Epilepsy surgery in countries with limited resources

Palmini, André; Radhakrishnan, Kurupath

doi:10.1002/9781118936979.ch81

Cited by 1 publication

(4 citation statements)

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“…Despite challenges, epilepsy surgery can enhance the quality of life for those with epilepsy, and extending access is imperative for healthcare equity. 8,12 The patients mostly came from Lima, where the only two epilepsy surgery centers in the country are situated. Patients from other regions of the country may have encountered obstacles due to various factors, including sociodemographic, cultural, and economic reasons.…”

Section: Discussionmentioning

confidence: 99%

“…19 Furthermore, in our country, epilepsy treatment and care have a significant gap due to shortage of ASM, long waiting times for ambulatory visits, and societal misconceptions and beliefs. 12 Two systematic reviews showed that ATL patients were more likely to achieve seizure freedom in Engel I than those who had selective amygdalohippocampectomy. [20][21][22] However, other studies have failed to identify any significant differences between the two groups.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, attempts have been made to enhance accessibility via training local medical staff and obtaining specialized equipment. Despite challenges, epilepsy surgery can enhance the quality of life for those with epilepsy, and extending access is imperative for healthcare equity 8,12 . The patients mostly came from Lima, where the only two epilepsy surgery centers in the country are situated.…”

Section: Discussionmentioning

confidence: 99%

“…The diverse outcomes after surgery reported in literature may be attributed to the different definitions of seizure freedom and the inconsistent use of ASM, including the timing and dosage reduction before withdrawal 19 . Furthermore, in our country, epilepsy treatment and care have a significant gap due to shortage of ASM, long waiting times for ambulatory visits, and societal misconceptions and beliefs 12 …”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Postsurgical outcomes in a cohort of patients with hippocampal sclerosis: Initial experience in a referral epilepsy center in Peru

Ramirez¹,

Zuñiga²,

Boluarte³

et al. 2023

Epilepsia Open

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Mesial temporal lobe epilepsy, one of the most common forms of epilepsy, is often linked with drug resistance. Surgical intervention is a reliable and safe treatment option, though research into postsurgical outcomes in our locality remains limited. We performed a retrospective observational study included 91 patients with mesial temporal lobe epilepsy and hippocampal sclerosis who had undergone anterior temporal lobectomy between 2012 and 2020 at a surgical epilepsy center located in Lima, Peru. Postoperative outcomes were analyzed using bivariate and multivariate analysis based on the Engel classification. We found that after 12 months of follow‐up, 78.65% of the 91 patients achieved an Engel IA classification, while 9.09% attained Engel IB classification and 11.24% were designated as Engel II, with only 1.12% classified as Engel IVA. The median QOLIE31 score was 84 (IQR: 75–90), with 74.16% of the participants successfully reintegrating into academic or employment activities. After 24 months, only 68 patients completed the follow‐up, with 69.12% achieving an Engel IA classification. Individuals with a secondary education or higher were more likely to achieve an Engel IA classification at 12 months (OR: 5.11; P = 0.005; CI: 1.63–16.01), after adjusting for sex and age. We concluded that most patients exhibited favorable outcomes after 1 year of follow‐up. However, lower educational attainment was linked to worse postsurgical outcomes.

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Section: Discussionmentioning

confidence: 99%