PMID- 33254133
OWN - NLM
STAT- MEDLINE
DCOM- 20220224
LR  - 20230617
IS  - 1933-0715 (Electronic)
IS  - 1933-0707 (Linking)
VI  - 27
IP  - 2
DP  - 2020 Nov 27
TI  - A needs assessment of pediatric epilepsy surgery in Haiti.
PG  - 189-195
LID - 10.3171/2020.7.PEDS20256 [doi]
AB  - OBJECTIVE: Epilepsy disproportionately affects low- and/or middle-income 
      countries (LMICs). Surgical treatments for epilepsy are potentially curative and 
      cost-effective and may improve quality of life and reduce social stigmas. In the 
      current study, the authors estimate the potential need for a surgical epilepsy 
      program in Haiti by applying contemporary epilepsy surgery referral guidelines to 
      a population of children assessed at the Clinique d'Epilepsie de Port-au-Prince 
      (CLIDEP). METHODS: The authors reviewed 812 pediatric patient records from the 
      CLIDEP, the only pediatric epilepsy referral center in Haiti. Clinical covariates 
      and seizure outcomes were extracted from digitized charts. Electroencephalography 
      (EEG) and neuroimaging reports were further analyzed to determine the prevalence 
      of focal epilepsy or surgically amenable syndromes and to assess the lesional 
      causes of epilepsy in Haiti. Lastly, the toolsforepilepsy instrument was applied 
      to determine the proportion of patients who met the criteria for epilepsy surgery 
      referral. RESULTS: Two-thirds of the patients at CLIDEP (543/812) were determined 
      to have epilepsy based on clinical and diagnostic evaluations. Most of them (82%, 
      444/543) had been evaluated with interictal EEG, 88% of whom (391/444) had 
      abnormal findings. The most common finding was a unilateral focal abnormality 
      (32%, 125/391). Neuroimaging, a prerequisite for applying the epilepsy surgery 
      referral criteria, had been performed in only 58 patients in the entire CLIDEP 
      cohort, 39 of whom were eventually diagnosed with epilepsy. Two-thirds (26/39) of 
      those patients had abnormal findings on neuroimaging. Most patients (55%, 18/33) 
      assessed with the toolsforepilepsy application met the criteria for epilepsy 
      surgery referral. CONCLUSIONS: The authors' findings suggest that many children 
      with epilepsy in Haiti could benefit from being evaluated at a center with the 
      capacity to perform basic brain imaging and neurosurgical treatments.
FAU - Crevier-Sorbo, Gabriel
AU  - Crevier-Sorbo G
AD  - 1Faculty of Medicine, McGill University, Montreal, Quebec.
FAU - Brunette-Clement, Tristan
AU  - Brunette-Clement T
AD  - 2Faculty of Medicine, University of Montreal, Quebec.
FAU - Medawar, Edgard
AU  - Medawar E
AD  - 1Faculty of Medicine, McGill University, Montreal, Quebec.
FAU - Mathieu, Francois
AU  - Mathieu F
AD  - 3Division of Neurosurgery, Department of Surgery, University of Toronto, Ontario.
FAU - Morgan, Benjamin R
AU  - Morgan BR
AD  - 4Faculty of Medicine, University of Toronto, Ontario, Canada.
FAU - Hachem, Laureen D
AU  - Hachem LD
AD  - 3Division of Neurosurgery, Department of Surgery, University of Toronto, Ontario.
FAU - Dewan, Michael C
AU  - Dewan MC
AD  - 7Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario.
FAU - Fallah, Aria
AU  - Fallah A
AD  - 5Department of Neurosurgery, UCLA Mattel Children's Hospital, David Geffen School 
      of Medicine at UCLA, Los Angeles, California.
FAU - Weil, Alexander G
AU  - Weil AG
AD  - 2Faculty of Medicine, University of Montreal, Quebec.
AD  - 6Division of Neurosurgery, Sainte-Justine Hospital, Montreal, Quebec.
FAU - Ibrahim, George M
AU  - Ibrahim GM
AD  - 3Division of Neurosurgery, Department of Surgery, University of Toronto, Ontario.
AD  - 7Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario.
AD  - 8Institute of Biomaterials and Biomedical Engineering, University of Toronto, 
      Ontario; and.
AD  - 9Institute of Medical Science, University of Toronto, Ontario, Canada.
LA  - eng
PT  - Journal Article
DEP - 20201127
PL  - United States
TA  - J Neurosurg Pediatr
JT  - Journal of neurosurgery. Pediatrics
JID - 101463759
SB  - IM
MH  - Adolescent
MH  - Age of Onset
MH  - Child
MH  - Child, Preschool
MH  - Cohort Studies
MH  - Electroencephalography
MH  - Epilepsies, Partial/surgery
MH  - Epilepsy/economics/*surgery
MH  - Female
MH  - Haiti
MH  - Humans
MH  - Infant
MH  - Male
MH  - *Needs Assessment
MH  - Neuroimaging
MH  - Neurosurgical Procedures/economics/*methods
MH  - Referral and Consultation
MH  - Retrospective Studies
MH  - Seizures/prevention & control
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Caribbean
OT  - epilepsy
OT  - global health
OT  - low- and middle-income countries
OT  - neurosurgery
OT  - pediatric
EDAT- 2020/12/01 06:00
MHDA- 2022/02/25 06:00
CRDT- 2020/11/30 20:15
PHST- 2020/04/06 00:00 [received]
PHST- 2020/07/06 00:00 [accepted]
PHST- 2020/12/01 06:00 [pubmed]
PHST- 2022/02/25 06:00 [medline]
PHST- 2020/11/30 20:15 [entrez]
AID - 10.3171/2020.7.PEDS20256 [doi]
PST - epublish
SO  - J Neurosurg Pediatr. 2020 Nov 27;27(2):189-195. doi: 10.3171/2020.7.PEDS20256.