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  1. Article: Cost and cost-effectiveness of epilepsy surgery.

    Silfvenius, H

    Epilepsia

    1999  Volume 40 Suppl 8, Page(s) 32–39

    MeSH term(s) Adult ; Cerebral Cortex/surgery ; Child ; Cost of Illness ; Cost-Benefit Analysis ; Economics, Medical ; Employment ; Epilepsy/diagnosis ; Epilepsy/economics ; Epilepsy/surgery ; Epilepsy, Temporal Lobe/economics ; Epilepsy, Temporal Lobe/surgery ; Health Care Costs/statistics & numerical data ; Humans ; Outcome Assessment (Health Care) ; Palliative Care/economics ; Prognosis ; Quality of Life ; Temporal Lobe/surgery
    Language English
    Publishing date 1999
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 216382-2
    ISSN 1528-1167 ; 0013-9580
    ISSN (online) 1528-1167
    ISSN 0013-9580
    DOI 10.1111/j.1528-1157.1999.tb00945.x
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  2. Article: Cost-benefit of epilepsy surgery.

    Silfvenius, H

    Acta neurologica Belgica

    1999  Volume 99, Issue 4, Page(s) 266–274

    Abstract: A cost-benefit study of Epilepsy Surgery (ES) evaluates the monetary consequences of the societal gain by reduced production loss. High direct cost of ES has been addressed by suggesting simpler diagnostics, preference for certain investigations, and ... ...

    Abstract A cost-benefit study of Epilepsy Surgery (ES) evaluates the monetary consequences of the societal gain by reduced production loss. High direct cost of ES has been addressed by suggesting simpler diagnostics, preference for certain investigations, and weighing the direct cost against the postoperative savings. New MRI technology has simplified diagnostics and, currently, the surgical procedure is more accurate. A shortlasting procedure will reduce theater cost and hospitalization. Resective procedures achieve freedom from seizures in 45-90%. Postoperative worsening may be burdened by permanent morbidity, or may cause death. Re-operation, an extra direct cost, yields freedom from seizures in 45-50%, being thereby justified health economically. If ES stops seizures at the expense of impaired cognition, it is of limited help in restoring quality of life. In adults, surgery often is performed late, and the social status may have declined for the patient. Children with epilepsy and their families experience social restrictions difficult to normalize. A successful outcome unaccompanied by other improvement in life may turn into disappointment. Operated patients employed preoperatively continue to be so postoperatively, or maintain their employment which may also improve, an effect experienced even after a re-operation. But, a limited gain in employment after surgery has likewise been reported. Early surgery has a positive effect on education and occupation. The postoperative income of adults may increase significantly. Similarly, successful pediatric surgery is cost-effective for the child and the family. Using seizure free rate as effectiveness measure shows that ES is cheaper than AED treatment alone. The high cost for advanced diagnostics should be seen in a long-term perspective. The reduction in life long indirect cost after successful pediatric surgery has been evaluated.
    MeSH term(s) Cost-Benefit Analysis ; Epilepsy/economics ; Epilepsy/surgery ; Humans
    Language English
    Publishing date 1999-12
    Publishing country Italy
    Document type Journal Article ; Review
    ZDB-ID 127315-2
    ISSN 2240-2993 ; 0300-9009
    ISSN (online) 2240-2993
    ISSN 0300-9009
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  3. Article: Latest advances in epilepsy surgery.

    Silfvenius, H

    Acta neurologica Scandinavica. Supplementum

    1995  Volume 162, Page(s) 11–16

    Abstract: Recent advances in epilepsy surgery are a result of improved methods of assessment and diagnosis, a better understanding of seizures, the possibility of surgery at a younger age and the development of new surgical techniques. These factors have led to a ... ...

    Abstract Recent advances in epilepsy surgery are a result of improved methods of assessment and diagnosis, a better understanding of seizures, the possibility of surgery at a younger age and the development of new surgical techniques. These factors have led to a wider selection of candidates for epilepsy surgery and shorter treatment trials with anti-epilepsy drugs before surgery is considered. The psychosocial indications for surgery, however, are often not examined thoroughly enough. Epilepsy surgery shows the best results following temporal lobe excision, with 68% of patients becoming seizure-free and 24% showing an improvement. Extra-temporal surgery results in 45% of patients seizure-free and 35% improved. The results of epilepsy surgery in children are similar to those of adults, with 67% of children becoming seizure-free and 21% showing improvement, following successful extensive cortical excision for non-inflammatory lesions. The beneficial psychosocial-economic effects of epilepsy surgery are, however, seldom documented and more research is needed into methods of quantifying, in broader perspectives, the outcome of surgery.
    MeSH term(s) Adult ; Anticonvulsants/administration & dosage ; Anticonvulsants/adverse effects ; Child ; Combined Modality Therapy ; Electroencephalography ; Epilepsy/physiopathology ; Epilepsy/surgery ; Follow-Up Studies ; Humans ; Postoperative Complications/etiology ; Postoperative Complications/physiopathology ; Psychosurgery ; Temporal Lobe/physiopathology ; Temporal Lobe/surgery ; Treatment Outcome
    Chemical Substances Anticonvulsants
    Language English
    Publishing date 1995
    Publishing country Denmark
    Document type Journal Article ; Review
    ZDB-ID 1956-2
    ISSN 0065-1427
    ISSN 0065-1427
    DOI 10.1111/j.1600-0404.1995.tb00492.x
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  4. Article: Pre- and postoperative rehabilitation related to epilepsy surgery.

