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FältnamnIndikatorerMetadata
00004787naa a2200733 4500
001oai:gup.ub.gu.se/274990
003SwePub
008240910s2018 | |||||||||||000 ||eng|
024a https://gup.ub.gu.se/publication/2749902 URI
024a https://doi.org/10.1212/WNL.00000000000057762 DOI
040 a (SwePub)gu
041 a eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
100a Baud, Maxime O4 aut
2451 0a European trends in epilepsy surgery.
264 1c 2018
520 a 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.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.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).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.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kirurgi0 (SwePub)302122 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Surgery0 (SwePub)302122 hsv//eng
700a Perneger, Thomas4 aut
700a Rácz, Attila4 aut
700a Pensel, Max C4 aut
700a Elger, Christian4 aut
700a Rydenhag, Bertil,d 1954u Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience4 aut0 (Swepub:gu)xrydbe
700a Malmgren, Kristina,d 1952u Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience4 aut0 (Swepub:gu)xmalkr
700a Cross, J. Helen4 aut
700a McKenna, Grainne4 aut
700a Tisdall, Martin4 aut
700a Lamberink, Herm J4 aut
700a Rheims, Sylvain4 aut
700a Ryvlin, Philippe4 aut
700a Isnard, Jean4 aut
700a Mauguière, François4 aut
700a Arzimanoglou, Alexis4 aut
700a Akkol, Serdar4 aut
700a Deniz, Kaancan4 aut
700a Ozkara, Cigdem4 aut
700a Lossius, Morten4 aut
700a Rektor, Ivan4 aut
700a Kälviäinen, Reetta4 aut
700a Vanhatalo, Lotta-Maria4 aut
700a Dimova, Petia4 aut
700a Minkin, Krassimir4 aut
700a Staack, Anke Maren4 aut
700a Steinhoff, Bernhard J4 aut
700a Kalina, Adam4 aut
700a Krsek, Pavel4 aut
700a Marusic, Petr4 aut
700a Jordan, Zsofia4 aut
700a Fabo, Daniel4 aut
700a Carrette, Evelien4 aut
700a Boon, Paul4 aut
700a Rocka, Saulius4 aut
700a Mameniškienė, Rūta4 aut
700a Vulliemoz, Serge4 aut
700a Pittau, Francesca4 aut
700a Braun, Kees P J4 aut
700a Seeck, Margitta4 aut
710a Göteborgs universitetb Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap4 org
773t Neurologyg 91:2q 91:2x 1526-632X
8564 8u https://gup.ub.gu.se/publication/274990
8564 8u https://doi.org/10.1212/WNL.0000000000005776

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