Comment

. 2022 Feb 1;98(5):e449-e458.

doi: 10.1212/WNL.0000000000013130. Epub 2021 Dec 8.

United States Epilepsy Center Characteristics: A Data Analysis From the National Association of Epilepsy Centers

Adam P Ostendorf¹, Stephanie M Ahrens², Fred Alexander Lado², Susan T Arnold², Shasha Bai², Meriem K Bensalem Owen², Kevin E Chapman², Dave F Clarke², Mariah Eisner², Nathan B Fountain², Johanna M Gray², Jennifer L Hopp², Ellen Riker², Stephan U Schuele², Barbara V Small², Susan T Herman²

Affiliations

¹ From the Department of Pediatrics (A.P.O., S.M.A.), Nationwide Children's Hospital and Ohio State University, Columbus; Department of Neurology (F.A.L.), Hofstra Northwell Comprehensive Epilepsy Center, Great Neck, NY; Department of Pediatrics (S.T.A.), Children's Medical Center, Dallas, TX; Pediatric Biostatistics Core (S.B.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (M.K.B.O.), University of Kentucky, Lexington; Department of Child Health (K.E.C.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital; Division of Pediatric Neurology (D.F.C.), Department of Neurology, Dell Medical School, University of Texas at Austin; Biostatistics Resource at Nationwide Children's Hospital (M.E.), Columbus, OH; Department of Neurology (N.B.F.), Comprehensive Epilepsy Program, University of Virginia, Charlottesville; National Association of Epilepsy Centers (J.M.G., E.R., B.V.S.), Washington, DC; University of Maryland Medical Center (J.L.H.), Baltimore, MD; Ken and Ruth Davee Department of Neurology (S.U.S.), Northwestern University Feinberg School of Medicine, Chicago, IL; and Department of Neurology (S.T.H.), Barrow Neurological Institute, Phoenix, AZ. adam.ostendorf@nationwidechildrens.org.
² From the Department of Pediatrics (A.P.O., S.M.A.), Nationwide Children's Hospital and Ohio State University, Columbus; Department of Neurology (F.A.L.), Hofstra Northwell Comprehensive Epilepsy Center, Great Neck, NY; Department of Pediatrics (S.T.A.), Children's Medical Center, Dallas, TX; Pediatric Biostatistics Core (S.B.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (M.K.B.O.), University of Kentucky, Lexington; Department of Child Health (K.E.C.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital; Division of Pediatric Neurology (D.F.C.), Department of Neurology, Dell Medical School, University of Texas at Austin; Biostatistics Resource at Nationwide Children's Hospital (M.E.), Columbus, OH; Department of Neurology (N.B.F.), Comprehensive Epilepsy Program, University of Virginia, Charlottesville; National Association of Epilepsy Centers (J.M.G., E.R., B.V.S.), Washington, DC; University of Maryland Medical Center (J.L.H.), Baltimore, MD; Ken and Ruth Davee Department of Neurology (S.U.S.), Northwestern University Feinberg School of Medicine, Chicago, IL; and Department of Neurology (S.T.H.), Barrow Neurological Institute, Phoenix, AZ.

PMID: 34880093
PMCID: PMC8826463
DOI: 10.1212/WNL.0000000000013130

Comment

United States Epilepsy Center Characteristics: A Data Analysis From the National Association of Epilepsy Centers

Adam P Ostendorf et al. Neurology. 2022.

. 2022 Feb 1;98(5):e449-e458.

doi: 10.1212/WNL.0000000000013130. Epub 2021 Dec 8.

Authors

Affiliations

¹ From the Department of Pediatrics (A.P.O., S.M.A.), Nationwide Children's Hospital and Ohio State University, Columbus; Department of Neurology (F.A.L.), Hofstra Northwell Comprehensive Epilepsy Center, Great Neck, NY; Department of Pediatrics (S.T.A.), Children's Medical Center, Dallas, TX; Pediatric Biostatistics Core (S.B.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (M.K.B.O.), University of Kentucky, Lexington; Department of Child Health (K.E.C.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital; Division of Pediatric Neurology (D.F.C.), Department of Neurology, Dell Medical School, University of Texas at Austin; Biostatistics Resource at Nationwide Children's Hospital (M.E.), Columbus, OH; Department of Neurology (N.B.F.), Comprehensive Epilepsy Program, University of Virginia, Charlottesville; National Association of Epilepsy Centers (J.M.G., E.R., B.V.S.), Washington, DC; University of Maryland Medical Center (J.L.H.), Baltimore, MD; Ken and Ruth Davee Department of Neurology (S.U.S.), Northwestern University Feinberg School of Medicine, Chicago, IL; and Department of Neurology (S.T.H.), Barrow Neurological Institute, Phoenix, AZ. adam.ostendorf@nationwidechildrens.org.
² From the Department of Pediatrics (A.P.O., S.M.A.), Nationwide Children's Hospital and Ohio State University, Columbus; Department of Neurology (F.A.L.), Hofstra Northwell Comprehensive Epilepsy Center, Great Neck, NY; Department of Pediatrics (S.T.A.), Children's Medical Center, Dallas, TX; Pediatric Biostatistics Core (S.B.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (M.K.B.O.), University of Kentucky, Lexington; Department of Child Health (K.E.C.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital; Division of Pediatric Neurology (D.F.C.), Department of Neurology, Dell Medical School, University of Texas at Austin; Biostatistics Resource at Nationwide Children's Hospital (M.E.), Columbus, OH; Department of Neurology (N.B.F.), Comprehensive Epilepsy Program, University of Virginia, Charlottesville; National Association of Epilepsy Centers (J.M.G., E.R., B.V.S.), Washington, DC; University of Maryland Medical Center (J.L.H.), Baltimore, MD; Ken and Ruth Davee Department of Neurology (S.U.S.), Northwestern University Feinberg School of Medicine, Chicago, IL; and Department of Neurology (S.T.H.), Barrow Neurological Institute, Phoenix, AZ.

