Epilepsy Surgery Series: A Study of 502 Consecutive Patients from a Developing Country

Maghrabi

et al. 2017

NSJ

Objective:To assess the progress in the field clinical epilepsy in Saudi Arabia, by analyzing in depth the research output productivity and publication pattern, and to identify the current situation of epilepsy research and offer solutions.Method:Literature search strategy was designed to retrieve accessible articles that are related to epilepsy utilizing PubMed, Google Scholar, and Embase. The retrieved articles were analyzed with several parameters, then evaluated using Oxford Center of Evidence Based Medicine level of evidence scale.Results:Of all identified articles, 90 were conducted in Kingdom of Saudi Arabia and therefore were included. The included articles had a frequency of only 3.5 publications per year, and growth of 24.4% between the periods of 1990-2003 and 2004-2016. Only 13.3% of the articles were related to surgical epilepsy but the majority (86.7%) were related to medical epilepsy. Many articles (53.3%) were level III studies. The most common study design was retrospective studies in 35.6%, and the citations number ranged from 1–289 (Mean=7).Conclusion:Pattern of publications in clinical epilepsy researches revealed a slow growth rate in the frequency and a lower significance in the quality throughout the past 26 years. Active institutional and national promotion of clinical research is needed to help assess and therefore improve the quality of the provided epilepsy services.

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Publications pattern of clinical epilepsy research in Saudi Arabia

Maghrabi

et al. 2017

NSJ

Journal of Neurosurgery

“…"Low/middle" income status of the home nation in which patients were based was determined according to the classification provided by the World Bank group; 63 studies that did not fall under this definition of LMIC but in which the authors considered themselves to be practicing in LMICs were included as such. 2 In cases of publications potentially based on a duplicate cohort of patients, the study with the largest sample set was selected. This review follows the PRISMA guidelines and MOOSE (Meta-analysis of Observational Studies in Epidemiology) criteria for meta-analyses.…”

Section: Search Strategy and Selection Criteriamentioning

confidence: 99%

“…49,50 One study was based on a mixed population but reported outcomes for adults and pediatrics separately. 2 One was purely focused on pediatric patients and was randomized. 15 The remaining studies either focused strictly on adults or reported pooled outcomes.…”

Section: Geographic Distribution Of Epilepsy Surgery Programs In Lmicsmentioning

confidence: 99%

Surgical outcomes for medically intractable epilepsy in low- and middle-income countries: a systematic review and meta-analysis

Mansouri

Taslimi²,

Abbasian

et al. 2019

OBJECTIVEThe aim of this study was to describe the current state of epilepsy surgery and establish estimates of seizure outcomes following surgery for medically intractable epilepsy (MIE) in low- and middle-income countries (LMICs).METHODSThe MEDLINE and Embase databases were searched without publication date restriction. This search was supplemented by a manual screen of key epilepsy and neurosurgical journals (January 2005 to December 2016). Studies that reported outcomes for at least 10 patients of any age undergoing surgery for MIE in LMICs over a defined follow-up period were included. A meta-analysis with a random-effects model was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and MOOSE (Meta-analysis of Observational Studies in Epidemiology) guidelines. Pooled estimates of seizure freedom and favorable seizure outcomes following anterior temporal lobectomy with or without amygdalohippocampectomy (ATL ± AH) were reported.RESULTSTwenty studies were selected, of which 16 were from Asian centers. The average age at surgery in all studies was less than 30 years, and the average preoperative duration of epilepsy ranged from 3 to 16.1 years. Mesial temporal sclerosis accounted for 437 of 951 described pathologies, and 1294 of the 1773 procedures were ATL ± AH. Based on 7 studies (646 patients) the pooled seizure freedom estimate following ATL ± AH was 68% (95% CI 55%–82%). Based on 8 studies (1096 patients), the pooled estimate for favorable seizure outcomes was 79% (95% CI 74%–85%).CONCLUSIONSSurgery for MIE in LMICs shows a high percentage of seizure freedom and favorable outcomes. These findings call for a concerted global effort to improve timely access to surgery for MIE patients in these regions, including investments aimed at refining existing and establishing additional centers.

“…In Saudi Arabia, epilepsy surgery was initiated in 1998, making the kingdom one of the first countries in the Middle East to offer such a service (Khan & Alsemari, 2008). In particular, King Faisal Specialist Hospital and Research Centre (KFSHRC) has developed a comprehensive epilepsy program (CEP) that achieves surgical outcomes comparable to other such centers worldwide (Alsemari et al, 2014). One goal of our program is the development of a state-of-the-science neuropsychological examination that also meets international standards.…”

Section: Introductionmentioning

confidence: 99%

Standardization of an Arabic-Language Neuropsychological Battery for Epilepsy Surgical Evaluations

Al-Joudi

Mincari

Baz

et al. 2019

J Int Neuropsychol Soc

Self Cite

Objectives: This study provides a standardized Arabic language neuropsychological test battery and tests its ability to distinguish patients with left and right hemisphere epileptic foci who are candidates for surgical resection. Methods: An Arabic language battery of 15 tests was developed based on the neuropsychological test battery used at the Johns Hopkins Hospital for surgical evaluation of patients undergoing temporal lobe resection. With modifications where culturally required, 11 tests were translated to Arabic by the principal investigator and back-translated by two bilingual health professionals; four tests were available in Arabic and added to the battery. The battery was administered to 21 Arabic-speaking patients with left temporal epileptic foci, 21 with right temporal epileptic foci, and 46 neurologically and psychiatrically healthy adults. Results: Nearly all the Arabic test versions were capable of differentiating healthy controls and the temporal lobe epilepsy (TLE) groups. Tests known to distinguish left and right temporal lobectomy candidates, such as wordlist memory and prose recall, were able to do so as accurately as the English versions. Also, a roughly “culturally free” task (the Baltimore Board) and a newly developed version of the Boston Naming Test demonstrated some sensitivity to left temporal lobe involvement. Conclusions: Arabic-language neuropsychological tests for epilepsy surgical evaluations are made available, demonstrate cultural sensitivity and clinical validity, and require further psychometric property and normative research. (JINS, 2019, 25, 761–771)