Fong, Si-Lei and Suppiah, Purnima Devi and Tee, Sow-Kuan and Khoo, Ching-Soong and Tan, Hui-Jan and Hung, Stefanie Kar-Yan and Looi, Irene and Lim, Kheng-Seang (2022) Seizure remission rates remain low in a resource-limited country, a multicentre comparison study in Malaysia. Journal of Clinical Neuroscience, 102. pp. 60-64. ISSN 0967-5868, DOI https://doi.org/10.1016/j.jocn.2022.05.028.
Full text not available from this repository.Abstract
Seizure remission rates of 60% with antiseizure medications were reported in developed countries, but might be lower in resource-limited countries. The challenges in epilepsy care in resource-limited regions were highlighted 10 years ago, and still remain an ongoing issue. This study aimed to determine the seizure freedom rates in level-2 epilepsy care centres (centres with general neurologists) compared to level-3/4 centres (centres with epileptologists providing epilepsy surgery evaluation) in Malaysia. This is a retrospective study of 1,347 adult epilepsy patients from two level-2 (n = 290) and two level-3/4 epilepsy care centres (n = 1,057). The seizure remission rates were significantly lower in level-2 centres (42.5%) compared to the level 3/4 centres (61.9%, p < 0.05). Level-2 centres had significantly more patients with undetermined seizure types compared to level-3/4 centres (6.6% vs 3.1%, p < 0.05). Level-3/4 centres had significantly more patients with epilepsy of structural and genetic origins, whereas more patients in level-2 centres had unknown aetiology (46.2% vs. 34.0% in level-3/4, p < 0.05). Level-2 centres had a lower neurologist-to-patient ratio (1:97 vs. 1:50 in level-3/4 centres, p < 0.05). Level-2 centres also had fewer patients, who underwent investigations such as EEG (74.1% vs. 89.6%) and brain MRI (54.1% vs. 72.4%, p < 0.05) in comparison with level-3/4 centres. Our study emphasized the existing challenges in epilepsy care in a resource-limited country to achieve the ideal 60% seizure remission rate.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | Epilepsy; Challenges; Seizure remission; Malaysia |
| Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry |
| Divisions: | Faculty of Medicine > Medicine Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 15 Oct 2023 12:42 |
| Last Modified: | 15 Oct 2023 12:44 |
| URI: | http://eprints.um.edu.my/id/eprint/41556 |
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