Neurology Department, Faculty of Medicine, Cairo University, Giza, Egypt.
Neurology Department, Faculty of Medicine, Assiut University, Asyut, Egypt.
Epilepsia Open. 2024 Aug;9(4):1233-1251. doi: 10.1002/epi4.12922. Epub 2024 May 24.
In epilepsy, early diagnosis, accurate determination of epilepsy type, proper selection of antiseizure medication, and monitoring are all essential. However, despite recent therapeutic advances and conceptual reconsiderations in the classification and management of epilepsy, serious gaps are still encountered in day-to-day practice in Egypt as well as several other resource-limited countries. Premature mortality, poor quality of life, socio-economic burden, cognitive problems, poor treatment outcomes, and comorbidities are major challenges that require urgent actions to be implemented at all levels. In recognition of this, a group of Egyptian epilepsy experts met through a series of consecutive meetings to specify the main concepts concerning the diagnosis and management of epilepsy, with the ultimate goal of establishing a nationwide Egyptian consensus.
The consensus was developed through a modified Delphi methodology. A thorough review of the most recent relevant literature and international guidelines was performed to evaluate their applicability to the Egyptian situation. Afterward, several remote and live rounds were scheduled to reach a final agreement for all listed statements.
Of 278 statements reviewed in the first round, 256 achieved ≥80% agreement. Live discussion and refinement of the 22 statements that did not reach consensus during the first round took place, followed by final live voting then consensus was achieved for all remaining statements.
With the implementation of these unified recommendations, we believe this will bring about substantial improvements in both the quality of care and treatment outcomes for persons with epilepsy in Egypt.
This work represents the efforts of a group of medical experts to reach an agreement on the best medical practice related to people with epilepsy based on previously published recommendations while taking into consideration applicable options in resource-limited countries. The publication of this document is expected to minimize many malpractice issues and pave the way for better healthcare services on both individual and governmental levels.
在癫痫中，早期诊断、准确确定癫痫类型、适当选择抗癫痫药物以及监测都至关重要。然而，尽管最近在癫痫的治疗进展和分类管理方面有了概念上的重新考虑，但在埃及以及其他一些资源有限的国家，日常实践中仍然存在严重的差距。过早死亡、生活质量差、社会经济负担、认知问题、治疗效果不佳和合并症都是需要在各个层面立即采取行动的主要挑战。认识到这一点，一组埃及癫痫专家通过一系列连续会议会面，明确了有关癫痫诊断和管理的主要概念，最终目标是在全国范围内建立埃及共识。
通过修改后的 Delphi 方法制定共识。对最新的相关文献和国际指南进行了全面审查，以评估其对埃及情况的适用性。之后，安排了几次远程和现场会议，以就所有列出的陈述达成最终协议。
在第一轮中审查的 278 条陈述中，有 256 条达到了≥80%的一致性。对第一轮中未达成共识的 22 条陈述进行了现场讨论和细化，随后进行了最终现场投票，所有其余陈述均达成共识。
实施这些统一的建议，我们相信这将为埃及的癫痫患者带来护理质量和治疗效果的显著改善。
这是一组医学专家的努力，旨在根据以前发表的建议，同时考虑资源有限国家的适用方案，就与癫痫患者相关的最佳医疗实践达成一致。该文件的发布有望最大限度地减少许多医疗事故问题，并为个人和政府层面的更好医疗服务铺平道路。
