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Trends in pediatric epilepsy surgery in Europe between 2008 and 2015: Country-, center-, and age-specific variation.

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.

journal_name

Epilepsia

journal_title

Epilepsia

authors

Barba C,Cross JH,Braun K,Cossu M,Klotz KA,De Masi S,Perez Jiménez MA,Gaily E,Specchio N,Cabral P,Toulouse J,Dimova P,Battaglia D,Freri E,Consales A,Cesaroni E,Tarta-Arsene O,Gil-Nagel A,Mindruta I,Di Gennaro G,Giu

doi

10.1111/epi.16414

subject

Has Abstract

pub_date

2020-02-01 00:00:00

pages

216-227

issue

2

eissn

0013-9580

issn

1528-1167

journal_volume

61

pub_type

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