Research ArticleOriginal Article
Open Access

Knowledge of and attitudes toward epilepsy surgery among neurologists in Saudi Arabia

Bandar Aljafen, Majed Alomar, Nawaf Abohamra, Mohammed Alanazy, Fawaz Al-hussain, Ziad Alhumayyd, Yousef Mohammad and Taim Muayqil
Neurosciences Journal January 2020, 25 (1) 43-49; DOI: https://doi.org/10.17712/nsj.2020.1.20190051

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Tables

  • TABLE 1

    Responses to the demographics section.

    Variablesn (%)
    Gender
    Male75 (70.8)
    Female31 (29.2)
    Age (Years) 
    <4052 (49.1)
    40–5041 (38.7)
    >5013 (12.2)
    Place of the most recent neurology certification
    North America52 (49.1)
    Saudi Arabia44 (41.5)
    Other10 (9.4)
    Region of practice
    Central59 (55.7)
    Western31 (29.2)
    Eastern12 (11.3)
    Southern2 (1.9)
    Northern2 (1.9)
    Type of practicing institute
    Ministry of health hospitals38 (35.8)
    University hospitals31 (29.2)
    Military hospitals24 (22.6)
    Other13 (12.3)
  • TABLE 2

    Responses to the knowledge section.

    Statementsn (%)
    What is the approximate percentage of patients who experience clinically significant (i.e., disabling) and permanent adverse effects after anterior temporal lobectomy?
    <5% (correct answer)38 (35.8)
    5-10%33 (31.1)
    11-50%3 (2.8)
    >50%1 (0.9)
    I don’t know31 (29.2)
    Is there a general agreement on the definition of drug-resistant epilepsy?
    Yes (correct answer)79 (74.5)
    No / I don’t know27 (25.5)
    In general, how many trials of antiepileptic drugs (AEDs) should be tried before considering the diagnosis of drug resistant epilepsy?
    Failure of seizure control after 1 AED1 (0.9)
    Failure of seizure control after 2 AEDs (correct answer)70 (66)
    Failure of seizure control after >3 AEDs34 (32.1)
    Failure of all approved AEDs1 (0.9)
    I don’t know0 (0)
    In general, how many AEDs would you try (assuming an adequate trial at an adequate dose) before referring a patient who remains drug resistant for consideration of epilepsy surgery?
    Failure of seizure control after 1 AED1 (0.9)
    Failure of seizure control after 2 AEDs (correct answer)53 (50)
    Failure of seizure control after >3 AEDs49 (46)
    Failure of all approved AEDs2 (1.9)
    I don’t know1 (0.9)
    For how long does a patient have to be drug resistant before you consider referral for epilepsy surgery evaluation?
    As early as possible (correct answer)50 (47.2)
    3 months - 1 year42 (39.6)
    2 - 5 years10 (9.4)
    > 5 years0 (0)
    No one should be referred for epilepsy surgery0 (0)
    I don’t know4 (3.8)
    Patients with focal epilepsy and a normal MRI may benefit from epilepsy surgery.
    Yes (correct answer)89 (84)
    No or I don’t know17 (16)
    Patients with generalized (non-focal) epilepsies are not candidates for epilepsy surgery.
    Yes or I don’t know40 (37.7)
    No (correct answer)66 (62.3)
    Patients with a developmental delay are not candidates for epilepsy surgery.
    Yes or I don’t know15 (14.2)
    No (correct answer)91 (85.8)
    Patients with psychiatric comorbidities are not candidates for epilepsy surgery.
    Yes or I don’t know24 (22.6)
    No (correct answer)82 (77.4)
    Patients with epileptic encephalopathies are not candidates for epilepsy surgery.
    Yes or I don’t know34 (32.1)
    No (correct answer)72 (67.9)
    Which one of the following is the most common neurological complication of epilepsy surgery?
    Aphasia10 (9.4)
    Visual field loss (correct answer)27 (25.5)
    Paralysis11 (10.4)
    Memory loss46 (43.4)
    I don’t know12 (11.3)
  • TABLE 3

    Responses to the attitude section.

    Statementsn (%)
    How often do you discuss surgical options — when indicated — with your epilepsy patients? (positive statement)
    0 = Never3 (2.8)
    1 = Rarely14 (13.2)
    2 = Sometimes38 (35.8)
    3 = Very often28 (26.4)
    4 = Always23 (21.7)
    Epilepsy surgery is a dangerous procedure (negative statement)
    0 = Strongly agree1 (0.9)
    1 = Somewhat agree18 (17)
    2 = Neither agree nor disagree24 (22.6)
    3 = Somewhat disagree34 (32.1)
    4 = Strongly disagree29 (27.4)
    Epilepsy surgery should be viewed as a last resort for patients with epilepsy. (negative statement)
    0 = Strongly agree11 (10.4)
    1 = Somewhat agree25 (23.6)
    2 = Neither agree nor disagree12 (11.3)
    3 = Somewhat disagree33 (31.1)
    4 = Strongly disagree25 (23.6)
    If I had epilepsy that was amenable to surgical therapy, I would agree to the option of epilepsy surgery. (positive statement)
    4 = Strongly agree66 (62.3)
    3 = Somewhat agree31 (29.2)
    2 = Neither agree nor disagree7 (6.6)
    1 = Somewhat disagree1 (0.9)
    0 = Strongly disagree1 (0.9)
    If one of my relatives had epilepsy that was amenable to surgical therapy, I would encourage him/her to undergo epilepsy surgery. (positive statement)
    4 = Strongly agree68 (64.4)
    3 = Somewhat agree30 (28.3)
    2 = Neither agree nor disagree5 (4.7)
    1 = Somewhat disagree0 (0)
    0 = Strongly disagree3 (2.8)
    Epilepsy surgery is an underutilized treatment method of epilepsy. (positive statement)
    4 = Strongly agree66 (62.3)
    3 = Somewhat agree23 (21.7)
    2 = Neither agree nor disagree9 (8.5)
    1 = Somewhat disagree7 (6.6)
    0 = Strongly disagree1 (0.9)
    Specialized epilepsy centers should be available in all tertiary hospitals. (positive statement)
    4 = Strongly agree76 (71.7)
    3 = Somewhat agree19 (17.9)
    2 = Neither agree nor disagree5 (4.7)
    1 = Somewhat disagree4 (3.8)
    0 = Strongly disagree2 (1.9)
    I think epilepsy surgery is a cost-effective treatment option. (positive statement)
    4 = Strongly agree70 (66)
    3 = Somewhat agree21 (19.8)
    2 = Neither agree nor disagree8 (7.5)
    1 = Somewhat disagree5 (4.7)
    0 = Strongly disagree2 (1.9)
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