Efficacy of the Danish epilepsy surgery programme

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Excerpt

Epilepsy occurs in 0.6% of the Danish population.1 Despite optimal medical treatment, approximately one‐third of patients with epilepsy continue to have seizures.2 Active epilepsy disrupts important aspects of life, and imposes physical, psychological and social burden on patients and families.2 Drug‐resistant epilepsy is defined as failure of adequate trials of two tolerated, appropriately chosen and used anti‐epileptic drug (AED) schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom.3 Drug‐resistant epilepsy accounts for over 75% of the cost of AEDs and over 60% of the total indirect cost.4 The total cost of epilepsy in Europe, 2010, was €13.8 billion.5
Seizure freedom in highly selected drug‐resistant patients after surgical removal of the epileptogenic tissue is well‐documented, including two randomised controlled trials.6 However, only a minority of patients with drug‐resistant focal epilepsy are evaluated and finally operated. Patients and professionals are often reluctant to consider epilepsy surgery as it is not without risk, although the risk of fatal or permanent morbidity is small.11 Here, we present the results of the Danish epilepsy surgery programme from 2009 to 2014.

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