Level 4 comprehensive epilepsy program in Malaysia, a resource-limited country
- Author:
Kheng-Seang LIM
1
;
Sherrini Ahmad Bazir Ahmad
;
Vairavan NARAYANAN
;
Kartini RAHMAT
;
Norlisah Mohd RAMLI
;
Kein-Seong MUN
;
Kum-Thong WONG
;
Noraini ISMAIL
;
Shweh-Fern LOO
;
Chong-Tin TAN
Author Information
1. Division of Neurology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Publication Type:Original article
- Keywords:
Epilepsy surgery;
intracranial monitoring;
refractory epilepsy
- From:Neurology Asia
2017;22(4):299-305
- CountryMalaysia
- Language:English
-
Abstract:
Background and Objective: There is a great challenge to establish a level 4 epilepsy care offeringcomplete evaluation for epilepsy surgery including invasive monitoring in a resource-limited country.This study aimed to report the setup of a level 4 comprehensive epilepsy program in Malaysia and theoutcome of epilepsy surgery over the past 4 years. Methods: This is a retrospective study analyzingcases with intractable epilepsy in a comprehensive epilepsy program in University Malaya MedicalCenter (UMMC), Kuala Lumpur, from January 2012 to August 2016. Results: A total of 92 caseshad comprehensive epilepsy evaluation from January 2012 till August 2016. The mean age was 35.57years old (range 15-59) and 54 (58.7%) were male. There were 17 cases having epilepsy surgeryafter stage-1 evaluation. Eleven cases had mesial temporal sclerosis and 81% achieved Engel classI surgical outcome. Six cases had lesionectomy and 60% had Engel class I outcome. A total of 16surgeries were performed after stage-2 evaluation, including invasive EEG monitoring in 9 cases.Among those with surgery performed more than 12 months from the time of data collection, 5/10(50%) achieved Engel I outcome, whereas 2 (20%) had worthwhile improvement (Engel class III)with 75% and 90% seizure reduction.Conclusion: Level 4 epilepsy care has an important role and is possible with joint multidisciplinaryeffort in a middle-income country like Malaysia despite resource limitation.
