Surgical outcomes for medically intractable epilepsy in low- and middle-income countries: a systematic review and meta-analysis.


:OBJECTIVEThe aim of this study was to describe the current state of epilepsy surgery and establish estimates of seizure outcomes following surgery for medically intractable epilepsy (MIE) in low- and middle-income countries (LMICs).METHODSThe MEDLINE and Embase databases were searched without publication date restriction. This search was supplemented by a manual screen of key epilepsy and neurosurgical journals (January 2005 to December 2016). Studies that reported outcomes for at least 10 patients of any age undergoing surgery for MIE in LMICs over a defined follow-up period were included. A meta-analysis with a random-effects model was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and MOOSE (Meta-analysis of Observational Studies in Epidemiology) guidelines. Pooled estimates of seizure freedom and favorable seizure outcomes following anterior temporal lobectomy with or without amygdalohippocampectomy (ATL ± AH) were reported.RESULTSTwenty studies were selected, of which 16 were from Asian centers. The average age at surgery in all studies was less than 30 years, and the average preoperative duration of epilepsy ranged from 3 to 16.1 years. Mesial temporal sclerosis accounted for 437 of 951 described pathologies, and 1294 of the 1773 procedures were ATL ± AH. Based on 7 studies (646 patients) the pooled seizure freedom estimate following ATL ± AH was 68% (95% CI 55%-82%). Based on 8 studies (1096 patients), the pooled estimate for favorable seizure outcomes was 79% (95% CI 74%-85%).CONCLUSIONSSurgery for MIE in LMICs shows a high percentage of seizure freedom and favorable outcomes. These findings call for a concerted global effort to improve timely access to surgery for MIE patients in these regions, including investments aimed at refining existing and establishing additional centers.


J Neurosurg


Journal of neurosurgery


Mansouri A,Taslimi S,Abbasian A,Badhiwala JH,Akbar MA,Alotaibi NM,Almenawer SA,Weil AG,Fallah A,Carmant L,Ibrahim GM




Has Abstract


2018-11-01 00:00:00










  • Delayed complication after Gamma Knife surgery for mesial temporal lobe epilepsy.

    abstract:OBJECT:Despite the controversy over the clinical significance of Gamma Knife surgery (GKS) for refractory mesial temporal lobe epilepsy (MTLE), the modality has attracted attention because it is less invasive than resection. The authors report long-term outcomes for 7 patients, focusing in particular on the long-term c...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Usami K,Kawai K,Koga T,Shin M,Kurita H,Suzuki I,Saito N

    更新日期:2012-06-01 00:00:00

  • Angiographic frequency of saccular intracranial aneurysms in patients with spontaneous cervical artery dissection.

    abstract::The pathogenesis of intracranial aneurysms and spontaneous cervical artery dissection is incompletely understood but a primary arteriopathy, possibly similar in both disorders, may be of importance. To investigate the frequency of intracranial aneurysms in patients with spontaneous cervical artery dissection, the angi...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Schievink WI,Mokri B,Piepgras DG

    更新日期:1992-01-01 00:00:00

  • Magnetic resonance imaging and aneurysm clips. Magnetic properties and image artifacts.

    abstract::The magnetic properties of 12 different types of aneurysm clip were investigated in order to identify which clips allow postoperative magnetic resonance (MR) imaging without risk. Clip-induced MR artifacts were also quantitatively studied using a geometrical phantom. Nonferromagnetic aneurysm clips like the Yaşargil P...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Romner B,Olsson M,Ljunggren B,Holtås S,Säveland H,Brandt L,Persson B

    更新日期:1989-03-01 00:00:00

  • Pretreatment texture analysis of routine MR images and shape analysis of the diffusion tensor for prediction of volumetric response after radiosurgery for meningioma.

    abstract::OBJECTIVEThe goal of this study was to identify parameters from routine T1- and T2-weighted MR sequences and diffusion tensor imaging (DTI) that best predict the volumetric changes in a meningioma after treatment with Gamma Knife radiosurgery (GKRS).METHODSIn 32 patients with meningioma, routine MRI and DTI data were ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Speckter H,Bido J,Hernandez G,Rivera D,Suazo L,Valenzuela S,Miches I,Oviedo J,Gonzalez C,Stoeter P

    更新日期:2018-12-01 00:00:00

  • A more potent bystander cytocidal effect elicited by tumor cells expressing the herpes simplex virus-thymidine kinase gene than by fibroblast virus-producer cells in vitro.

