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European trends in epilepsy surgery.
Baud, Maxime O; Perneger, Thomas; Rácz, Attila; Pensel, Max C; Elger, Christian; Rydenhag, Bertil; Malmgren, Kristina; Cross, J Helen; McKenna, Grainne; Tisdall, Martin; Lamberink, Herm J; Rheims, Sylvain; Ryvlin, Philippe; Isnard, Jean; Mauguière, François; Arzimanoglou, Alexis; Akkol, Serdar; Deniz, Kaancan; Ozkara, Cigdem; Lossius, Morten; Rektor, Ivan; Kälviäinen, Reetta; Vanhatalo, Lotta-Maria; Dimova, Petia; Minkin, Krassimir; Staack, Anke Maren; Steinhoff, Bernhard J; Kalina, Adam; Krsek, Pavel; Marusic, Petr; Jordan, Zsofia; Fabo, Daniel; Carrette, Evelien; Boon, Paul; Rocka, Saulius; Mameniskiene, Ruta; Vulliemoz, Serge; Pittau, Francesca; Braun, Kees P J; Seeck, Margitta.
Afiliación
  • Baud MO; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Perneger T; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Rácz A; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Pensel MC; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Elger C; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Rydenhag B; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Malmgren K; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Cross JH; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • McKenna G; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Tisdall M; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Lamberink HJ; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Rheims S; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Ryvlin P; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Isnard J; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Mauguière F; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Arzimanoglou A; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Akkol S; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Deniz K; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Ozkara C; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Lossius M; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Rektor I; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Kälviäinen R; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Vanhatalo LM; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Dimova P; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Minkin K; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Staack AM; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Steinhoff BJ; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Kalina A; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Krsek P; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Marusic P; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Jordan Z; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Fabo D; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Carrette E; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Boon P; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Rocka S; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Mameniskiene R; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Vulliemoz S; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Pittau F; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Braun KPJ; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
  • Seeck M; From the Department of Neurology (M.O.B., S.V., F.P., M.S.), and Center for Clinical Research (T.P.), University Hospital Geneva; Department of Neurology (M.O.B.), University Hospital Bern; Wyss Center for Bio- and Neuro-Engineering (M.O.B.), Geneva, Switzerland; Klinik und Poliklinik für Epileptolo
Neurology ; 91(2): e96-e106, 2018 07 10.
Article en En | MEDLINE | ID: mdl-29898967
OBJECTIVE: Resective surgery is effective in treating drug-resistant focal epilepsy, but it remains unclear whether improved diagnostics influence postsurgical outcomes. Here, we compared practice and outcomes over 2 periods 15 years apart. METHODS: Sixteen European centers retrospectively identified 2 cohorts of children and adults who underwent epilepsy surgery in the period of 1997 to 1998 (n = 562) or 2012 to 2013 (n = 736). Data collected included patient (sex, age) and disease (duration, localization and diagnosis) characteristics, type of surgery, histopathology, Engel postsurgical outcome, and complications, as well as imaging and electrophysiologic tests performed for each case. Postsurgical outcome predictors were included in a multivariate logistic regression to assess the strength of date of surgery as an independent predictor. RESULTS: Over time, the number of operated cases per center increased from a median of 31 to 50 per 2-year period (p = 0.02). Mean disease duration at surgery decreased by 5.2 years (p < 0.001). Overall seizure freedom (Engel class 1) increased from 66.7% to 70.9% (adjusted p = 0.04), despite an increase in complex surgeries (extratemporal and/or MRI negative). Surgeries performed during the later period were 1.34 times (adjusted odds ratio; 95% confidence interval 1.02-1.77) more likely to yield a favorable outcome (Engel class I) than earlier surgeries, and improvement was more marked in extratemporal and MRI-negative temporal epilepsy. The rate of persistent neurologic complications remained stable (4.6%-5.3%, p = 0.7). CONCLUSION: Improvements in European epilepsy surgery over time are modest but significant, including higher surgical volume, shorter disease duration, and improved postsurgical seizure outcomes. Early referral for evaluation is required to continue on this encouraging trend.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Resultado del Tratamiento / Procedimientos Neuroquirúrgicos / Epilepsia Refractaria Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Neurology Año: 2018 Tipo del documento: Article
Texto completo
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Resultado del Tratamiento / Procedimientos Neuroquirúrgicos / Epilepsia Refractaria Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Neurology Año: 2018 Tipo del documento: Article