PMID: 34880093
PMCID: PMC8826463
DOI: 10.1212/WNL.0000000000013130

Abstract

Background and objectives: Patients with drug-resistant epilepsy (DRE) may benefit from specialized testing and treatments to better control seizures and improve quality of life. Most evaluations and procedures for DRE in the United States are performed at epilepsy centers accredited by the National Association of Epilepsy Centers (NAEC). On an annual basis, the NAEC collects data from accredited epilepsy centers on hospital-based epilepsy monitoring unit (EMU) size and admissions, diagnostic testing, surgeries, and other services. This article highlights trends in epilepsy center services from 2012 through 2019.

Methods: We analyzed data reported in 2012, 2016, and 2019 from all level 3 and level 4 NAEC accredited epilepsy centers. Data were described using frequency for categorical variables and median for continuous variables and were analyzed by center level and center population category. EMU beds, EMU admissions, epileptologists, and aggregate procedure volumes were also described using rates per population per year.

Results: During the period studied, the number of NAEC accredited centers increased from 161 to 256, with the largest increases in adult- and pediatric-only centers. Growth in EMU admissions (41%), EMU beds (26%), and epileptologists (109%) per population occurred. Access to specialized testing and services broadly expanded. The largest growth in procedure volumes occurred in laser interstitial thermal therapy (LiTT) (61%), responsive neurostimulation (RNS) implantations (114%), and intracranial monitoring without resection (152%) over the study period. Corpus callosotomies and vagus nerve stimulator (VNS) implantations decreased (-12.8% and -2.4%, respectively), while growth in temporal lobectomies (5.9%), extratemporal resections (11.9%), and hemispherectomies/otomies (13.1%) lagged center growth (59%), leading to a decrease in median volumes of these procedures per center.

Discussion: During the study period, the availability of specialty epilepsy care in the United States improved as the NAEC implemented its accreditation program. Surgical case complexity increased while aggregate surgical volume remained stable or declined across most procedure types, with a corresponding decline in cases per center. This article describes recent data trends and current state of resources and practice across NAEC member centers and identifies several future directions for driving systematic improvements in epilepsy care.

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Figures

**Figure 1. Number of National Association of Epilepsy Centers Member Centers Over Time**
(A) By Level. (B) Demographic.

See this image and copyright information in PMC

Comment in

Epilepsy Centers in the United States: The Times They Are A-Changing.
Meador KJ, Jobst BC. Meador KJ, et al. Neurology. 2022 Feb 1;98(5):175-176. doi: 10.1212/WNL.0000000000013132. Epub 2021 Dec 8. Neurology. 2022. PMID: 34880096 No abstract available.
The State of Specialized Epilepsy Care in the States: Increased Access, New Tools, but the Same Dismal Underutilization of Epilepsy Surgery.
Punia V. Punia V. Epilepsy Curr. 2022 Jul 16;22(4):228-230. doi: 10.1177/15357597221099065. eCollection 2022 Jul-Aug. Epilepsy Curr. 2022. PMID: 36187142 Free PMC article. No abstract available.

Comment on

Epilepsy Centers in the United States: The Times They Are A-Changing.
Meador KJ, Jobst BC. Meador KJ, et al. Neurology. 2022 Feb 1;98(5):175-176. doi: 10.1212/WNL.0000000000013132. Epub 2021 Dec 8. Neurology. 2022. PMID: 34880096 No abstract available.

References

1. Zack MM, Kobau R. National and state estimates of the numbers of adults and children with active epilepsy: United States, 2015. MMWR Morb Mortal Wkly Rep. 2017;66(31):821-825. - PMC - PubMed
1. Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med. 2000;342(5):314-319. - PubMed
1. Ostendorf AP, Gedela S. Effect of epilepsy on families, communities, and society. Semin Pediatr Neurol. 2017;24(4):340-347. - PubMed
1. Wilner AN, Sharma BK, Thompson A, Soucy A, Krueger A. Diagnoses, procedures, drug utilization, comorbidities, and cost of health care for people with epilepsy in 2012. Epilepsy Behav. 2014;41:83-90. - PubMed
1. Dwivedi R, Ramanujam B, Chandra PS, et al. . Surgery for drug-resistant epilepsy in children. N Engl J Med. 2017;377(17):1639-1647. - PubMed

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United States Epilepsy Center Characteristics: A Data Analysis From the National Association of Epilepsy Centers

Affiliations

United States Epilepsy Center Characteristics: A Data Analysis From the National Association of Epilepsy Centers

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