    abstract::Retrovirus-mediated herpes simplex virus-thymidine kinase (HSV-tk) gene therapy is a promising approach in the treatment of brain tumors. Previous in vitro and in vivo studies have demonstrated a bystander effect in which nonmodified tumor cells in proximity to HSV-tk-modified tumor cells are killed with the modified ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Vrionis FD,Wu JK,Qi P,Cano W,Cherington V

    更新日期:1995-10-01 00:00:00

  • Giant-cell tumor of the sphenoid bone. Review of 10 cases.

    abstract::Giant-cell tumor rarely affects the sphenoid bone. Ten cases of this tumor seen at the Mayo Clinic are reviewed, bringing the number of cases in the world literature to 31. These tumors, which present in the second and third decades of life and are slightly more frequent in women than in men, may present with various ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Wolfe JT 3rd,Scheithauer BW,Dahlin DC

    更新日期:1983-08-01 00:00:00

  • Surgically reversible hypothalamic hypopituitarism due to aqueductal stenosis. Case report.

    abstract::A 13-year-old girl was referred for evaluation of the deceleration in her rate of linear growth, an arrest in the progression of her pubertal maturation, and bifrontal headaches. Detailed endocrinological and radiological studies revealed the following abnormalities: partial growth hormone deficiency, prepubertal lute...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Dempsey RJ,Chandler WF,Sauder SE

    更新日期:1983-06-01 00:00:00

  • Pediatric orbital multifocal cavernous hemangiomas associated with bilateral arachnoid cysts of the middle cranial fossa. Case report and review of the literature.

    abstract::Cavernous hemangiomas of the orbit are benign vascular growths that commonly occur in adults and account for 6% of all intraorbital tumors. Multifocal intraorbital cavernous hemangiomas are quite rare. The reported incidence of arachnoid cysts accounts for only 1% of lesions that occupy intracranial space, and they ar...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Tatli M,Guzel A,Keklikci U,Guzel E

    更新日期:2005-11-01 00:00:00

  • Experimental chronic subdural hematoma in mice. Gross morphology and light microscopic observations.

    abstract::A new experimental model of chronic subdural hematoma in mice is described. A single intraperitoneal injection of 6-aminonicotinamide (25 mg/kg body weight) on the 5th postnatal day induced hydrocephalus in mice with almost 100% success. Approximately 60% of the mice spontaneously developed intracranial hemorrhage 20 ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Aikawa H,Suzuki K

    更新日期:1987-11-01 00:00:00

  • Reliability assessment of the Biffl Scale for blunt traumatic cerebrovascular injury as detected on computer tomography angiography.

    abstract::OBJECTIVE Blunt traumatic cerebrovascular injury (TCVI) represents structural injury to a vessel due to high-energy trauma. The Biffl Scale is a widely accepted grading scheme for these injuries that was developed using digital subtraction angiography. In recent years, screening CT angiography (CTA) has been used to i...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Foreman PM,Griessenauer CJ,Kicielinski KP,Schmalz PGR,Rocque BG,Fusco MR,Sullivan JC 3rd,Deveikis JP,Harrigan MR

    更新日期:2017-07-01 00:00:00

  • Spinal cord arteriovenous malformations with significant intramedullary components.

    abstract::Few neurosurgeons have stressed the occurrence, manifestations, and resectability of intramedullary spinal arteriovenous malformations (AVM's). In six of 17 patients in the authors' series of operable spinal AVM's, the lesions had major intramedullary components. Three of these six patients presented with subarachnoid...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Cogen P,Stein BM

    更新日期:1983-09-01 00:00:00

  • Harvey W. Cushing and cerebrovascular surgery: Part II, Vascular malformations.

    abstract::The surgical treatment of cerebrovascular malformations intrigued early neurosurgeons. Cushing defined vascular malformations as tumors arising from cerebral blood vessels. He successfully resected the first arteriovenous malformation 3 years after it had been irradiated. In the absence of angiography, the pathoanatom...

    journal_title:Journal of neurosurgery

    pub_type: 传,历史文章,杂志文章


    authors: Cohen-Gadol AA,Spencer DD

    更新日期:2004-09-01 00:00:00

  • Increased population density of neurosurgeons associated with decreased risk of death from motor vehicle accidents in the United States.

    abstract:OBJECT:Motor vehicle accidents (MVAs) are a leading cause of death and disability in young people. Given that a major cause of death from MVAs is traumatic brain injury, and neurosurgeons hold special expertise in this area relative to other members of a trauma team, the authors hypothesized that neurosurgeon populatio...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Desai A,Bekelis K,Zhao W,Ball PA