    Silfvenius, H

    Acta neurochirurgica. Supplementum

    1990  Volume 50, Page(s) 100–106

    Abstract: A short review is presented of the mental impairment and personality deficits of persons with severe epilepsy and of their consequences, that require psychosocial and occupational rehabilitation, as well as of some aspects of health economics related to ... ...

    Abstract A short review is presented of the mental impairment and personality deficits of persons with severe epilepsy and of their consequences, that require psychosocial and occupational rehabilitation, as well as of some aspects of health economics related to epilepsy surgery. It is concluded that detailed studies on the psychosocial outcome of epilepsy surgery are rather rare in the vast literature on epilepsy surgery, a situation that needs to be changed in order to promote better understanding of the therapeutic and palliative surgical treatment of epilepsy, to develop and broaden it, and to motivate more financial support from health authorities.
    MeSH term(s) Activities of Daily Living/psychology ; Epilepsies, Partial/rehabilitation ; Epilepsies, Partial/surgery ; Humans ; Neurocognitive Disorders/rehabilitation ; Neuropsychological Tests ; Personality Disorders/rehabilitation ; Postoperative Complications/rehabilitation ; Rehabilitation, Vocational/psychology ; Social Adjustment
    Language English
    Publishing date 1990
    Publishing country Austria
    Document type Journal Article ; Review
    DOI 10.1007/978-3-7091-9104-0_20
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  5. Article: Methods and results of epilepsy surgery.

    Silfvenius, H

    Acta neurologica Scandinavica. Supplementum

    1988  Volume 116, Page(s) 78–88

    MeSH term(s) Adult ; Cerebral Cortex/physiopathology ; Cerebral Cortex/surgery ; Child ; Electroencephalography ; Epilepsy/physiopathology ; Epilepsy/surgery ; Humans ; Middle Aged ; Neuropsychological Tests ; Neurosurgery/methods
    Language English
    Publishing date 1988
    Publishing country Denmark
    Document type Journal Article ; Review
    ZDB-ID 1956-2
    ISSN 0065-1427
    ISSN 0065-1427
    DOI 10.1111/j.1600-0404.1988.tb07988.x
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  6. Article: Economic costs of epilepsy--treatment benefits.

    Silfvenius, H

    Acta neurologica Scandinavica. Supplementum

    1988  Volume 117, Page(s) 136–154

    MeSH term(s) Adult ; Anticonvulsants/therapeutic use ; Child ; Costs and Cost Analysis ; Epilepsy/drug therapy ; Epilepsy/economics ; Epilepsy/mortality ; Epilepsy/surgery ; Female ; Hospitalization/economics ; Humans ; Male ; Psychological Tests ; Regional Medical Programs/economics ; Scandinavian and Nordic Countries ; United States
    Chemical Substances Anticonvulsants
    Language English
    Publishing date 1988
    Publishing country Denmark
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1956-2
    ISSN 0065-1427
    ISSN 0065-1427
    DOI 10.1111/j.1600-0404.1988.tb08015.x
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  7. Article: Overview: epilepsy surgery in developing countries.

    Wieser, H G / Silfvenius, H

    Epilepsia

    2000  Volume 41 Suppl 4, Page(s) S3–9

    Abstract: Epilepsy surgery (ES) is addressed in relation to economic classifications of national resources and welfare in developing countries. A decade ago, ten developing countries conducted ES; now 26 such countries have reported results of ES. A number of ... ...

