Variables Associated with Acceptance of Epilepsy Surgery, in a Latin-American Center: Pediatric Experience.
Abstract number :
3.213
Submission category :
Year :
2001
Submission ID :
156
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
R. Villalobos, MD, Neurology, FETEN, San Luis Potosi, Mexico; J. Torres-Corzo, MD, Neurosurgery, FETEN, San Luis Potosi, Mexico; R. Rodriguez, MD, Neurosurgery, FETEN, San Luis Potosi, Mexico; J.L. Garcia, MD, Neurology, FETEN, San Luis Potosi, Mexico; F.
RATIONALE: Epilepsy surgery is becoming increasingly accepted as an alternative for the treatment of intractable seizures in the last decade in industrialized countries, unfortunately its impact in developing countries has been poorly studied. The acceptance of such a radical procedure in different cultures is as well unknown.
Our objective is to identify the variables important in the acceptance of epilepsy surgery, as an alternative to patients, and their families, in a multidisciplinary epilepsy surgery center in Mexico, in the setting of intractable seizures.
METHODS: We selected prospectively a population of patients scheduled to undergo epilepsy surgery in the period comprehended between January 1998 and December 1999 at our institution. The performed procedures were callosotomies, hemispherectomies, neocortical resections, and temporal lobectomies. All candidates received at least 3 major anticonvulsants, and were intractable for at least 2 years. A questionnaire with symptoms of importance to families in their decision making process was scored by the following criteria: functionality (normal IQ), recurrence (by 2 or more seizures per week), and need of assistance (by the presence of disabling seizures). We classified the family background education of at least one parent having completed schooling as: elementary (elementary school completed), mid-level (at least high school completed) and professional (university degree).
RESULTS: Patients age was 3 years to 18 years old, mean of 11.3 years. Males 9, females 7. 4 patients in the non functional group and 12 in the functional group, all patients presented with 2 or more seizures per week, 9 cases needed immediate assistance during or after the events. The family background consisted of: 2 elementary, 9 mid-level and 5 professional education. All patients studied underwent surgery.
CONCLUSIONS: The variable most often associated with acceptance of epilepsy surgery for intractability in a Mexican population is seizure recurrence, followed by the need for assistance during the actual episode. Acceptance it is not related to the family background. The functional individuals are more likely to undergo surgery than the non functional ones, however a larger population is desirable.