Cellular and network Physiology Group, Neuroscience Research Center, Charité - Universitätsmedizin Berlin, Germany; Neuroscience Lab, Caucasus Medical Centre, Tbilisi, Georgia; Institute of Integrative Neuroanatomy, Charité - Universitätsmedizin Berlin, Germany.
Cellular and network Physiology Group, Neuroscience Research Center, Charité - Universitätsmedizin Berlin, Germany; Institute of Integrative Neuroanatomy, Charité - Universitätsmedizin Berlin, Germany.
Epilepsy Behav. 2020 Oct;111:107259. doi: 10.1016/j.yebeh.2020.107259. Epub 2020 Jul 1.
Surgery is the most effective therapeutic approach for medically refractory epilepsies and a safe and cost-efficient treatment in terms of long-term expenses of direct, indirect, and intangible costs. Georgia is a Caucasian low- to middle-income country with a remarkable effort to deal with epileptic diseases, but without an appropriate epilepsy surgery program. To address the needs for such a service in this country, two joint German-Georgian projects were initiated in 2017 and 2019. In the framework of these projects, a productive exchange program involving German and Georgian experts was undertaken in the past two years. This program included training and mentoring for Georgian clinical colleagues, as well as joint case conferences and workshops with the aim of optimizing presurgical diagnostics and preparing for an epilepsy surgery program in Georgia. Finally, a postsurgical medium- and long-term follow-up scheme was organized as the third component of this comprehensive approach. As a result of our efforts, the first patients underwent anterior temporal lobectomy and all of them remain seizure-free up to the present day. Hence, epilepsy surgery is not only feasible, but also already available in Georgia. In this report, we aim to share our experiences in the initiation and implementation of surgical epilepsy intervention in Georgia and illustrate our recent endeavor and achievements.
手术是治疗药物难治性癫痫最有效的治疗方法，从直接、间接和无形成本的长期费用来看，手术也是一种安全且具有成本效益的治疗方法。格鲁吉亚是一个白种人为主的中低收入国家，在应对癫痫疾病方面做出了巨大努力，但缺乏适当的癫痫手术项目。为满足该国对此类服务的需求，德国和格鲁吉亚于 2017 年和 2019 年分别启动了两个联合项目。在这些项目的框架内，过去两年开展了涉及德格两国专家的富有成效的交流计划。该计划包括对格鲁吉亚临床同事进行培训和指导，以及举行联合病例会议和研讨会，旨在优化术前诊断并为格鲁吉亚的癫痫手术项目做准备。最后，作为这一综合方法的第三个组成部分，组织了术后中远期随访计划。由于我们的努力，第一批患者接受了前颞叶切除术，到目前为止，他们所有人都没有癫痫发作。因此，癫痫手术不仅可行，而且已经在格鲁吉亚开展。在本报告中，我们旨在分享我们在格鲁吉亚开展手术性癫痫干预的启动和实施方面的经验，并介绍我们最近的努力和成就。
