Surgery is now long established as standard management of carefully selected patients with focal epilepsy. There are many aspects, however, that can be particularly challenging and deserve special consideration in the evaluation for surgery and planning of surgical strategy.
Epilepsy-surgery in appropriately evaluated patients is seen to be effective over a wide age range, and over a spectrum of clinical presentations and pathologies. Furthermore, the likely impact that can result from early evaluation and surgery with resulting seizure control suggest that patients, especially children, should be referred and assessed early in their clinical course.
The members of this WG contribute to:
– Regular e-care visioconferences and face-to-face sessions (U-Task) led by experts, to discuss best practices in pre-surgical evaluation; epilepsy-surgery indications; results of surgery, both successes and failures. The case discussions are also of high educational value and are open to all EpiCARE members.
– IT platform: it allowed each EpiCARE centre to get access and use sophisticated neuroimaging and EEG postprocessing tools (e.g. Curry8).
– Epilepsy Surgery REDCap eCRF: This comprehensive eCRF aimed at collecting all relevant data from patients undergoing presurgical evaluation and epilepsy surgery. Its regular use by the centres will allow collection of comparable data on the natural history of focal epilepsies per aetiology, both retrospectively and prospectively.
– The CogniEEG project: EpiCARE centres are core members of the CogniEEG project which aims at leveraging cognitive research performed in patients with epilepsy undergoing intracerebral EEG recordings (iEEG). It is expected that all data collected through the above activities will progressively populate th EpiCARE Registry, thus facilitating the design and performance of academic studies related to epilepsy-surgery needs and outcomes.
Members of the WG are active participants to the just launched process for Guidelines on pre-surgical evaluation; epilepsy-surgery; and invasive neuromodulation.
(1) Only some centers of the E-pilepsy network can offer comprehensive epilepsy care for all types of epilepsy and for all ages, corresponding to EpiCARE eligibility criteria for a membership accreditation by the European Commission. However, despite this administrative limitation, we considered it essential to continue the cooperation with all those e-pilepsy centers wishing to voluntarily contribute to the production of guidelines, state-of-the-art methodologies and web-based tools which help increase the effectiveness and safety of pre-surgical evaluation and epilepsy surgery. Epilepsy surgery is a highly complex process and, compared to the patient needs, rare are the medical teams with an established expertise.
The EpiCARE WG, dedicated to pre-surgical evaluation procedures and epilepsy surgery, integrated, in 2017, a pre-existing pilot network, E-pilepsy, co-funded by the EU. E-pilepsy has been operating since January 2014, under the leadership of Prs. Helen Cross (UK) and Philippe Ryvlin (Switzerland), progressively involving 52 centers. It has provided a large number of publications and sustained activities that have been consolidated and further developed in EpiCARE (1).
In collaboration with the ILAE Pediatric Epilepsy Surgery Task Force the network proposed criteria for paediatric epilepsy surgery center levels of care (Gaillard et al, 2020).
Epilepsy-surgery in appropriately evaluated patients is seen to be effective over a wide age range, and over a spectrum of clinical presentations and pathologies (Sanders et al 2024). Furthermore, the likely impact that can result from early evaluation and surgery with resulting seizure control suggest that patients, especially children, should be referred and assessed early in their clinical course (Baud et al 2018; Barba et al 2020).
If you are interested to voluntarily contribute to this WG activities, please use the contact form to let us know.
