[Evaluation of a pathway of epilepsy surgery in a polyvalent video-EEG center: retrospective analysis of a series of 295 patients].
OBJECTIVE
The supply for diagnosis and treatment is inadequate in France for epileptic patients eligible for surgery. Our institution includes a Video-electroencephalography (v-EEG) unit and a general neurosurgery department. Our objective was to evaluate the efficacy and morbidity of the surgery performed in a center non-dedicated to epilepsy surgery.


METHODS
We conducted a retrospective study of a cohort of 295 patients explored with long lasting v-EEG from 1991 to 2008 in Tours in which we evaluated the efficacy and morbidity of the surgery distinguishing between hippocampal sclerosis and other epileptogenic lesions.


RESULTS
Phase I directly led to surgery in 31 cases. Of them were 19 hippocampal sclerosis were operated with no surgical morbidity, and 12 other epileptogenic lesions operated with a comorbidity in two patients. Results of surgery were similar to larger studies, with 80% of patients Engel's Class I. Best results were observed in the hippocampal sclerosis group: 94.7 Class I (IA: 84%), versus 58% Class I (IA: 33%) for other etiologies.


CONCLUSIONS
Despite the small number of operated patients, the surgical treatment keeps its efficiency without adding morbidity. v-EEG centers combined with non-specialists neurosurgical teams can contribute to improve care without reducing their quality.
Service de neurochirurgie, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France. frederic.sauvaget@etu.univ-tours.fr
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Sauvaget
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Jeffredo-Rhanimi
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Velut
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Destrieux
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De Toffol
D000328:Adult; D017668:Age of Onset; D001254:Astrocytoma / Q000150:complications / Q000601:surgery; D001932:Brain Neoplasms / Q000150:complications / Q000601:surgery; D015331:Cohort Studies; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D005602:France; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery / Q000592:standards*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D012598:Sclerosis; D015899:Tomography, Emission-Computed, Single-Photon; D055815:Young Adult