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International collaboration on epilepsy surgery in Tunisia - a model for the future

International collaboration on epilepsy surgery in Tunisia - a model for the future. Introduction. Epilepsy is a frequent neurological disorder Medication does not always work If seizures> 2 years and 2 drug trials then the chance of long term control of epilepsy with medication is ~ 10%

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International collaboration on epilepsy surgery in Tunisia - a model for the future

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  1. International collaboration on epilepsy surgery in Tunisia - a model for the future

  2. Introduction • Epilepsy is a frequent neurological disorder • Medication does not always work If seizures> 2 years and 2 drug trials then the chance of long term control of epilepsy with medication is ~10% • Epilepsy have an adverse impact upon • Work • Education • Driving • Mariage • Life expectancy

  3. Introduction • Epilepsy surgery : effective treatment for medically refractory seizures. • 60–80% of patients with temporal epilepsy become seizure free after resective surgery • This technique, although effective, remains limited in developing countries, creating a significant ‘‘surgical treatment gap’’

  4. 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

  5. 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

  6. Contribution of EUMEDCONNECT

  7. 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 backbone network, a rapid access transfer of the video-EEG recordings from Tunis to France was performed

  8. Video-EEG recordings were then discussed between the two Neurophysiological teams. In cases of concordance of clinical, neuropsychological, neuroimaging data and video-EEG recording, the surgery indication was then considered

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