Increasing volume and complexity of pediatric epilepsy surgery with stable seizure outcome between 2008 and 2014: A nationwide multicenter study

Carmen Barba, Nicola Specchio, Renzo Guerrini, Laura Tassi, Salvatore De Masi, Francesco Cardinale, Simona Pellacani, Luca De Palma, Domenica Battaglia, Gianpiero Tamburrini, Giuseppe Didato, Elena Freri, Alessandro Consales, Paolo Nozza, Nelia Zamponi, Elisabetta Cesaroni, Giancarlo Di Gennaro, Vincenzo Esposito, Marco Giulioni, Paolo TinuperGabriella Colicchio, Raffaele Rocchi, Guido Rubboli, Flavio Giordano, Giorgio Lo Russo, Carlo Efisio Marras, Massimo Cossu

Research output: Contribution to journalArticle

Abstract

Objective The objective of the study was to assess common practice in pediatric epilepsy surgery in Italy between 2008 and 2014. Methods A survey was conducted among nine Italian epilepsy surgery centers to collect information on presurgical and postsurgical evaluation protocols, volumes and types of surgical interventions, and etiologies and seizure outcomes in pediatric epilepsy surgery between 2008 and 2014. Results Retrospective data on 527 surgical procedures were collected. The most frequent surgical approaches were temporal lobe resections and disconnections (133, 25.2%) and extratemporal lesionectomies (128, 24.3%); the most frequent etiologies were FCD II (107, 20.3%) and glioneuronal tumors (105, 19.9%). Volumes of surgeries increased over time independently from the age at surgery and the epilepsy surgery center. Engel class I was achieved in 73.6% of patients (range: 54.8 to 91.7%), with no significant changes between 2008 and 2014. Univariate analyses showed a decrease in the proportion of temporal resections and tumors and an increase in the proportion of FCDII, while multivariate analyses revealed an increase in the proportion of extratemporal surgeries over time. A higher proportion of temporal surgeries and tumors and a lower proportion of extratemporal and multilobar surgeries and of FCD were observed in low (< 50 surgeries/year) versus high-volume centers. There was a high variability across centers concerning pre- and postsurgical evaluation protocols, depending on local expertise and facilities. Significance This survey reveals an increase in volume and complexity of pediatric epilepsy surgery in Italy between 2008 and 2014, associated with a stable seizure outcome.

Original languageEnglish
Pages (from-to)151-157
Number of pages7
JournalEpilepsy and Behavior
Volume75
DOIs
Publication statusPublished - Oct 1 2017

Keywords

  • Children
  • Epilepsy surgery
  • Evaluation protocol
  • Surgical approach
  • Survey

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience

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    Barba, C., Specchio, N., Guerrini, R., Tassi, L., De Masi, S., Cardinale, F., Pellacani, S., De Palma, L., Battaglia, D., Tamburrini, G., Didato, G., Freri, E., Consales, A., Nozza, P., Zamponi, N., Cesaroni, E., Di Gennaro, G., Esposito, V., Giulioni, M., ... Cossu, M. (2017). Increasing volume and complexity of pediatric epilepsy surgery with stable seizure outcome between 2008 and 2014: A nationwide multicenter study. Epilepsy and Behavior, 75, 151-157. https://doi.org/10.1016/j.yebeh.2017.08.010