A Review of Current Research and Barriers to Access: Exploring Disparities in Pediatric Epilepsy Surgery

Surgery is an effective treatment for pediatric DRE with a favorable risk profile, potential for seizure freedom, improved neurodevelopmental outcomes, and potential reduction in SUDEP risk. Yet, surgery remains underutilized due to disparities driven by socioeconomic status, insurance, race, geography, and systemic barriers such as limited provider awareness, inconsistent referrals, and uneven distribution of National Association of Epilepsy Centers Level 4 hospitals. Future efforts should focus on research to further define disparities and evaluate evidence for systems-based solutions, increasing accessibility of specialized centers, enhancing referring provider education, dissemination and regular revisitation of pediatric-specific epilepsy surgical guidelines for referral, and implementing policy reforms to improve insurance coverage and care coordination for this pediatric patient population.