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Neuropsychiatric involvement in epilepsy surgery pathways in the UK
Faye Stanage1, Maria Oto2, Ana Miorelli1
1Atkinson Morley Wing, St George's Hospital, London, UK; South West London and St George's Mental Health Trust, London, UK; Neuroscience Department, City St George's University, London, UK; Faculty of Neuropsychiatry, Royal College of Psychiatrists, UK.
Epilepsy & Behavior : E&B
|September 26, 2025
Summary
Epilepsy surgery care lacks standardized neuropsychiatric input across UK centers. Implementing routine assessments and national guidelines is vital for consistent patient care in epilepsy surgery programs.
Area of Science:
- Neuroscience
- Psychiatry
- Surgical Care
Background:
- Epilepsy surgery offers effective treatment for drug-refractory epilepsy.
- Neuropsychiatric care integration in epilepsy surgery programs is inconsistent.
- Lack of standardized neuropsychiatric care poses risks despite known psychiatric comorbidities.
Purpose of the Study:
- To evaluate the current level of neuropsychiatric involvement in UK epilepsy surgery centers.
- To identify gaps in current neuropsychiatric care provision.
- To provide consensus recommendations for optimal neuropsychiatric input.
Main Methods:
- A self-administered questionnaire was developed by the Royal College of Psychiatrists (RCPsych) Neuropsychiatry Faculty epilepsy surgery working group.
- Surveys were distributed to UK epilepsy surgical centers in 2013 and 2021-22.
- Data analysis focused on service provision, resources, operations, and clinician perspectives.
Main Results:
- 12 out of 15 centers responded to each survey.
- Significant variability exists in preoperative and postoperative neuropsychiatric assessments.
- Resource constraints and lack of formal pathways lead to fragmented care.
Conclusions:
- Standardized neuropsychiatric care is essential for epilepsy surgery programs.
- Routine pre- and post-operative neuropsychiatric assessments should be integrated.
- National guidelines and increased funding are crucial for equitable care.
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