing to disclose.
Sydney P. Hopkins, MPH Miss Hopkins has received personal compensation for serving as an employee of Epilepsy Foundation New England.
Ariel Kim No disclosure on file
John Rolston John Rolston has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neuropace. The institution of John Rolston has received research support from NIH. The institution of John Rolston has received research support from Raynor Foundation. The institution of John Rolston has received research support from Pediatric Epilepsy Research Foundation. The institution of John Rolston has received research support from Lennox-Gastaut Foundation.
Ellen Bubrick, MD (Brigham and Women'S Hospital) Dr. Bubrick has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UniQure.