Authors' objectives:

To provide an overview of the epidemiology, methods for diagnosis and status of surgical treatment for epilepsy in Sweden and make recommendations.

Authors' results and conclusions: About 5-10% of Swedes will, at some time, experience a suspected epileptic seizure that is investigated. About 70% of the 100,000 Swedes with repeated seizure take pharmaceuticals for seizure control. In many cases this medication is inadequate and has severe side effects.

Authors' recommendations: In cases where seizures cannot be controlled by medication, neurosurgery is considered. There are no scientifically rigorous studies of surgical treatment for epilepsy, but based on clinical experience, results of surgery are found to be good or very good. Regardless of the type of treatment, epilepsy patients require extensive habilitation, rehabilitation and social support. Surgical treatment of epilepsy requires a well integrated, specialised team of personnel including neurologists, neurosurgeons, neuropsychiatrists, social workers, occupational therapists and remedial teachers, all with special training in epilepsy. Further resources should be allocated to the treatment of epilepsy in Sweden. There is a large need for investigation and specialised treatment of epilepsy. Approximately 100 additional patients per year should be investigated for possible epilepsy surgery in Sweden. All cases of epilepsy that have not become seizure free following traditional therapy should be investigated at the regional level within a neurology subspecialty. About one half of serious epilepsy cases investigated at a specialised department are suitable for surgical treatment. Resources for epilepsy surgery should be increased at a centre with specialised knowledge to operate on at least 15-20 cases per surgical team per year and not more than 30 cases as a maximum load. The goal for additional resources should be up to four centres for investigation and three centres for surgery at regional hospitals. Habilitation and rehabilitation resources must also be provided for cases not suited for surgery. It is important that neuropaediatrics, and paediatric rehabilitation resources are well established in Sweden because a large proportion of patients eligible for investigation and surgery are children. It is desirable to dedicate more research to epilepsy, particularly for children.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.sbu.se/Published

Year Published: 1991

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Sweden

Organisation Name: Swedish Agency for Health Technology Assessment and Assessment of Social Services

Contact Address: P.O. Box 3657, SE-103 59 Stockholm, Sweden. Tel: +46 8 4123200, Fax: +46 8 4113260

Contact Name: registrator@sbu.se

Contact Email: registrator@sbu.se

Copyright: The Swedish Council on Technology Assessment in Health Care