International collaboration on epilepsy surgery in Tunisia - a
model for the future
Introduction Epilepsy is a frequent neurological disorder Medication does not always workIf seizures> 2 years and 2 drug trials then the chanceof long term control of epilepsy with medication is
~10% Epilepsy have an adverse impact upon
Work Education Driving Mariage Life expectancy
Introduction
Epilepsy surgery : effective treatment for medically refractory seizures.
60–80% of patients with temporal epilepsybecome seizure free after resective surgery This technique, although effective, remainslimited in developing countries, creating asignificant ‘‘surgical treatment gap’’
Presurgical evaluation of epilepsy
Identification of candidates eligible for surgery : crucial step before surgery
Established at the Neurological Department of Charles Nicolle Hospital (Tunis)
Includes : detailed history, neurological exam, brain MRI, scalp video-EEG monitoring and neuropsychological tests
Video-EEG Monitoring
Seizure focus
•Continuous EEG recording with simultaneous video recording of the patient clinical manifestations
•Objective: localization seizure origin and propagation
•Requires technical and medical competencies
Contribution of EUMEDCONNECT
EUMEDCONNECT network project
Length of video-EEG Combination of Video and EEG
large files causing problems in data transfer
Using in real time the high speed NECT backbonenetwork, a rapid access transfer of the video-EEGrecordings from Tunis to France was performed
Video-EEG recordings were then discussedbetween the two Neurophysiological teams. In cases of concordance of clinical,neuropsychological, neuroimaging data andvideo-EEG recording, the surgery indicationwas then considered
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