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Titolo:
THE CONTRIBUTION OF TERTIARY CENTERS TO THE QUALITY OF THE DIAGNOSIS AND TREATMENT OF EPILEPSY
Autore:
AVANZINI G; BINELLI S; FRANCESCHETTI S; GRANATA T; PANZICA F; CANGER R; CANEVINI MP; SGRO V; MONTANINI R; BASSO PF; ZACCHETTI O; BASSO F; CERNIBORI A; COSTA P; DEFANTI CA; BOATI E; ANTONINI L; GUARNERI B; MIRONI F; MARCHINI M; GUARNERI M; ARISI A; BEGHI E; BOGLIUN G; GUARESCHI A; LENTI C; VIANI F; ROMEO T; VIRI M; TARTARA A; GALIMBERTI CA; MANNI R;
Indirizzi:
MARIO NEGRI INST PHARMACOL RES,VIA ERITREA 62 I-20157 MILAN ITALY IST NEUROCHIRURG C BESTA I-20133 MILAN ITALY OSPED SAN PAOLO,CLIN NEUROL 1 MILAN ITALY OSPED S ANTONIO ABATE GALLARATE ITALY OSPED LECCO LECCO ITALY OSPED CIVILE SONDRIO ITALY OSPED RIUNITI BERGAMO,DIV NEUROL 1 I-24100 BERGAMO ITALY SPEDALI CIVIL BRESCIA I-25125 BRESCIA ITALY OSPED CARLO POMA MANTOVA ITALY OSPED CREMONA CREMONA ITALY OSPED SAN GERARDO MONZA ITALY UNIV MILAN MILAN ITALY REGINA ELENA MILAN ITALY FDN C MONDINO,NEUROL CLIN PAVIA ITALY
Titolo Testata:
Epilepsia
fascicolo: 12, volume: 38, anno: 1997,
pagine: 1338 - 1343
SICI:
0013-9580(1997)38:12<1338:TCOTCT>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTERNATIONAL-LEAGUE; CLASSIFICATION; SEIZURES; EXPERIENCE; REDUCTION;
Keywords:
EPILEPSY; AUDIT; DIAGNOSIS; CLASSIFICATION; TREATMENT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
21
Recensione:
Indirizzi per estratti:
Citazione:
G. Avanzini et al., "THE CONTRIBUTION OF TERTIARY CENTERS TO THE QUALITY OF THE DIAGNOSIS AND TREATMENT OF EPILEPSY", Epilepsia, 38(12), 1997, pp. 1338-1343

Abstract

Purpose: A survey was made of a network of 14 epilepsy centers in Italy to assess whether integrated diagnosis and treatment monitoring ledto a more precise syndromic classification of the patients and a better response to treatment.Methods: Data on the diagnosis and treatment of epilepsy and the degree of seizure control were recorded in a register on 2 separate occasions, on June 30, 1990 (t0), before starting the integrated activities, and on June 30, 1992 (t1), on completion of a2-year follow-up. Each patient's history was required to fit a specific category of the International Classification of the Epilepsies (ICE) (1). Response to treatment was classified as complete remission, occasional seizures, recurrent nonrefractory seizures, and drug-resistantepilepsy. A total of 3,469 patients of the ages of 4-80 years were enrolled. Results: At t0, 44% of cases had localization-related epilepsy, 31% generalized epilepsy, 9% undetermined epilepsy, 6% special syndromes, and 10% epileptic syndromes with atypical features. At t1, the percentages in each category were 51, 27, 7, 6, and 9%. The cases classified as ''other'' within each syndromic category at t0 were 11-23% and remained unchanged at t1. Patients with symptomatic localization-related epilepsies were largely recoded as symptomatic of cryptogenic epilepsies. About one-third of patients with symptomatic generalized epilepsy were recoded as localization-related epilepsies. Nine percent of patients were classified as ''uncertain'' epilepsies at t0, and the same proportion at t1. However, many ''uncertain'' diagnoses became ''definite'' and vice versa. Conclusions: There was a slight increase in the proportion of patients achieving complete remission (from 13 to 28%) and untreated patients (from 10 to 17%). Nine percent of patients unresponsive to treatment at t0 had achieved remission at t1. Drug resistance was confirmed in 78% of cases and was mostly independent of the therapeutic decision. Ten percent of cases achieved remission with unchanged or simplified treatment schedules.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 06:51:08