The Treatment Gap

There is a significant gap in effective treatment
options for children with epilepsy.

RAJSEKAR R. RAJARAMAN, MD & SHAUN HUSSAIN, MD

As Care & Cure Fellows, Dr. Rajaraman and Dr. Hussain work at Level 4 Epilepsy Centers to bridge the treatment gap for children with complex epilepsy.

the treatment gap

Paths to Proper Care

The majority of US hospitals are NOT equipped to treat complex epilepsy, especially in children. Only hospitals with the highest level of accreditation, or Level 4 Centers, are are able to treat cases of complex epilepsy. The specialized neurosurgeons and robust treatment options that these centers provide allow doctors to take the full patient into account and provide more complex treatment solutions. Level 4 Centers are generally partnered with major academic institutions and have accredited fellowship programs, but are very limited in number, especially those with pediatric units.

In fact, Only 46 of the 198 Level 4 Epilepsy Centers in the US have dedicated pediatric epilepsy units, resulting in overloaded hospitals and less access to high quality care. Uneven and spotty access to treatment is called ‘the treatment gap.’

the treatment gap

Why the Treatment Gap Exists

There is a critical shortage of Pediatric Epilepsy specialists in the United States, with existing Level 4 Epilepsy Centers struggling to staff enough experts. This leads to limited access to care, especially in underserved areas, and increases wait times, resulting in less optimal outcomes for children with complex epilepsy. The shortage also hampers research, as specialists are unable to balance clinical care with research responsibilities.

The shortage of pediatric epileptologists is largely due to the long, costly, and demanding qualification process, which few doctors can afford in terms of time and financial resources. This limits the number of specialists available to treat and research epilepsy in children, exacerbating the challenges in providing adequate care.

ELAM MALLORY

Elam’s story underscores the need for more pediatric epilepsy specialists to ensure every child with complex epilepsy can thrive.

the treatment gap

How many years does it take to become a pediatric epileptologist?

We need more pediatric epileptologists and thus, increased access to doctor training. In total, the journey to becoming a certified pediatric epileptologist requires more than 12 years of specialized training.

Step 1

4 Years

Medical School:

Become a doctor

Step 2

7 Years (3 additional years)

Pediatric Residency:

Become a pediatrician

Step 3

10 Years (3 additional years)

Neurology Residency:

Become a neurologist

Step 4

13 Years (3 additional years)

Pediatric Epilepsy Fellowship:
Become a pediatric epileptologist

The most important thing we need is more doctors. There are many patients in the community with epilepsy, and the best treatment for them is seeing a pediatric epileptologist. Unfortunately, there just aren’t enough of us.

Dr. Deborah Holder
Program Director, Pediatric Epilepsy

Cedars-Sinai, Pediatrics
the treatment gap

Barriers to Treatment

Lack of Qualified Doctors

The road to becoming a Pediatric Epileptologist is long and expensive; Few doctors are able to commit the time or the funds needed to become an epileptologist. 

Geographic Location

The Geographic distance between centers makes access difficult for those who don’t live within the immediate area.

Pediatric Care Bottlenecks

Limited number of pediatric centers results in overloaded centers and long wait times, often between 6 and 12 months.

Gaps in Pediatric Care

Shortage of pediatric-specific centers forces many children to seek adult neurologists, who are less equipped to effectively treat complex childhood epilepsy.

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Help Close the Treatment Gap

Your support ensures that more children can receive expert diagnosis, treatment, and hope for a seizure-free future.