Epilepsy surgery program in Tunisia: An example of a Tunisian French collaboration

Khiari, Hela Mrabet; Khemiri, Emna; Parain, D.; Hattab, N.; Proust, F.; Mrabet, A.

doi:10.1016/j.seizure.2009.11.010

Cited by 20 publications

(8 citation statements)

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“…In India, for instance, excellent seizure outcome (seizure-free or having only auras) was achieved in 7/17 patients (41%) [ 28 ] and in Uganda’s series 6/10 60% of patients were seizure-free after temporal lobe epilepsy surgery [ 29 ]. Remarkably, Mrabet KH, and Campos et al, reported 100% and 88.24% of patients in Engel class I after epilepsy surgery [ 30 , 31 ]. The former included 15 patients with hippocampal sclerosis in an epilepsy surgery program in Tunisia with French collaboration, whereas the latter comprised 17 cases.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Electroclinical and Employment Follow up in Temporal Lobe Epilepsy Surgery. A Cuban Comprehensive Epilepsy Surgery Program

Chacón

Maeso

Martín

et al. 2018

Behavioral Sciences

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The purpose of this paper is to present a long- term electroclinical and employment follow up in temporal lobe epilepsy (TLE) patients in a comprehensive epilepsy surgery program. Forty adult patients with pharmacoresistant TLE underwent detailed presurgical evaluation. Electroencephalogram (EEG) and clinical follow up assessment for each patient were carried out. The occurrence of interictal epileptiform activity (IEA) and absolute spike frequency (ASF) were tabulated before and after 1, 6, 12, 24 and 72 months surgical treatment. Employment status pre- to post-surgery at the last evaluated period was also examined. Engel scores follow-up was described as follows: at 12 months 70% (28) class I, 10% (4) class II and 19% (8) class III-IV; at 24 months after surgery 55.2% (21) of the patients were class I, 28.9% (11) class II and 15.1% (6) class III-IV. After one- year follow up 23 (57.7%) patients were seizure and aura-free (Engel class IA). These figures changed to 47.3%, and 48.6% respectively two and five years following surgery whereas 50% maintained this condition in the last follow up period. A decline in the ASF was observed from the first year until the sixth year after surgery in relation to the preoperative EEG. The ASF one year after surgery allowed to distinguish “satisfactory” from “unsatisfactory” seizure relief outcome at the last follow up. An adequate social functioning in terms of education and employment in more than 50% of the patients was also found. Results revealed the feasibility of conducting a successful epilepsy surgery program with favorable long term electroclinical and psychosocial functioning outcomes in a developing country as well.

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Section: Discussionmentioning

confidence: 99%

Long-Term Electroclinical and Employment Follow up in Temporal Lobe Epilepsy Surgery. A Cuban Comprehensive Epilepsy Surgery Program

Chacón

Maeso

Martín

et al. 2018

Behavioral Sciences

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“…There must also be a collaboration with centers in HIC to bring functional techniques to LMIC. Tunisia, the northernmost country within the African continent, established its first epilepsy center in the late 2000s following collaboration with the departments of neurosurgery and neurophysiology at Charles Nicolle Hospital in Rouen, France [ 20 ]. Fifteen patients with mesial temporal lobe epilepsy, refractory to oral medications, were included in the original study, 10 of whom underwent surgery.…”

Section: Reviewmentioning

confidence: 99%

Challenges and Solutions for Functional Neurosurgery in Developing Countries

Fezeu¹,

Ramesh

Melmer

et al. 2018

Cureus

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Functional neurosurgery techniques remain integral to the neurosurgical treatment armamentarium but data on global implementation remains scarce. In comparison to high-income countries (HIC), low- and middle-income countries (LMIC) suffer from an increased prevalence of diseases like epilepsy, which may be amenable to functional techniques, and therefore, LMIC may benefit from an increased utilization of these treatment modalities. However, functional techniques tend to be expensive and thus difficult to implement in the LMIC setting. A review was performed to assess the current status of functional neurosurgical techniques in LMIC as a starting point for future initiatives.For methodology, a review of the current body of literature on functional neurosurgery in LMIC was conducted through the United States National Library of Medicine Pubmed search engine. Search terms included “functional neurosurgery,” “developing countries,” “low and middle income,” and other related terms.It was found that though five billion people lack access to safe surgical care, the burden of disease amenable to treatment with functional neurosurgical procedures remains unknown. Increasingly, reports of successful, long-term, international neurosurgical collaborations are being reported, but reports in the sub-field of functional neurosurgery are lacking.In conclusion, awareness of global surgical disparities has increased dramatically while global guidelines for functional techniques are currently lacking. A concerted effort can harness these techniques for wider practice. Partnerships between centers in LMIC and HIC are making progress to better understand the burden of disease in LMIC and to create context-specific solutions for practice in the LMIC setting, but more collaborations are warranted.

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“…Consequently, MTLE patients with a clear-cut surgical recommendation and excellent outcome prognosis accumulate in these countries, even though those patients could be identified appropriately within a limited resource setting [15]. In addition, emerging economies like Argentina [16], Colombia [17], India [15,18], Lebanon [19], Panama [20] or Tunisia [21] report seizure freedom rates after surgical resection comparable to that of high-income countries [22]. Similar results can be achieved even in low-resource settings, as reported for Uganda [23].…”

Section: Introductionmentioning

confidence: 99%

Initiating a new national epilepsy surgery program: Experiences gathered in Georgia

Dugladze

Bäuerle

Kasradze³

et al. 2020

Epilepsy & Behavior

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Epilepsy surgery program in Tunisia: An example of a Tunisian French collaboration

Abstract: Our model of twin affiliations between advanced epilepsy surgery programs in a developed country and starting programs in a developing country, using Internet technology, can be a model for collaboration in other countries.

Cited by 20 publications

References 14 publications

Long-Term Electroclinical and Employment Follow up in Temporal Lobe Epilepsy Surgery. A Cuban Comprehensive Epilepsy Surgery Program

Long-Term Electroclinical and Employment Follow up in Temporal Lobe Epilepsy Surgery. A Cuban Comprehensive Epilepsy Surgery Program

Challenges and Solutions for Functional Neurosurgery in Developing Countries

Initiating a new national epilepsy surgery program: Experiences gathered in Georgia

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