    Abstract Epilepsy surgery (ES) is addressed in relation to economic classifications of national resources and welfare in developing countries. A decade ago, ten developing countries conducted ES; now 26 such countries have reported results of ES. A number of international authorities define indicators of national economic welfare. Adopting the economic classification of the International Monetary Fund. we find that ES is nonexistent in 98% of African countries, 76% of Asian countries, 58% of European countries, 82% of Middle East countries, and in 86% of countries of the Western Hemisphere. The 1980-1990 global ES survey conducted by the International League Against Epilepsy identified ten developing countries reporting ES (DCRES): Brazil, China, Czechoslovakia, Hungary, Mexico, Poland, Taiwan, the U.S.S.R., Yugoslavia, and Viet Nam. The present survey based on the proceedings of the 19th-23rd International Epilepsy Congresses and Medline reports from 1991 to November 1999 revealed at least 26 (18.3%) DCRES of 142 developing countries: Argentina, Brazil, Chile, China, Colombia, Czech Republic, Egypt, Estonia, Hungary, India, Iran, Israel, Korea, Lithuania, Mexico, P.R.China, the U.S.S.R., Singapore, Slovenia, South Africa, South Korea, Taiwan, Turkey, Ukraine, Uruguay, and former Yugoslavia. National vital statistics expose the hardships of developing countries. The population ratio of developed countries to developing countries is approximately 1:5. The reverse per capita Gross Domestic Product ratio is 20:1. Great disparities exist in vital statistics, all to the disadvantage of the DCRES. The World Health Organization defines health-related sectors geographically, then divides developing countries into several subgroups. Disability caused by length of disease and years lived with disability can be quantified monetarily for epilepsy, and the total health expenditures of developed and developing countries can be compared. The DCRES are short of technology, and their ES teams must choose from an excess of surgical candidates, investigating with computed tomography, magnetic resonance imaging, noninvasive video-electroencephalography, and neuropsychology. The surgical outcomes achieved are similar to those in the developed world, but at a fractional cost. To internationalize ES, outcome, cost, and savings from care, evolution of assessment methodology is needed. Also needed is general support from the developed world.
    MeSH term(s) Adolescent ; Adult ; Developed Countries/economics ; Developed Countries/statistics & numerical data ; Developing Countries/economics ; Developing Countries/statistics & numerical data ; Epilepsy/economics ; Epilepsy/mortality ; Epilepsy/surgery ; Female ; Health Care Costs ; Health Care Surveys/economics ; Health Care Surveys/statistics & numerical data ; Humans ; International Cooperation ; Male ; Outcome Assessment (Health Care) ; Vital Statistics ; World Health Organization
    Language English
    Publishing date 2000
    Publishing country United States
    Document type Journal Article
    ZDB-ID 216382-2
    ISSN 1528-1167 ; 0013-9580
    ISSN (online) 1528-1167
    ISSN 0013-9580
    DOI 10.1111/j.1528-1157.2000.tb01538.x
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  8. Article: World-wide disparities in epilepsy care: a Latin American outlook.

    Fandiño-Franky, J / Silfvenius, H

    Epilepsia

    1999  Volume 40 Suppl 8, Page(s) 48–54

    MeSH term(s) Anticonvulsants/economics ; Anticonvulsants/therapeutic use ; Cerebral Cortex/surgery ; Cost of Illness ; Delivery of Health Care/economics ; Delivery of Health Care/statistics & numerical data ; Developing Countries ; Direct Service Costs/statistics & numerical data ; Drug Costs/statistics & numerical data ; Epilepsy/economics ; Epilepsy/epidemiology ; Epilepsy/therapy ; Global Health ; Health Care Costs/statistics & numerical data ; Humans ; Latin America/epidemiology ; Phytotherapy ; Prevalence ; Social Class ; Surgicenters/statistics & numerical data
    Chemical Substances Anticonvulsants
    Language English
    Publishing date 1999
    Publishing country United States
    Document type Journal Article
    ZDB-ID 216382-2
    ISSN 1528-1167 ; 0013-9580
    ISSN (online) 1528-1167
    ISSN 0013-9580
    DOI 10.1111/j.1528-1157.1999.tb00948.x
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  9. Article: Hypothermia with air cooling in neurosurgical operations under ether anaesthesia.

    NIELSEN, K C / NORDSTROM, L / SILFVENIUS, H

    Acta anaesthesiologica Scandinavica. Supplementum

    2003  Volume 12, Page(s) 53–54

    MeSH term(s) Anesthesia ; Anesthesia, Inhalation ; Anesthesiology ; Ether ; Humans ; Hypothermia ; Hypothermia, Induced ; Neurosurgery
    Chemical Substances Ether (0F5N573A2Y)
    Language English
    Publishing date 2003-10-03
    Publishing country England
    Document type Journal Article
    ISSN 0515-2720
    ISSN 0515-2720
    DOI 10.1111/j.1399-6576.1962.tb00167.x
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  10. Article: EVALUATION OF INSULAR ABLATION IN SURGICAL TREATMENT OF TEMPORAL LOBE EPILEPSY.

    SILFVENIUS, H / GLOOR, P / RASMUSSEN, T

    Epilepsia

    2002  Volume 5, Page(s) 307–320

    MeSH term(s) Electroencephalography ; Epilepsy ; Epilepsy, Temporal Lobe ; Humans ; Neurosurgery ; Neurosurgical Procedures ; Postoperative Complications ; Temporal Lobe
    Language English
    Publishing date 2002-09-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 216382-2
    ISSN 1528-1167 ; 0013-9580
    ISSN (online) 1528-1167
    ISSN 0013-9580
    DOI 10.1111/j.1528-1157.1964.tb03338.x
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