R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
Acta Neurol Scand. 2021 May;143(5):521-529. doi: 10.1111/ane.13393. Epub 2021 Jan 13.
To study the trends for pediatric epilepsy surgery between 2000 and 2014 in a tertiary epilepsy surgery center in India in order to gain a lower- and middle-income country (LMIC) perspective.
Children aged <18 years and undergoing epilepsy surgery were divided into three groups based on the year that they underwent surgery-group 1: year 2000-2004; group 2: year 2005-2009; and group 3: year 2010-2014. Data including the rate of surgery, type of surgery, and duration of epilepsy before referral were analyzed from the medical records and compared.
Between 2000 and 2014, 463 pediatric epilepsy surgeries were performed. The proportion of pediatric epilepsy surgeries showed an increasing trend-218 (total 510 surgeries, 42.74%) in group 3, compared with 115 (total 375 surgeries, 30.66%) in group 1 and 130 (total 466 surgeries, 27.9%) in group 2. A significant decrease in the age at evaluation and duration of epilepsy before referral was noted between 2000 and 2014, particularly in patients belonging to the lowest income group. There was a two-fold increase in the number of extratemporal surgeries over time. The proportion of children undergoing surgery for benign tumors, cortical malformations, and gliosis/atrophy showed an upward trend while that for mesial temporal sclerosis did not show an increase.
Promising trends in pediatric epilepsy surgery were noted with increasing number of surgeries and decreasing age at presurgical evaluation. Seen from an LMIC perspective, this reflects an evolution in the practice of pediatric epilepsy surgery, mirroring trends in high-income countries.
研究印度一家三级癫痫外科中心 2000 年至 2014 年小儿癫痫外科的趋势，以获得中低收入国家（LMIC）的视角。
根据手术年份将年龄<18 岁且接受癫痫手术的儿童分为三组：第 1 组：2000-2004 年；第 2 组：2005-2009 年；第 3 组：2010-2014 年。从病历中分析并比较了手术率、手术类型和转诊前癫痫持续时间的数据。
2000 年至 2014 年，共进行了 463 例小儿癫痫手术。小儿癫痫手术的比例呈上升趋势-第 3 组为 218 例（总手术 510 例，占 42.74%），第 1 组为 115 例（总手术 375 例，占 30.66%），第 2 组为 130 例（总手术 466 例，占 27.9%）。与 2000 年相比，2014 年评估年龄和转诊前癫痫持续时间明显下降，特别是在收入最低的患者中。随着时间的推移，颞外手术的数量增加了两倍。行手术治疗良性肿瘤、皮质发育不良和神经胶质增生/萎缩的儿童比例呈上升趋势，而海马硬化症则没有增加。
小儿癫痫外科手术数量增加，术前评估年龄降低，呈现出可喜的趋势。从中低收入国家的角度来看，这反映了小儿癫痫外科实践的演变，反映了高收入国家的趋势。
