| Chair & Contact Information:
Prof. H.G. Wieser
Neurologische Klinik und Poliklinik
Universitatsspital Zurich
Neurologische, Frauenklinikstrasse 26
CH-8091 Zurich, Switerland
Phone: +41 1 255 5531
Fax: +41 1 255 4429
E-mail:
Goals:
Previously Formulated Goals/Specific aims
- To improve epilepsy surgery around the world.
- To establish information on current and previous research in evaluating
the effectiveness and value of various forms of surgical treatment,
with particular emphasis on long-term outcome data and palliative
as well as "experimental" procedures.
- To identify areas of research that should be addressed by the
Commission.
- To assist the "Global Campaign".
- To liaise with the ILAE Commissions on Therapeutic Strategies
(Chair Richard Mattson) - Subcommission Epilepsy Surgery
(Claudio Munari+/ new liaison person shall be nominated) [Topics:
Minimal requirements for the evaluation of patients prior to specific
therapeutic interventions; Distribution of AEDs in surgical samples...etc...]
with the Burden of Epilepsy - Subcommission on Outcome Measures
(Chair Gus A Baker) and Subcommission on Projects related to
the Global Campaign (Chair JWA S Sander) with the Burden
of Epilepsy - Subcommission on the implementation of adequate therapy,
including neurosurgery in developing countries with the Commission
on Pediatrics (Chair B.Dalla Bernardina) - Subcommission
on Surgery and pre-surgical evaluation (Chair [Claudio Munari+]/
new liaison person shall be nominated) and the Working Group
Pharmaco-resistance which plans a Workshop around the European
Epilepsy Congress in Florence in 2000 with the Commission on
Psychobiology (Chair Michael Trimble) - Subcommission on
Surgery (Liaison person Bettina Schmitz; action taken by S.Koch-Stoecker/Bielefeld,
Germany)
The ILAE Commission for the Developing World
(Chair Rajendra Kale; Commission Members: Hasan Aziz/Pakistan; Michel
Dumas/France; Jaime Fandino Franky/Colobia; Peter Halasz/Hungary;
Byung-In-Lee/Korea; Antonia Martins da Silva/Portugal; JWAS Sander/UK)
There are liasions with the Commission on Diagnostic Strategies
(Chair Martha Morrell, liasion Walter v.Emde-Boas) and with Commission
on Therapeutic Strategies (Chair Richard Mattson; liasion [Claudio
Munari +], as well as Paulo de Bittencourt and Esat Eskazan).
Unfortunately Claudio Munari died unexpectedly
List of subcommissions
Subcommission Corpus callosum section (John Gates)
Subcommission Vagus nerve stimulation (Paul Boon)
Subcommission Multiple subpial transsection (Susan Spencer)
Subcommission Radiosurgery for intractable epilepsy (Jean Regis
- Charles Polkey)
Subcommission Paediatric epilepsy surgery (Hans Holthausen / Helen
Cross)
Subcommission Outcome classification from the point of view of epilepsy
surgery
(Heinz Gregor Wieser) Members: [Claudio Munari +], J.Engel, Walter
van Emde Boas. Hans Holthausen, Cigdem Oezkara, Susan Spencer Joint
Subcommission Epilepsy surgery in the developing world (Rajendra
Kale - H Gregor Wieser) Members: Walter van Emde Boas, Jaime Fandino-Franky,
Cigdem Oezkara, André Palmini, K. Radhakrishnan, Bhaskara
Rao Malla, Luisa Rocha, Herbert Silvenius, Peter D. Williamson
Meetings held by the Commission:
Dec 7, 1999 : CNE, Orlando
Sept 15, 1999: CNE, Prague
Sept 14, 1999, Prague Meeting " ILAE Joint Subcommission Epilepsy
Surgery in Developing Countries"
Status of reports and guidelines:
Commission on Neurosurgery of the International League against
Epilepsy
1. (ILAE): Recommended Standards. With minimal changes
this paper (formulated under the chairmenship of Charles Polkey
and Colin Binnie) is now agreed on and has been submitted to Epilepsia
for publication .
2. Outcome classification from the point of view of
epilepsy surgery: Wieser has prepared a proposal "Classification
of Outcome with Respect to Epileptic Seizures" which is the
summary of a Satellite Workshop held on June 26, 1998, Cleveland,
with the following participants: W.T.Blume, D.Fish, E.Goldensohn,
A.Hufnagel, D.King, H.Lüders, M.R.Sperling, H.G.Wieser. This
proposal was consequently discussed at the Dartmouth meeting between
Lüders, King and Wieser and further circulated, among others,
to J.Engel. It has been circulated among the members of the ILAE-CNE
together with the comments of J.Engel, and a subcommission has agreed
on it. It goes now to the ILAE Executive and possible publication
in Epilepsia.
