[Epilepsy surgery in children: from a multidisciplinary network to the creation of an expertise and care centre]

Details

Serval ID
serval:BIB_FFCAEA86592C
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Title
[Epilepsy surgery in children: from a multidisciplinary network to the creation of an expertise and care centre]
Journal
Neurochirurgie
Author(s)
Arzimanoglou A., Bourgeois M., Kahane P., Hirsch E., Boddaert N., Ryvlin P., Sainte-Rose C.
ISSN
0028-3770 (Print)
ISSN-L
0028-3770
Publication state
Published
Issued date
05/2008
Volume
54
Number
3
Pages
479-83
Language
english
Notes
Arzimanoglou, A
Bourgeois, M
Kahane, P
Hirsch, E
Boddaert, N
Ryvlin, P
Sainte-Rose, C
fre
English Abstract
France
Neurochirurgie. 2008 May;54(3):479-83. doi: 10.1016/j.neuchi.2008.02.017. Epub 2008 Apr 15.
Abstract
We report on the experience of a network created in 1994 to evaluate children with drug-resistant epilepsies who are candidates for surgical treatment. The network includes epilepsy units from several university hospitals in France that decided to share not only their clinical expertise to better respond to the need for a multidisciplinary approach of epilepsy surgery in children, but also all the technical and human resources available in the various teams. This mode of operation has certainly provided concrete proof of its efficacy since it undoubtedly facilitated, and even accelerated, access to optimal presurgical evaluation and epilepsy surgery for hundreds of children. However, after 10 years of this very enriching practice it became evident that our approach was certainly necessary but not sufficient. It is estimated that every year in France nearly 500 children are candidates for surgical treatment, and following a presurgical evaluation, 50% of them could be operated on. Today, only 150-200 children have access to a presurgical evaluation every year. This is a highly paradoxical situation since, even if the human suffering component that such a situation generates is set aside, the direct and indirect life-time costs for every 100 nonoperated patients is estimated at 40 million euros. As a result of our cumulated experience, in 2004 we proposed a different operating model with the creation of an expertise center that will combine not only medical care services provided by a fully equipped multidisciplinary team, but also a pole of applied clinical and fundamental research, a medicosocial center managed by a lay association and an industrial development pole. The project has been recently validated by the Ministry of Health and is supported by a number of national and regional institutions. The Institute for Children and Adolescents with Epilepsy--IDEE--is designed to accelerate diagnostic procedures and, when indicated, access to optimal presurgical evaluation, while also serving as a model for a medical and economic evaluation of epilepsy care in children.
Keywords
Academic Medical Centers/*organization & administration, Adolescent, Adult, Child, Child, Preschool, Clinical Competence, Community Networks/*organization & administration, Epilepsy/economics/*surgery, Female, France, Humans, Male, Models, Organizational, *Neurosurgical Procedures/economics/statistics & numerical data, Research
Pubmed
Create date
29/11/2018 13:36
Last modification date
20/08/2019 17:30
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