|Jerome Engel, Jr.
|Walter van Emde Boas
Amsterdam, The Netherlands
New Hampshire, USA
- To advise the ILAE Executive Committee with regard to epilepsy surgery.
- 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 Against Epilepsy.
- To liaise with other ILAE commissions:
- ILAE Commission on Therapeutic Strategies.
- Subcommission on Epilepsy Surgery (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.
- Subcommission on projects related to the Global Campaign and the burden of epilepsy.
- Subcommission on the implementation of adequate therapy, including neurosurgery, in developing countries with the Commission on Pediatrics.
- Subcommission on Surgery and Pre-surgical Evaluation with the Commission on Psychobiology.
- Subcommission on Surgery with the Latin American Commission.
- Subcommission for Epilepsy Surgery.
Commission Activities from June 30, 2004 until August 31, 2005
- The Commission started to reexamine goals and finished some projects.
- The position paper of the Subcommission on Pediatric Epilepsy Surgery (meeting 9-11 October 2003 in Dordogne, France) has been approved by the Commission and is ready for submission to Epilepsia.
- Evaluation of the roles of radiosurgery for epilepsy and of deep brain stimulation (ongoing).
- Support of and participation in the ILAE Epilepsy Human Tissue Network (ILAE-EPITINET; see proposal of Roberto Spreafico, 10 February 2003) (ongoing).
- High priority is assigned to demonstration projects for epilepsy surgery in developing countries. Pete Engel was appointed to lead this subcommission and will coordinate further activities in close collaboration with the Global Campaign and WHO and with Peter Williamson, who is involved in several ongoing projects in South and Central America that should remain incorporated in the activities of the subcommission and linked to the proposed demonstration projects.
The Commission had business meetings in New Orleans (December 2004) and Paris (August 2005).
The chairperson attended the strategic meeting of the chairpersons of all ILAE Commissions in New Orleans (December 2004). The Commission organized a parallel session on Towards a Consensus Defining the Epileptogenic Zone (Participants: HO Lüders, P Kahane; SS Spencer HG Wieser: Chair J Engel, Jr. – see Epilepsia 2005; 46(Suppl.6):44-45.
- Subcommissions/Working Groups (chaired by):
- Subcommission on Callosotomy (John Gates)
- Subcommission on Vagal Nerve Stimulation (Paul Boon)
- Subcommission on Radiosurgery (Jean Regis)
- Subcommission on Pediatric Epilepsy Surgery (Helen Cross)
- Subcommission on Epilepsy Surgery in Countries with Emerging Economies (Jerome Engel)
- Working Group on MEG (Christoph Baumgartner)
- Working Group on Multiple Subpial Transsection (Gates, Tanaka, Polkey).
Members of one or more Subcommissions/Working Groups: Christian Elger, Eleanor Ben Menachim, Susan Spencer, Jean Regis, Oskar Schröttner, Youssef Comair, Hermann Stefan, Johannes Schramm.
Publications: Commission on Neurosurgery of the International League Against Epilepsy (ILAE) 1997- 2001: Wieser HG, Blume WT, Fish D, Goldensohn E, Hufnagel A, King D, Sperling MR, Lüders H, Pedley T. Proposal for a New Classification of Outcome with Respect to Epileptic Seizures Following Epilepsy Surgery. Epilepsia 2001; 42:282-286.
Wieser HG (for the ILAE Commission on Neurosurgery of Epilepsy). Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis. Epilepsia. 2004;45:695-714.
Wieser HG (for the ILAE Commission on Neurosurgery). Surgery for Epilepsy. ILAE Annual Report 2004: 24-27.
Recommendations for Future Work
It is proposed that the Commission on Neurosurgery is allowed to continue its present activities (as outlined in the minutes of the Paris 2005 Business Meeting).
The Commission proposes that G Mathern be accepted as chair. If accepted he will discuss with the EC the expected activities of the commission and its subcommissions and working groups and the question whether and how possible new members should be appointed/invited. The present members all are willing to continue to participate in the Commission’s activities.
The Subcommission on Pediatric Epilepsy Surgery intends to continue its activities in its present form and membership with the specific goal to present at the end of their four-year tenure the results of a prospective assessment of pediatric epilepsy surgery worldwide, and to provide guidelines, protocols, outcome measures and medical technology assessment regarding all aspects of epilepsy surgery in children.
The Working Group on MEG plans to conduct a survey on the various applications of MEG in the diagnosis and clinical or scientific evaluation of patients with epilepsy, including its applications for cognitive or functional assessment, as compared to other investigational techniques. Results from this survey will be available within the four-year period.
The Subcommission on VNS and CC intends to replicate its previous activities by a new extended survey of current VNS practice worldwide, including indications, patient selection, number of patients (adults and children), subgroups, protocols and outcome, a more specific project to be submitted by Boon to the Commission and the EC at short notice. The name of the subcommission should be changed, with CC being deleted.
Continuation of the activities of the Subcommission on Radiosurgery will be a point of discussion.
There is a clear need for continuation of the activities of the Subcommision on Epilepsy Surgery in the Developing Countries but there may be shift from operational activities to consultant and educational activities, depending on further developments within the regional commissions of the ILAE and the GCAE. Further projects/activities of the subcommission are to be formulated. Dr Bhaskara Rao (currently in Bharain) has prepared a project related to this topic.
The issue of deep brain stimulation is one other possible project for the new commission period and the same goes for further specific activities on the issue of multiple subpial transsection and for the creation of a new workgroup for the neuropsychological and psychiatric aspects of epilepsy surgery.
Heinz Gregor Wieser,