Knowledge, attitude and perception of epilepsy patients toward epilepsy surgery at Jordan University hospital

Introduction: Epilepsy is a condition associated with stigma and considerable morbidity, placing a significant burden on patients and their families. It is fundamental to be mindful of the fact that a substantial number of patients remain unaware of the effective surgical procedures that have shown great success in many cases, drawing upon the global underutilization of epilepsy surgery (ES). In this study, we explore the knowledge and attitudes of epilepsy patients towards ES at Jordan University Hospital (JUH). Aim: This study aims to evaluate epilepsy patients' attitudes and knowledge regarding ES at JUH, identify the variables affecting their attitudes, and compare the results with other Middle Eastern and Western reports. Methods: In this cross-sectional study, conducted between the 1st of March and the 1st of September 2023, we gathered and analyzed data from epilepsy patients in the neurology clinic at JUH. A self-administered questionnaire was utilized, with questions emphasizing patients' demographics, disease status, and their knowledge and attitude toward ES. In order to determine the predictors of attitude, logistic regression was performed on the univariate analysis using the SPSS software. Results: This study included 145 participants, most of them within the 17 and 29 age group, and a mean age at first seizure of 21.6 years. Our sample included more generalized than focal epilepsy patients, with an additional 30 % of patients being unaware of their specific seizure type. 46 % of patients were on at least 2 antiepileptic drugs (AEDs), especially among the focal epilepsy group and 61 % were non-adherent to their medications. Eighty-two participants (57 %) were aware of ES, yet only twenty-five have shown a high level of understanding. The majority of patients (77 %) have expressed a positive attitude towards ES. Although patients' attitude was significantly associated with their first impression towards ES, age, age at first seizure and not possessing a driving license, the regression model did not reveal significant predictors. Despite the perception of 94 % of the patients that ES has a moderate to high risk, this did not have any significant influence on their final attitude. Furthermore, our results concluded that income, insurance type, educational level, frequency of seizures, and poor academic outcome played no significant role in patients' final attitude towards ES. Conclusion: ES is no longer considered an "experimental" or "last resort" treatment option. The results emphasize the importance of adapting educational interventions to improve knowledge and understanding of ES and implement measures to surgically pre-evaluate potential candidates. Further research should be done to overcome and address this gap in underutilization. In our study, we conclude that this gap is still present especially in people who are in need and may potentially be candidates for ES, but with the displayed positive attitude in the majority of our patients we are optimistic that the remaining barriers can be overcome, and that the results obtained from our study will be helpful for positive advancements in patients' quality of life.