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Updated: Feb 6, 2026

Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy
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Evolution of disparities in pediatric epilepsy surgery use over two decades

Alex S Aguirre1, Ellen C Broekhuizen2, Daan A Pijs3

  • 1Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Pediatrics, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA.

Seizure
|February 4, 2026
PubMed

Insights

Despite increased use of epilepsy surgery for children with drug-resistant epilepsy, disparities in access based on insurance, race, and ethnicity have widened between 2004 and 2024.

Area of Science:

  • Pediatric Neurology
  • Health Services Research
  • Surgical Outcomes

Background:

  • Drug-resistant epilepsy affects a significant number of children.
  • Epilepsy surgery is a crucial treatment option for refractory cases.
  • Understanding trends in surgical access is vital for equitable care.

Purpose of the Study:

  • To analyze the evolution of epilepsy surgery utilization in pediatric patients with drug-resistant epilepsy from 2004 to 2024.
  • To identify and quantify disparities in surgical access based on insurance, race, and ethnicity over two decades.

Main Methods:

  • Retrospective analysis of the Pediatric Health Information System database (2004-2024).
  • Examined epilepsy surgery rates and time to surgery.
  • Multivariable analyses assessed predictors including insurance type, race, and ethnicity.

Main Results:

  • Epilepsy surgery rates increased significantly, from 4.0 to 15.8 per 100 person-years between 2004-2006 and 2022-2024.
  • Disparities widened: Odds ratios for private insurance (1.50 to 1.75), White vs. Black patients (1.35 to 2.39), and non-Hispanic vs. Hispanic patients (1.08 to 1.23) all increased.
  • Hazard ratios showed similar widening trends for these disparities.

Conclusions:

  • Epilepsy surgery use has increased in pediatric patients with drug-resistant epilepsy.
  • Significant disparities persist and are widening across insurance types, race, and ethnicity.
  • Addressing these inequities is critical for improving surgical access for all children with epilepsy.
Abstract

Keywords:
DisparitiesDrug-resistant epilepsyEpidemiologyEpilepsy surgeryHealth care resource utilization

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