The contribution of tertiary centers to the quality of the diagnosis and treatment of epilepsy.
A survey was made of a network of 14 epilepsy centers in Italy to assess whether integrated diagnosis and treatment monitoring led to a more precise syndromic classification of the patients and a better response to treatment.
Data on the diagnosis and treatment of epilepsy and the degree of seizure control were recorded in a register on 2 separate occasions, on June 30,1990 (t0), before starting the integrated activities, and on June 30,1992 (tl), on completion of a 2-year follow-up.
Each patient's history was required to fit a specific category of the International Classification of the Epilepsies (ICE) (1).
Response to treatment was classified as complete remission, occasional seizures, recurrent nonrefractory seizures, and drug-resistant epilepsy.
A total of 3,469 patients of the ages of 4-80 years were enrolled.
At t0,44% of cases had localization-related epilepsy, 31% generalized epilepsy, 9% undetermined epilepsy, 6% special syndromes, and 10% epileptic syndromes with atypical features.
At t1, the percentages in each category were 51,27,7,6, and 9%. The cases classified as « other » within each syndromic category at t0 were 11-23% and remained unchanged at tl.
Patients with symptomatic localization-related epilepsies were largely recoded as symptomatic or cryptogenic epilepsies.
About one-third of patients with symptomatic generalized epilepsy were recoded as localization-related epilepsies. (...)
Mots-clés Pascal : Epilepsie, Syndrome, Italie, Europe, Institution spécialisée, Classification, Audit, Diagnostic, Traitement, Influence, Homme, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie
Mots-clés Pascal anglais : Epilepsy, Syndrome, Italy, Europe, Specialized institution, Classification, Audit, Diagnosis, Treatment, Influence, Human, Nervous system diseases, Central nervous system disease, Cerebral disorder
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0042042
Code Inist : 002B17A03. Création : 17/04/1998.