Highlights
- •Epilepsy surgeries in western China has not risen with years.
- •Patient age at surgery or epilepsy duration has not changed with years.
- •Hippocampal sclerosis was the most frequent type of drug-resistant TLE.
Abstract
Objective
Despite the strong evidence for the efficacy of surgery to treat temporal lobe epilepsy,
the number of such surgeries has plateaued in western countries. This study examined
trends in the number of epilepsy cases diagnosed, number of surgeries performed, and
certain characteristics of surgery patients in western China between January 2009
and December 2017.
Methods
Data were obtained for a population-based sample from a healthcare information system,
as well as for a patient population from West China Hospital. Age at epilepsy onset,
age at surgery, duration of epilepsy, and type of epilepsy pathology based on surgical
samples were analyzed.
Results
Data were obtained for 14,710 hospitalizations from the healthcare system and 17,302
hospitalizations from West China Hospital. The number of hospitalizations, but not
the number of epilepsy surgeries, increased during the study period. Patients' age
at epilepsy onset, age at surgery or epilepsy duration did not change significantly
during the study period.
Significance
Our analysis suggests that in western China, as in western countries, the number of
temporal epilepsy surgeries has plateaued. In contrast, disease-modifying factors
have not changed over time in western China. Further studies are needed to explore
what may contribute to these findings.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Neurological SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- A randomized, controlled trial of surgery for temporal-lobe epilepsy.N. Engl. J. Med. 2001; 345: 311-318https://doi.org/10.1056/nejm200108023450501
- Revised version of quality guidelines for presurgical epilepsy evaluation and surgical epilepsy therapy issued by the Austrian, German, and Swiss working group on presurgical epilepsy diagnosis and operative epilepsy treatment.Epilepsia. 2016; 57: 1215-1220https://doi.org/10.1111/epi.13449
- Temporal trends in pre-surgical evaluations and epilepsy surgery in the U.S. from 1998 to 2009.Epilepsy Res. 2013; 103: 270-278https://doi.org/10.1016/j.eplepsyres.2012.07.016
- Trends in epilepsy surgery: stable surgical numbers despite increasing presurgical volumes.J. Neurol. Neurosurg. Psychiatry. 2016; 87: 1322-1329https://doi.org/10.1136/jnnp-2016-313831
- Epilepsy surgery trends in the United States, 1990-2008.Neurology. 2012; 78: 1200-1206https://doi.org/10.1212/WNL.0b013e318250d7ea
- Temporal lobe surgery in Germany from 1988 to 2008: diverse trends in etiological subgroups.Eur. J. Neurol. 2014; 21: 827-834https://doi.org/10.1111/ene.12322
- The evolution of epilepsy surgery between 1991 and 2011 in nine major epilepsy centers across the United States, Germany, and Australia.Epilepsia. 2015; 56: 1526-1533https://doi.org/10.1111/epi.13116
- China's health care system reform: progress and prospects.Int. J. Health Plann. Manag. 2017; 32: 240-253https://doi.org/10.1002/hpm.2424
- Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies.Epilepsia. 2010; 51: 1069-1077https://doi.org/10.1111/j.1528-1167.2009.02397.x
- R: A Language and Environment for Statistical Computing.R Foundation for Statistical Computing, 2018
Article Info
Publication History
Published online: June 25, 2019
Received in revised form:
June 22,
2019
Received:
April 15,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
