Carmen Barba1, Judith Helen Cross2, Kees Braun3, Massimo Cossu4, Kerstin Alexandra Klotz5, Salvatore De Masi6, Maria Angeles Perez Jiménez7, Eija Gaily8, Nicola Specchio9, Pedro Cabral10, Joseph Toulouse11, Petia Dimova12, Domenica Battaglia13, Elena Freri14, Alessandro Consales15, Elisabetta Cesaroni16, Oana Tarta-Arsene17, Antonio Gil-Nagel18, Ioana Mindruta19, Giancarlo Di Gennaro20, Marco Giulioni21, Martin M Tisdall22, Christin Eltze22, Muhammad Zubair Tahir22, Floor Jansen3, Peter van Rijen3, Maurits Sanders3, Laura Tassi4, Stefano Francione4, Giorgio Lo Russo4, Julia Jacobs23, Thomas Bast24,25, Giulia Matta1, Marcelo Budke26, Concepción Fournier Del Castillo27, Eeva-Liisa Metsahonkala8, Atte Karppinen28, José Carlos Ferreira10, Krasimir Minkin12, Carlo Efisio Marras29, Alexis Arzimanoglou11, Renzo Guerrini1,30. 1. Neuroscience Department, Children's Hospital Meyer-University of Florence, Florence, Italy. 2. University College London, National Institute for Health Research, Biomedical Research Centre, Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children, London, UK. 3. Department of Child Neurology, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands. 4. Claudio Munari Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy. 5. Department of Epileptology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. 6. Clinical Trial Office, Children's Hospital Meyer, Florence, Italy. 7. Epilepsy Surgery Program, Clinical Neurophysiology Section, Niño Jesús Pediatric University Hospital, Madrid, Spain. 8. Epilepsia-Helsinki, New Children's Hospital, Helsinki University Hospital, Helsinki, Finland. 9. Rare and Complex Epilepsies Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. 10. Department of Neurology, Pediatric Neurology Unit, Centro de Referência de Epilepsia Refractária, CRER, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal. 11. Department of Pediatric Clinical Epileptology, Sleep Disorders, and Functional Neurology, University Hospitals of Lyon, Lyon, France. 12. Epilepsy Surgery Center, Department of Neurosurgery, St Ivan Rilski University Hospital, Sofia, Bulgaria. 13. Pediatric Neurology and Psychiatry Unit, Agostino Gemelli University Hospital, Catholic University of the Sacred Heart, Rome, Italy. 14. Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy. 15. Neurosurgery Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy. 16. Child Neurology and Psychiatry Unit, G. Salesi Children's Hospital-University of Ancona, Ancona, Italy. 17. Pediatric Neurology Clinic, Al Obregia Hospital, Carol Davila University of Medicine, Bucharest, Romania. 18. Department of Neurology, Ruber International Hospital, Madrid, Spain. 19. Epilepsy Monitoring Unit, Neurology Department, University Emergency Hospital of Bucharest, Bucharest, Romania. 20. IRCCS NEUROMED, Pozzilli (IS), Italy. 21. Neurosurgery Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy. 22. Great Ormond Street Hospital for Children, London, UK. 23. Department of Neuropediatrics and Muscle Disorders, Center for Pediatrics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. 24. Faculty of Medicine, University of Freiburg, Freiburg, Germany. 25. Epilepsy Center Kork, Kehl-Kork, Germany. 26. Epilepsy Surgery Program, Neurosurgery Service, Niño Jesús Pediatric University Hospital, Madrid, Spain. 27. Epilepsy Surgery Program, Clinical Psychology Section, Niño Jesús Pediatric University Hospital, Madrid, Spain. 28. Epilepsia-Helsinki and Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland. 29. Neurosurgery Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. 30. IRCCS Stella Maris, Pisa, Italy.
Abstract
OBJECTIVE: To profile European trends in pediatric epilepsy surgery (<16 years of age) between 2008 and 2015. METHODS: We collected information on volumes and types of surgery, pathology, and seizure outcome from 20 recognized epilepsy surgery reference centers in 10 European countries. RESULTS: We analyzed retrospective aggregate data on 1859 operations. The proportion of surgeries significantly increased over time (P < .0001). Engel class I outcome was achieved in 69.3% of children, with no significant improvement between 2008 and 2015. The proportion of histopathological findings consistent with glial scars significantly increased between the ages of 7 and 16 years (P for trend = .0033), whereas that of the remaining pathologies did not vary across ages. A significant increase in unilobar extratemporal surgeries (P for trend = .0047) and a significant decrease in unilobar temporal surgeries (P for trend = .0030) were observed between 2008 and 2015. Conversely, the proportion of multilobar surgeries and unrevealing magnetic resonance imaging cases remained unchanged. Invasive investigations significantly increased, especially stereo-electroencephalography. We found different trends comparing centers starting their activity in the 1990s to those whose programs were developed in the past decade. Multivariate analysis revealed a significant variability of the proportion of the different pathologies and surgical approaches across countries, centers, and age groups between 2008 and 2015. SIGNIFICANCE: Between 2008 and 2015, we observed a significant increase in the volume of pediatric epilepsy surgeries, stability in the proportion of Engel class I outcomes, and a modest increment in complexity of the procedures. Wiley Periodicals, Inc.
OBJECTIVE: To profile European trends in pediatric epilepsy surgery (<16 years of age) between 2008 and 2015. METHODS: We collected information on volumes and types of surgery, pathology, and seizure outcome from 20 recognized epilepsy surgery reference centers in 10 European countries. RESULTS: We analyzed retrospective aggregate data on 1859 operations. The proportion of surgeries significantly increased over time (P < .0001). Engel class I outcome was achieved in 69.3% of children, with no significant improvement between 2008 and 2015. The proportion of histopathological findings consistent with glial scars significantly increased between the ages of 7 and 16 years (P for trend = .0033), whereas that of the remaining pathologies did not vary across ages. A significant increase in unilobar extratemporal surgeries (P for trend = .0047) and a significant decrease in unilobar temporal surgeries (P for trend = .0030) were observed between 2008 and 2015. Conversely, the proportion of multilobar surgeries and unrevealing magnetic resonance imaging cases remained unchanged. Invasive investigations significantly increased, especially stereo-electroencephalography. We found different trends comparing centers starting their activity in the 1990s to those whose programs were developed in the past decade. Multivariate analysis revealed a significant variability of the proportion of the different pathologies and surgical approaches across countries, centers, and age groups between 2008 and 2015. SIGNIFICANCE: Between 2008 and 2015, we observed a significant increase in the volume of pediatric epilepsy surgeries, stability in the proportion of Engel class I outcomes, and a modest increment in complexity of the procedures. Wiley Periodicals, Inc.
Authors: Elena Solli; Nicole A Colwell; Christopher Markosian; Anmol S Johal; Rebecca Houston; M Omar Iqbal; Irene Say; Joseph I Petrsoric; Luke D Tomycz Journal: Acta Neurochir (Wien) Date: 2021-11-13 Impact factor: 2.216
Authors: Rory J Piper; Chayanin Tangwiriyasakul; Elhum A Shamshiri; Maria Centeno; Xiaosong He; Mark P Richardson; Martin M Tisdall; David W Carmichael Journal: Front Neurol Date: 2021-08-02 Impact factor: 4.003
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