    更新日期:2012-09-01 00:00:00

  • Secondary removal of retained bone fragments in missile wounds of the brain.

    abstract::Secondary operations for the removal of retained bone fragments have been performed in 116 of the 1133 casualties with craniocerebral missile wounds incurred in the war in Vietnam, 1967 to 1970. Various complications developed in 19 of these 116 casualties. Dehiscence of the wound occurred in eight patients, five of w...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Meirowsky AM

    更新日期:1982-11-01 00:00:00

  • Liposomes coupled with monoclonal antibodies against glioma-associated antigen for targeting chemotherapy of glioma.

    abstract::Liposomes have a variety of attributes as a drug delivery system. Targeting of liposomes to specific cells has been investigated by using appropriate cytophilic ligands such as monoclonal antibodies (MAb's). In the present study, liposomes with selective cytotoxicity toward glioma cells were obtained. An MAb which rea...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Kito A,Yoshida J,Kageyama N,Kojima N,Yagi K

    更新日期:1989-09-01 00:00:00

  • Depressed skull fracture overlying the superior sagittal sinus as a cause of benign intracranial hypertension. Case report.

    abstract::The use of surgical treatment for depressed skull fractures that are located over major venous sinuses is a matter of controversy. However, if clinical and radiological findings of sinus obliteration and related intracranial hypertension are present, surgical decompression is indicated. The authors present the case of...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Uzan M,Ciplak N,Dashti SG,Bozkus H,Erdinçler P,Akman C

    更新日期:1998-03-01 00:00:00

  • Evolution of the graded repair of CSF leaks and skull base defects in endonasal endoscopic tumor surgery: trends in repair failure and meningitis rates in 509 patients.

    abstract:Objective:The authors previously described a graded approach to skull base repair following endonasal microscopic or endoscope-assisted tumor surgery. In this paper they review their experience with skull base reconstruction in the endoscopic era. Methods:A retrospective review of a single-institution endonasal endosc...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Conger A,Zhao F,Wang X,Eisenberg A,Griffiths C,Esposito F,Carrau RL,Barkhoudarian G,Kelly DF

    更新日期:2018-05-11 00:00:00

  • A vascular malformation mimicking an intracanalicular acoustic neurilemoma. Case report.

    abstract::A patient with an enhancing, completely intracanalicular mass on magnetic resonance imaging was operated on for a presumed acoustic neurilemoma, but was found at surgery to have an intracanalicular vascular malformation. This rare lesion should be distinguished from angiomatous change within an acoustic neurilemoma an...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Linskey ME,Jannetta PJ,Martinez AJ

    更新日期:1991-03-01 00:00:00

  • The cerebral hemodynamics of normotensive hypovolemia during lower-body negative pressure.

    abstract::Although severe hypovolemia can lead to hypotension and neurological decline, many patients with neurosurgical disorders experience a significant hypovolemia while autonomic compensatory mechanisms maintain a normal blood pressure. To assess the effects of normotensive hypovolemia upon cerebral hemodynamics, transcran...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Giller CA,Levine BD,Meyer Y,Buckey JC,Lane LD,Borchers DJ

    更新日期:1992-06-01 00:00:00

  • Recurrent intracranial Masson's vegetant intravascular hemangioendothelioma. Case report and review of the literature.

    abstract::In the central nervous system, recurrence of intracranial Masson's vegetant intravascular hemangioendothelioma (MVIH) is rare. To the authors' knowledge, only three recurrent intracranial cases have been reported. The authors report the case of a 75-year-old woman with a recurrent left-sided cerebellopontine angle and...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,评审


    authors: Avellino AM,Grant GA,Harris AB,Wallace SK,Shaw CM

    更新日期:1999-08-01 00:00:00

  • Translabyrinthine and transtentorial removal of acoustic nerve tumors. Results in 150 cases.

    abstract::The translabyrinthine route or an extension of it was used to remove 150 acoustic nerve tumors. The mortality was 2% and the morbidity low. Preservation of the facial nerve was achieved in 100% of the small and 80% of the medium-sized tumors, but in only 20% of the large growths. The complications encountered are disc...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: King TT,Morrison AW

    更新日期:1980-02-01 00:00:00

  • Microsurgical removal of previously placed aneurysm clips and application of new clips for recurrent cerebral aneurysms. Technical note.

    abstract::A technique is described for removing previously placed aneurysm clips and applying new aneurysm clips for the treatment of regrown or reruptured cerebral aneurysms in patients more than 10 years after the original clipping of the aneurysm neck. The adherent tissue covering previously placed clips is cut just on and a...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Kashimura H,Ogasawara K,Kubo Y,Otawara Y,Ogawa A

