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. 2020 Feb;61(2):216-227.
doi: 10.1111/epi.16414. Epub 2019 Dec 26.

Trends in pediatric epilepsy surgery in Europe between 2008 and 2015: Country-, center-, and age-specific variation

Carmen Barba  1 , Judith Helen Cross  2 , Kees Braun  3 , Massimo Cossu  4 , Kerstin Alexandra Klotz  5 , Salvatore De Masi  6 , Maria Angeles Perez Jiménez  7 , Eija Gaily  8 , Nicola Specchio  9 , Pedro Cabral  10 , Joseph Toulouse  11 , Petia Dimova  12 , Domenica Battaglia  13 , Elena Freri  14 , Alessandro Consales  15 , Elisabetta Cesaroni  16 , Oana Tarta-Arsene  17 , Antonio Gil-Nagel  18 , Ioana Mindruta  19 , Giancarlo Di Gennaro  20 , Marco Giulioni  21 , Martin M Tisdall  22 , Christin Eltze  22 , Muhammad Zubair Tahir  22 , Floor Jansen  3 , Peter van Rijen  3 , Maurits Sanders  3 , Laura Tassi  4 , Stefano Francione  4 , Giorgio Lo Russo  4 , Julia Jacobs  23 , Thomas Bast  24   25 , Giulia Matta  1 , Marcelo Budke  26 , Concepción Fournier Del Castillo  27 , Eeva-Liisa Metsahonkala  8 , Atte Karppinen  28 , José Carlos Ferreira  10 , Krasimir Minkin  12 , Carlo Efisio Marras  29 ; European Survey Group; Alexis Arzimanoglou  11 , Renzo Guerrini  1   30
Collaborators, Affiliations

Trends in pediatric epilepsy surgery in Europe between 2008 and 2015: Country-, center-, and age-specific variation

Carmen Barba et al. Epilepsia. 2020 Feb.

Abstract

Objective: To profile European trends in pediatric epilepsy surgery (<16 years of age) between 2008 and 2015.

Methods: We collected information on volumes and types of surgery, pathology, and seizure outcome from 20 recognized epilepsy surgery reference centers in 10 European countries.

Results: We analyzed retrospective aggregate data on 1859 operations. The proportion of surgeries significantly increased over time (P < .0001). Engel class I outcome was achieved in 69.3% of children, with no significant improvement between 2008 and 2015. The proportion of histopathological findings consistent with glial scars significantly increased between the ages of 7 and 16 years (P for trend = .0033), whereas that of the remaining pathologies did not vary across ages. A significant increase in unilobar extratemporal surgeries (P for trend = .0047) and a significant decrease in unilobar temporal surgeries (P for trend = .0030) were observed between 2008 and 2015. Conversely, the proportion of multilobar surgeries and unrevealing magnetic resonance imaging cases remained unchanged. Invasive investigations significantly increased, especially stereo-electroencephalography. We found different trends comparing centers starting their activity in the 1990s to those whose programs were developed in the past decade. Multivariate analysis revealed a significant variability of the proportion of the different pathologies and surgical approaches across countries, centers, and age groups between 2008 and 2015.

Significance: Between 2008 and 2015, we observed a significant increase in the volume of pediatric epilepsy surgeries, stability in the proportion of Engel class I outcomes, and a modest increment in complexity of the procedures.

Keywords: children; epilepsy surgery; histopathology; outcome; survey.

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References

REFERENCES

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