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Only 1% of severe epilepsy patients get surgery in Korea
  • By Song Soo-youn
  • Published 2019.08.09 13:48
  • Updated 2019.08.09 13:48
  • comments 0

Most Korean patients with severe epilepsy -- except for 1.3 percent of them -- cannot receive surgery because local hospitals do not have the right equipment, experts said.

Korean Epilepsy Society (KES) on Thursday released an interim report commissioned by the National Medical Center for public health research.

Magnetoencephalography (MEG) used in epilepsy surgery (Credit: Korean Epilepsy Society)

According to KES’ analysis on the data of the Health Insurance Review and Assessment Service (HIRA), the nation has about 360,000 epilepsy patients. About 100,000 of them have drug-refractory epilepsy where medicines can not control seizures.

Patients with intractable epilepsy should consider receiving surgery because anticonvulsants do not eliminate their symptoms. Severely drug-refractory epilepsy, which makes it difficult to lead a normal life, urgently needs surgery. In Korea, 37,225 patients have severely drug-refractory epilepsy.

Among them, 22,335 have been diagnosed as patients requiring surgery. Epilepsy surgery can cure 71.6 percent of patients but only about 300 people, of only 1.3 percent, receive surgery a year in Korea.

KES attributes the problem to the lack of the right equipment. In an epilepsy operation, physicians need magnetoencephalography (MEG), stereoelectroencephalography (SEEG) robotic surgery system, and laser interstitial thermal therapy (LITT). However, none of them is available in Korea, KES said.

MEG is state-of-the-art diagnostic equipment for measuring the magnetism generated by the cranial nerve cells. There are 179 MEGs around the world. Since there is no MEG in Korea, patients with severely drug-refractory epilepsy have to visit Kyoto University Hospital in Japan for a test.

MEG costs about 3 billion won ($24.8 million), and KES said Korea needs three or four MEGs.

SEEG-assisted surgeries are considered to be safe and effective. In the U.S. and Europe, over 70 percent of epilepsy surgeries use SEEG. As of April, there were 146 SEEG robotic surgery systems.

There is no SEEG robotic system in Korea, so the operation takes more than twice as much time, and the accuracy is lower, KES said. SEEG robotic system costs about 1 billion won per unit.

LITT is the latest surgical equipment that drills a small hole in the skull without opening it and removes epileptic lesions by endoscopy. There are 215 LITT in the world but none in Korea. The machine costs about 500 million won.

“Over 4,000 patients with drug-refractory epilepsy get a test every year, but only 300 get surgery. Epilepsy is a common disease occurring in all age groups from zero to 100 years old, but Korea is surely an underdeveloped country in the treatment of intractable epilepsy,” KES said.

The society went on to say that if the government supports only 5 billion won, severe epilepsy patients can receive surgery without going to Japan or the U.S.

“The government supports several trillion won for dementia treatment. The number of epilepsy patients is half that of dementia patients. I hope the government could provide even a hundredth of dementia support for epilepsy treatment,” KES added.

soo331@docdocdoc.co.kr

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