Twenty-five years of epilepsy surgery at a Central European
comprehensive epilepsy center-Trends in intervention delay and
outcomes

J 2023

Twenty-five years of epilepsy surgery at a Central European comprehensive epilepsy center-Trends in intervention delay and outcomes

VŠIANSKÝ, Vít; Milan BRÁZDIL; Ivan REKTOR; Irena DOLEŽALOVÁ; Jitka KOČVAROVÁ et al.

Základní údaje

Originální název

Twenty-five years of epilepsy surgery at a Central European comprehensive epilepsy center-Trends in intervention delay and outcomes

Autoři

Vydání

Epilepsia Open, HOBOKEN, WILEY, 2023, 2470-9239

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30210 Clinical neurology

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.800

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/23:00130974

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

drug-resistant epilepsy; drug-resistant epilepsy epidemiology; drug-resistant epilepsy surgery

Štítky

14110112, 14110127, 14110131, 14110320, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 23. 1. 2024 08:52, Mgr. Eva Dubská

Anotace

V originále

ObjectiveWe analyzed trends in patients' characteristics, outcomes, and waiting times over the last 25 years at our epilepsy surgery center situated in Central Europe to highlight possible areas of improvement in our care for patients with drug-resistant epilepsy. MethodsA total of 704 patients who underwent surgery at the Brno Epilepsy Center were included in the study, 71 of those were children. Patients were separated into three time periods, 1996-2000 (n = 95), 2001-2010 (n = 295) and 2011-2022 (n = 314) based on first evaluation at the center. ResultsThe average duration of epilepsy before surgery in adults remained high over the last 25 years (20.1 years from 1996 to 2000, 21.3 from 2001 to 2010, and 21.3 from 2011 to 2020, P = 0.718). There has been a decrease in rate of surgeries for temporal lobe epilepsy in the most recent time period (67%-70%-52%, P < 0.001). Correspondingly, extratemporal resections have become more frequent with a significant increase in surgeries for focal cortical dysplasia (2%-8%-19%, P < 0.001). For resections, better outcomes (ILAE scores 1a-2) have been achieved in extratemporal lesional (0%-21%-61%, P = 0.01, at least 2-year follow-up) patients. In temporal lesional patients, outcomes remained unchanged (at least 77% success rate). A longer duration of epilepsy predicted a less favorable outcome for resective procedures (P = 0.024) in patients with disease duration of less than 25 years. SignificanceThe spectrum of epilepsy surgery is shifting toward nonlesional and extratemporal cases. While success rates of extratemporal resections at our center are getting better, the average duration of epilepsy before surgical intervention is still very long and is not improving. This underscores the need for stronger collaboration between epileptologists and outpatient neurologists to ensure prompt and effective treatment for patients with drug-resistant epilepsy.

Návaznosti

LX22NPO5107, projekt VaV

Název: Národní ústav pro neurologický výzkum

Investor: Ministerstvo školství, mládeže a tělovýchovy ČR, Národní ústav pro neurologický výzkum, 5.1 EXCELES

Přiložené soubory

Twenty-five_years_of_epilepsy_surgery_at_a_Central_European_comprehensive_epilepsy_center-Trends_in_intervention_delay_and_outcomes.pdf

Citovat

VŠIANSKÝ, Vít; Milan BRÁZDIL; Ivan REKTOR; Irena DOLEŽALOVÁ; Jitka KOČVAROVÁ; Ondřej STRÝČEK; Jan HEMZA; Jan CHRASTINA; Eva BRICHTOVÁ; Ondřej HORÁK; Patrícia MUŽLAYOVÁ; Markéta HERMANOVÁ; Michal HENDRYCH a Martin PAIL. Twenty-five years of epilepsy surgery at a Central European comprehensive epilepsy center-Trends in intervention delay and outcomes. Epilepsia Open. HOBOKEN: WILEY, 2023, roč. 8, č. 3, s. 991-1001. ISSN 2470-9239. Dostupné z: https://doi.org/10.1002/epi4.12769.