Publications:
- Epilepsy Surgery in Developing Countries: The presentations
at the Roundtable Conference of the ILAE Commissions on Epilepsy
Surgery & Epilepsy Surgery in Developing Countries (organized
by H. Silfvenius and H.G.Wieser) and some input from the Business
Meeting of the ILAE Joint Subcommission on Epilepsy Surgery in
Developing World resulted in several selected manuscripts which
are presently edited by by H. Silfvenius and H.G.Wieser and ready
to be sent for publication as a Supplementum to Epilepsia
- The Liaison group to the European Federation of
Neurological Societies [EFNS] (Stefan, Wieser, Polkey) has stipulated
a position paper on Minimal Standards for Epilepsy Surgery based
on The "Recommended Standards" of the ILAE-CNE Commission
(submitted to the ILAE Executive and dealt with ultimately at the
Orlando Meeting)
- Presurgical Evaluation for Epilepsy Surgery - European
Standards" . [Task Force members: Christoph Baumgartner/Vienna,
Austria; Milan Bradzil/Brno, Czech Republic; Colin Binnie/London,
England; Oliver de la Lande/Paris, France; Mogens Dam/Aarhus, Denmark;
Jerzy Majkowski/ Warsaw, Poland; Charles Polkey/London, England;
Antonio Russi/Barcelona, Spain; Johannes Schramm/Bonn, Germany;
Hermann Stefan/Erlangen, Germany; Heinz Gregor Wieser/Zurich, Switzerland;
Aarne Ylinen/Kuopio, Finland]. The draft has been submitted to European
Neurology.
Contacts and interactions with other commissions:
Y. Comair, Beirut, Lebanon
J. Fandino-Franky, Cartagena, Colombia;
H.S. Hosny, Cairo, Egypt
Cigdem Oezkara, Turkey;
André Palmini, Porto Alegre, Brasil;
K. Radhakrishnan, Trivandrum, India;
M. Baskara Rao, Trivandrum, India;
Herbert Silfvenius, Umeå, Sweden;
V.P. Singh, AIIMS, Delhi, India;
Peter D. Williamson, Dartmouth, USA
Summary of your activities in the past year:
The work of several subcommissions working in the area Palliative
epilepsy surgery, including vagal nerve stimulation, callosal sections,
and multiple subpial transsections [Morrel-Whisler] resulted in
the following draft papers:
- Régis J, Roberts D, Bartolomei F, Rey M, Hayashi M, Dravet
C, Genton P, Bureau M, Gastaut J-L, Chauvel P, Peragut J-C. Role
of gamma knife surgery in the treatment of severe epilepsy (discussed
at Orlando)
- Boon P, Gates J. Vagus nerve stimulation for refractory epilepsy
(discussed at Orlando)
At the Orlando Meeting we took notice and discussed
the
- Proposal for evaluation of stereotactic radiosurgery in the treatment
of drug-resistant epilepsy (Polkey CE, Binnie CD, Oxbury J, Kerr
R, Kemeny A, Chadwick D, Duncan J)
and the paper of
- Pendl et al.: Corpus Callosotomy with radiosurgery. Neurosurgery
1999; 45:303-308
Plans for the coming year:
- Cigdem Oezkara‘s Meeting on MTLE
- Better definition of clinical epilepsy syndromes amenable to epilepsy
surgery (Cigdem Oezkara). A special Workshop is planned by Cigdem
Oezkara. A grant proposal has been submitted to ILAE for a satellite
Meeting in Turkey on MTLE (by Oezkara, supported by the Commission
CNE). This meeting will be held in 2000 provided that sufficient
money can be raised. Cigdem Oezkara is in contact with the main
Sponsor Sanofi. A Scientific Advisory Board has been nominated with
G.Avanzini, Jerome Engel, Michael Sperling and H Gregor Wieser
The place of Vagal Nerve Stimulation versus Callosal
Sections should be elaborated carefully by the nominated subcommission
(chaired by Paul Boon) works on the formulation of inclusion and
exclusion criteria of VNS. A liaison should be made with the Graz
group (Schröttner) using Gamma Knife for CC-tomy.
Multiple subpial transsections [Morrel-Whisler]: A
subcommission (chaired by Susan Spencer) started to work on the
compilation of MST cases. The goal is the formulation of inclusion
and exclusion criteria for MST.
-
Jean Regis and Charles Polkey have contacted representatives
of several epilepsy surgery programs to explore the possibility
for a randomized study "Gamma-Knife Surgery versus classical
Selective Amygdalohippocampectomy in MTLE
-
Special issues and a concrete plan action with
regard to Pediatric epilepsy surgery; Intractable childhood
epilepsy; and Migrational disorders (Hans Holthausen nominated
J.H. Cross/London) is expected.
H. G. Wieser
Chair
Annual Report 2000 Table of Contents
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