Kissani Najib, Nafia Sanaa, El Khiat Abdelaati, Bengamara Noureddine, Maiga Youssoufa, Sogoba Youssouf, Ahmed A Ibrahim Eetedal, Agbetou Mendinatou, Massi Daniel Gams, Assogba Komi, Matar Gaye Ndiaga, Kuate Tegueu Callixte, Hussein Ragab Amany, Razafimahefa Julien, Wilmshurst Jo, Naidoo Ansuya, Jabang John N, Watila Musa
Laboratory of Clinical and Experimental Neuroscience. Faculty of Medicine, Cadi Ayyad University, Marrakech, Morocco; Department of Neurology. University Teaching, Hospital Mohammed VI, Marrakesh, Morocco.
Laboratory of Clinical and Experimental Neuroscience. Faculty of Medicine, Cadi Ayyad University, Marrakech, Morocco.
Epilepsy Behav. 2021 May;118:107910. doi: 10.1016/j.yebeh.2021.107910. Epub 2021 Mar 18.
Epilepsy is an important public health problem representing 0.6% of the global burden of disease that particularly impacts people living in the lowest income countries where epilepsy incidence may be 10 fold more than in the developed world. The battery of treatments designed to counteract the clinical manifestations of this disease are various and range from a wide spectrum of antiseizure medicationand specific diets, to surgical techniques for resection of the epileptogenic focus. The aim of our study was to describe the State of the art of Epilepsy Surgery (ES) in Africa and examine ways to deal with the high surgical treatment gap.
In an observational study, we prospectively disseminated questionnaires via email or directly administered to main epileptologists and neurologists involved in epilepsy care, in key African countries. We also conducted a literature search using PubMed, Google scholar on ES in all the African countries.
We received responses from the majority of African countries, which allowed us to identify 3 levels of care for ES in African countries, a first level that uses ES with invasive presurgical evaluation, a second level that uses ES but without invasive presurgical evaluation, and a third level that does not use ES, and we summarized these results on a map.
This paper studied the availability of ES as a treatment modality in several African countries. We aimed to establish optimal pathways for initiating ES with noninvasive Electroencephalography and readily available investigations. This could be achieved through collaboration with epilepsy programs in developed countries directly or by using telemedicine.
癫痫是一个重要的公共卫生问题，占全球疾病负担的0.6%，对生活在低收入国家的人群影响尤为严重，这些国家的癫痫发病率可能比发达国家高出10倍。为对抗该疾病临床表现而设计的一系列治疗方法多种多样，从广泛的抗癫痫药物和特定饮食，到切除致痫灶的手术技术。我们研究的目的是描述非洲癫痫手术（ES）的现状，并探讨解决手术治疗差距较大问题的方法。
在一项观察性研究中，我们通过电子邮件前瞻性地分发问卷，或直接发放给非洲主要国家参与癫痫治疗的主要癫痫专家和神经科医生。我们还使用PubMed、谷歌学术对所有非洲国家的癫痫手术进行了文献检索。
我们收到了大多数非洲国家的回复，这使我们能够确定非洲国家癫痫手术的三级护理水平，第一级使用术前有创评估的癫痫手术，第二级使用无术前有创评估的癫痫手术，第三级不使用癫痫手术，我们在地图上总结了这些结果。
本文研究了癫痫手术作为一种治疗方式在几个非洲国家的可及性。我们旨在建立通过无创脑电图和现有检查启动癫痫手术的最佳途径。这可以通过直接与发达国家的癫痫项目合作或使用远程医疗来实现。
