Highlights
- •There is high variability of surgical procedures performed throughout Latin America.
- •Advanced surgical interventions are performed throughout Latin America.
- •Laser ablation procedures are not widely available.
- •There are areas to improve training and exposure in surgical epilepsy internationally.
Abstract
Introduction
To describe the variety of surgical epilepsy procedures offered in Latin America and
characterize the training in surgical management for epilepsy and neurophysiology
fellows.
Materials & Methods
A 15-question survey was sent to Spanish-speaking epilepsy specialists in Latin America
(members of the International Consortium in Epilepsy Surgery Education) to characterize their epilepsy surgery practices and formal training programs when
present, including fellowship program characteristics, trainee involvement, and assessment
of trainee performance. Epilepsy surgery procedures included resective/ablative interventions
and neuromodulation therapies approved for drug-resistant epilepsy. Associations between
categorical variables were evaluated using the Fisher Exact test.
Results
There were 42 responses from a total of 57 survey recipients (73% response rate).
Most surgical programs performed either 1 to 10 procedures (36%) or 11 to 30 procedures
(31%) per year. Most centers (88%) performed resective procedures, while none of the
surveyed institutions performed laser ablations. Most of the centers performing intracranial
EEG (88%) and advanced neuromodulation (93%) were in South America. Centers with formal
fellowship training programs were more likely to perform intracranial EEG procedures
compared to centers without fellows (92% vs 48%, respectively, OR = 12.2 [95% CI 1.45–583],
p = 0.007).
Discussion
There is significant variability in surgical procedures performed across epilepsy
centers in a Latin American educational consortium. Advanced surgical diagnostic procedures
and interventions are performed in a fair number of surveyed institutions. Strategies
to enhance access to epilepsy surgery procedures and facilitate formal training in
surgical management are necessary.
Keywords
Abbreviations:
DRE (drug-resistant epilepsy), CNP (clinical neurophysiology), ACGME (Accreditation Council for Graduate Medical Education), EMG (electromyography), LITT (laser interstitial thermal therapy), RNS (responsive neurostimulator), DBS (deep brain stimulator implantation), EEG (electroencephalography), VNS (vagus nerve stimulation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 17, 2023
Accepted:
April 1,
2023
Received in revised form:
March 31,
2023
Received:
January 24,
2023
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
