caa a22 4500 606214038 CHVBK 20210128101050.0 cr unu---uuuuu 210128e20150901xx s 000 0 eng 10.1007/s00701-015-2496-3 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2496-3 Perspectives of epilepsy surgery in resource-poor countries: a study in Georgia [Elektronische Daten] [Sofia Kasradze, Maia Alkhidze, Giorgi Lomidze, Giorgi Japaridze, Aleksander Tsiskaridze, Andro Zangaladze] Background: To identify patients with concordant seizure semiology, interictal epileptiform discharges on standard EEG and brain MRI changes to define the patients with pharmacoresistant epilepsy (PRE) who would be suitable for epilepsy surgery according to non-invasive protocol. Methods: The medical records of the patients with epilepsy seen in Epilepsy Center of Institute of Neurology and Neuropsychology (ECINN) (Tbilisi, Georgia) were reviewed retrospectively. The diagnostic work-up included neurological examination, standard EEG, and MRI. The degree of concordance of the seizure semiology, EEG, and neuroimaging was used to determine the potential candidates for surgery. The probability of seizure freedom rate was estimated based on known predictive values of anatomical, electrophysiological, and semiological characteristics. Results: A total of 83 (25%) patients met the criteria of PRE. Fourteen (17%) patients had complete concordance of seizure semiology, MRI, and EEG. Out of these patients, 11 had mesial temporal sclerosis on MRI and three had focal cortical dysplasia (FCD). Estimated seizure-free surgical success rate in this group was 75-95% without the need for further investigations. Out of 25 (30%) non-lesional MRI cases, the concordance of seizure semiology and EEG was in nine patients with probable success rate up to 60%. Thirteen patients (16%) had discordant EEG and MRI data and were not suitable for surgery without further testing. Conclusions: A significant portion of PRE patients with concordant anatomical, electrophysiological, and semiological characteristics can be treated surgically in resource-limited countries. Nevertheless, most patients will still require further investigation for proper localization of epileptogenic focus. Springer-Verlag Wien, 2015 Pharmacoresistant epilepsy nationallicence Surgical treatment nationallicence Developing country nationallicence Kasradze Sofia Institute of Neurology and Neuropsychology, 83/11 Vazha-Pshavela Ave., 0186, Tbilisi, Georgia aut Alkhidze Maia Institute of Neurology and Neuropsychology, 83/11 Vazha-Pshavela Ave., 0186, Tbilisi, Georgia aut Lomidze Giorgi Institute of Neurology and Neuropsychology, 83/11 Vazha-Pshavela Ave., 0186, Tbilisi, Georgia aut Japaridze Giorgi Institute of Neurology and Neuropsychology, 83/11 Vazha-Pshavela Ave., 0186, Tbilisi, Georgia aut Tsiskaridze Aleksander Iv. Javakhishvili Tbilisi State University, 0179, Tbilisi, Georgia aut Zangaladze Andro Virtua Neuroscience, 08043, Voorhees, NJ, USA aut Acta Neurochirurgica Springer Vienna 157/9(2015-09-01), 1533-1540 0001-6268 157:9<1533 2015 157 701 https://doi.org/10.1007/s00701-015-2496-3 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2496-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kasradze Sofia Institute of Neurology and Neuropsychology, 83/11 Vazha-Pshavela Ave., 0186, Tbilisi, Georgia aut NATIONALLICENCE 700 1- Alkhidze Maia Institute of Neurology and Neuropsychology, 83/11 Vazha-Pshavela Ave., 0186, Tbilisi, Georgia aut NATIONALLICENCE 700 1- Lomidze Giorgi Institute of Neurology and Neuropsychology, 83/11 Vazha-Pshavela Ave., 0186, Tbilisi, Georgia aut NATIONALLICENCE 700 1- Japaridze Giorgi Institute of Neurology and Neuropsychology, 83/11 Vazha-Pshavela Ave., 0186, Tbilisi, Georgia aut NATIONALLICENCE 700 1- Tsiskaridze Aleksander Iv. Javakhishvili Tbilisi State University, 0179, Tbilisi, Georgia aut NATIONALLICENCE 700 1- Zangaladze Andro Virtua Neuroscience, 08043, Voorhees, NJ, USA aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/9(2015-09-01), 1533-1540 0001-6268 157:9<1533 2015 157 701