• Neurochirurgie · Aug 2012

    [Evaluation of a pathway of epilepsy surgery in a polyvalent video-EEG center: retrospective analysis of a series of 295 patients].

    • F Sauvaget, S Jeffredo-Rhanimi, S Velut, C Destrieux, and B De Toffol.
    • Service de neurochirurgie, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France. frederic.sauvaget@etu.univ-tours.fr
    • Neurochirurgie. 2012 Aug 1; 58 (4): 225-9.

    Background And PurposeThe supply for diagnosis and treatment is inadequate in France for epileptic patients eligible for surgery. Our institution includes a Video-electroencephalography (v-EEG) unit and a general neurosurgery department. Our objective was to evaluate the efficacy and morbidity of the surgery performed in a center non-dedicated to epilepsy surgery.MethodsWe conducted a retrospective study of a cohort of 295 patients explored with long lasting v-EEG from 1991 to 2008 in Tours in which we evaluated the efficacy and morbidity of the surgery distinguishing between hippocampal sclerosis and other epileptogenic lesions.ResultsPhase I directly led to surgery in 31 cases. Of them were 19 hippocampal sclerosis were operated with no surgical morbidity, and 12 other epileptogenic lesions operated with a comorbidity in two patients. Results of surgery were similar to larger studies, with 80% of patients Engel's Class I. Best results were observed in the hippocampal sclerosis group: 94.7 Class I (IA: 84%), versus 58% Class I (IA: 33%) for other etiologies.ConclusionDespite the small number of operated patients, the surgical treatment keeps its efficiency without adding morbidity. v-EEG centers combined with non-specialists neurosurgical teams can contribute to improve care without reducing their quality.Copyright © 2012 Elsevier Masson SAS. All rights reserved.

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