    更新日期:2007-10-01 00:00:00

  • Neurocognitive function before and after surgery for insular gliomas.

    abstract:OBJECT:Insular gliomas can be resected with acceptable rates of neurological morbidity, but little is known with regard to impairment of higher-order neurocognitive functions. The frequency and functional impact of neurocognitive deficits in patients with gliomas has until recently been underappreciated. The authors th...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Wu AS,Witgert ME,Lang FF,Xiao L,Bekele BN,Meyers CA,Ferson D,Wefel JS

    更新日期:2011-12-01 00:00:00

  • Intravertebral vacuum phenomenon in osteoporotic compression fracture: report of 67 cases with quantitative evaluation of intravertebral instability.

    abstract:OBJECT:The objectives of this study were to: 1) describe the incidence and clinical features of intravertebral vacuum phenomenon (IVVP) in a relatively large number of cases; 2) quantitatively evaluate intravertebral instability and determine the factors affecting instability; and 3) evaluate the efficacy of percutaneo...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Kim DY,Lee SH,Jang JS,Chung SK,Lee HY

    更新日期:2004-01-01 00:00:00

  • Intraoperative localization using an armless, frameless stereotactic wand. Technical note.

    abstract::A technique of "frameless" stereotaxy that allows real-time intraoperative neurosurgical localization is described. The system is composed of four components: a hand-held probe containing two ultrasonic emitters, a microphone array that is rigidly affixed to the operating table in proximity to the surgical field, hard...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Barnett GH,Kormos DW,Steiner CP,Weisenberger J

    更新日期:1993-03-01 00:00:00

  • Usefulness of 123I-iomazenil single-photon emission computed tomography in discriminating between mesial and lateral temporal lobe epilepsy in patients in whom magnetic resonance imaging demonstrates normal findings.

    abstract:OBJECT:To provide greater accuracy in determining the epileptogenic zone during preoperative evaluation, the authors retrospectively examined 123I-iomazenil single-photon emission computed tomography (IMZ SPECT) studies obtained in patients with temporal lobe epilepsy (TLE) in whom there was no evidence of an abnormali...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Umeoka S,Matsuda K,Baba K,Usui N,Tottori T,Terada K,Usui K,Nakamura F,Inoue Y,Fujiwara T,Mihara T

    更新日期:2007-08-01 00:00:00

  • Neurocognitive changes in pituitary adenoma patients after Gamma Knife radiosurgery.

    abstract::OBJECTIVEPituitary adenomas and the treatment required for the underlying neuropathology have frequently been associated with cognitive dysfunction. However, the mechanisms for these impairments remain the subject of much debate. The authors evaluated cognitive outcomes in patients treated with or without Gamma Knife ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Tooze A,Sheehan JP

    更新日期:2018-12-01 00:00:00

  • Bilateral trigeminal neuralgia.

    abstract::Bilateral trigeminal neuralgia occurred in 32 (11.9%) of 269 consecutive patients who were treated with radiofrequency electrocoagulation (RFE). This is a higher incidence than has been reported before and may be explained by the prospective nature of the present study, the long follow-up period, and the inclusion of ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Brisman R

    更新日期:1987-07-01 00:00:00

  • Thalamic tumors in children. Long-term follow-up and treatment guidelines.

    abstract::The authors review the cases of 60 children (aged 5 months to 18 years) with thalamic tumors who were seen at The Hospital for Sick Children between 1951 and 1983. The diagnosis of thalamic tumor was based on neuroradiological studies; 33 children were first seen in the pre-computerized tomography (CT) era and 27 sinc...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Bernstein M,Hoffman HJ,Halliday WC,Hendrick EB,Humphreys RP

    更新日期:1984-10-01 00:00:00

  • Magnetic resonance spectroscopy detection of high lipid levels in intraaxial tumors without central necrosis: a characteristic of malignant lymphoma.

    abstract:OBJECT:The differentiation of malignant lymphomas from gliomas or malignant gliomas by conventional MRI can be difficult. The authors studied Gd-enhanced MR images to obtain a differential diagnosis between malignant lymphomas and gliomas without central necrosis or cystic changes and investigated the diagnostic value ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Yamasaki F,Takayasu T,Nosaka R,Amatya VJ,Doskaliyev A,Akiyama Y,Tominaga A,Takeshima Y,Sugiyama K,Kurisu K

    更新日期:2015-06-01 00:00:00