The cultivation of epilepsy neurosurgeons: requirements and challenges

Abstract

Epilepsy surgery has been accepted as an effective treatment in drug-resistant focal epilepsy. However, the number of epilepsy neurosurgeons is not enough in China compared with the huge demand. The content of epilepsy neurosurgeon cultivation includes surgery itself as well as presurgical evaluation. In this article, we review not only different categories of epilepsy surgeries but also the presurgical evaluation approaches including non-invasive methods, such as semiology analysis, high-resolution structural and functional imaging techniques, scalp electroencephalography monitoring as well as invasive methods, such as electrocorticography (ECoG) and stereotactic electroencephalography (SEEG). We also discuss the importance of learning each method briefly. In addition, we suggest that epilepsy neurosurgeons should have a solid structural and functional anatomy basis as it plays pivotal role in localizing epileptogenic zone. Epilepsy neurosurgeons should also be familiar with the staged presurgical evaluation starting from the most preliminary examinations and progressing to more complex and invasive methods. During the diagnosis and therapeutic procedures, collaboration between epilepsy neurosurgeons and other specialists is essential. At last, the necessity of epilepsy neurosurgeon cultivation has been emphasized.

The Efficacy of Electroacupuncture in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta‐Analysis

“…The interactions between factors were tested in the following two ways. [30] 1) qualitative assessment: if the 95% CI of each subgroup overlapped, there was probably no interaction. 2) quantitative assessment: if the subgroup difference was higher than 0.05, there was no interaction.…”

Surgeon-Led Initiatives to Increase Access to Surgical Treatment of Epilepsy at an Academic Level 4 Epilepsy Center: An Observational Cohort Study

“…Although some of the details of this study are unique to the United States, we believe that a collaborative approach on the part of surgeons is globally applicable and stands to benefit patients with epilepsy regardless of location. Similar challenges regarding expanding epilepsy care are found internationally; as described by Zhang et al, they note, “In China, the number of epilepsy surgeries performed each year is relatively few and could not meet the huge demand…Qualified epilepsy centers cluster in a few metropolises, which causes inconvenience to patients from remote areas.” 10 Certain individual countries including the United States 11-13 and Germany 14,15 have seen stagnating epilepsy volume, with volume actually decreasing in the United Kingdom. 16 Indeed, coordinated effort by the WHO and European Union countries 17 has demonstrated improvement in European epilepsy case volume in the subsequent years, although Seeck et al note this to be “modest,” 18 suggesting a role for continued outreach and collaboration by surgeons to actively grow access to surgical epilepsy care.…”