Abstracts

Rationale: Neuropsychology is a critical tool in managing pediatric patients with epilepsy, and awareness of the indications for neuropsychology is important for appropriate patient referrals. However, there is currently little information on physician understanding of the benefits of neuropsychology for this population. This study assessed physician perspectives on the benefits of neuropsychology in managing pediatric patients with epilepsy. Methods: A survey was constructed to assess the familiarity of healthcare providers with the indications for neuropsychological assessment in the management of pediatric patients with epilepsy. Information including physician age, number of years of practicing medicine, subspecialty, practice affiliation, and patient population were also collected. The survey was sent to health care providers in Central Texas specializing in pediatrics, family medicine, neurology, and neurosurgery. Data was summarized using descriptive statistics. Results: 146 (~10%) responded to the survey. 57.5% were pediatric, 12.6% were neurology/neurosurgery, and 29.9% were family medicine physicians. Gender was equally represented (48.2% male) and the majority were Caucasian (74%). Respondents saw a median of 1 new seizure case per month and a median of 2.5 pediatric epilepsy patients per month. Half had been practicing medicine for <15 years. Most clinicians indicated that neuropsychology was useful for planning educational services (90%), and a majority agreed that neuropsychology was helpful in determining how seizures affect functioning (83%). Only 67% reported that neuropsychology was helpful in managing the medical treatment of epilepsy, and only 65% indicated neuropsychology was essential to epilepsy surgery workup. On most items, physicians either agreed or were unsure about the benefits of neuropsychology, with few disagreeing that it is helpful. A higher rate of neurologists/neurosurgeons disagreed with neuropsychology's role in helping manage the medical treatment of epilepsy (29%), and pediatricians/family medicine physicians were much less sure of neuropsychology's role in surgery planning (36.4% and 34.3%, respectively). Pediatricians/family medicine physicians reported higher rates of uncertainty about the benefits of neuropsychology for improving quality of life and functional outcomes (21.7% and 22.2%, respectively). Conclusions: Physicians generally agree that neuropsychology is helpful for planning educational services, and their responses suggest general agreement that neuropsychology can help identify the impact of seizures on level of functioning and help improve quality of life. Disagreement and uncertainty exists about neuropsychology's role in treatment planning, with neurologists/neurosurgeons expressing more disagreement that neuropsychology can help in guiding medical decision making. Pediatricians/family medicine physicians are more likely to endorse uncertainty about the role of neuropsychology in surgical planning. These results identify opportunities to educate subspecialists about the benefits of neuropsychology for children with epilepsy.