@article{2291649,
   author = {Všianský, Vít and Brázdil, Milan and Rektor, Ivan and Doležalová, Irena and Kočvarová, Jitka and Strýček, Ondřej and Hemza, Jan and Chrastina, Jan and Brichtová, Eva and Horák, Ondřej and Mužlayová, Patrícia and Hermanová, Markéta and Hendrych, Michal and Pail, Martin},
   article_location = {HOBOKEN},
   article_number = {3},
   doi = {https://doi.org/10.1002/epi4.12769},
   keywords = {drug-resistant epilepsy; drug-resistant epilepsy epidemiology; drug-resistant epilepsy surgery},
   language = {eng},
   issn = {2470-9239},
   journal = {Epilepsia Open},
   title = {Twenty-five years of epilepsy surgery at a Central European comprehensive epilepsy center-Trends in intervention delay and outcomes},
   url = {https://onlinelibrary.wiley.com/doi/full/10.1002/epi4.12769},
   volume = {8},
   year = {2023}
}

TY  - JOUR
ID  - 2291649
AU  - Všianský, Vít - Brázdil, Milan - Rektor, Ivan - Doležalová, Irena - Kočvarová, Jitka - Strýček, Ondřej - Hemza, Jan - Chrastina, Jan - Brichtová, Eva - Horák, Ondřej - Mužlayová, Patrícia - Hermanová, Markéta - Hendrych, Michal - Pail, Martin
PY  - 2023
TI  - Twenty-five years of epilepsy surgery at a Central European comprehensive epilepsy center-Trends in intervention delay and outcomes
JF  - Epilepsia Open
VL  - 8
IS  - 3
SP  - 991-1001
EP  - 991-1001
PB  - WILEY
SN  - 24709239
KW  - drug-resistant epilepsy
KW  - drug-resistant epilepsy epidemiology
KW  - drug-resistant epilepsy surgery
UR  - https://onlinelibrary.wiley.com/doi/full/10.1002/epi4.12769
N2  - ObjectiveWe analyzed trends in patients' characteristics, outcomes, and waiting times over the last 25 years at our epilepsy surgery center situated in Central Europe to highlight possible areas of improvement in our care for patients with drug-resistant epilepsy. MethodsA total of 704 patients who underwent surgery at the Brno Epilepsy Center were included in the study, 71 of those were children. Patients were separated into three time periods, 1996-2000 (n = 95), 2001-2010 (n = 295) and 2011-2022 (n = 314) based on first evaluation at the center. ResultsThe average duration of epilepsy before surgery in adults remained high over the last 25 years (20.1 years from 1996 to 2000, 21.3 from 2001 to 2010, and 21.3 from 2011 to 2020, P = 0.718). There has been a decrease in rate of surgeries for temporal lobe epilepsy in the most recent time period (67%-70%-52%, P < 0.001). Correspondingly, extratemporal resections have become more frequent with a significant increase in surgeries for focal cortical dysplasia (2%-8%-19%, P < 0.001). For resections, better outcomes (ILAE scores 1a-2) have been achieved in extratemporal lesional (0%-21%-61%, P = 0.01, at least 2-year follow-up) patients. In temporal lesional patients, outcomes remained unchanged (at least 77% success rate). A longer duration of epilepsy predicted a less favorable outcome for resective procedures (P = 0.024) in patients with disease duration of less than 25 years. SignificanceThe spectrum of epilepsy surgery is shifting toward nonlesional and extratemporal cases. While success rates of extratemporal resections at our center are getting better, the average duration of epilepsy before surgical intervention is still very long and is not improving. This underscores the need for stronger collaboration between epileptologists and outpatient neurologists to ensure prompt and effective treatment for patients with drug-resistant epilepsy.
ER  -

VŠIANSKÝ, Vít; Milan BRÁZDIL; Ivan REKTOR; Irena DOLEŽALOVÁ; Jitka KOČVAROVÁ; Ondřej STRÝČEK; Jan HEMZA; Jan CHRASTINA; Eva BRICHTOVÁ; Ondřej HORÁK; Patrícia MUŽLAYOVÁ; Markéta HERMANOVÁ; Michal HENDRYCH a Martin PAIL. Twenty-five years of epilepsy surgery at a Central European comprehensive epilepsy center-Trends in intervention delay and outcomes. \textit{Epilepsia Open}. HOBOKEN: WILEY, 2023, roč.~8, č.~3, s.~991-1001. ISSN~2470-9239. Dostupné z: https://doi.org/10.1002/epi4.12769.

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