Evidence map›Paper›PMID 40719747›Full record

ArticleEpilepsia2025

Trends in epilepsy surgery in Italy before and after the COVID-19 pandemic: A nationwide study.

Giuseppe Didato, Federico Vigevano, Laura Tassi, Renzo Guerrini, Marco de Curtis, Luca De Palma, Giancarlo Di Gennaro, Lino Nobili, Matteo Martinoni, Stefano Meletti and 41 more

Abstract read
In one paragraph

Article in Epilepsia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Mapping integrated care for brain tumour-related epilepsy in the Italian RIN-IRCCS network.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

51 authors.

Giuseppe DidatoEpilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.ORCID https://orcid.org/0000-0002-4812-6310
Federico VigevanoDepartment of Paediatric Neurorehabilitation, IRCCS San Raffaele, Rome, Italy.ORCID https://orcid.org/0000-0001-7513-0051
Laura Tassi"C. Munari" Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy.
Renzo GuerriniPediatric Neurology Unit, Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS, Florence, Italy.ORCID https://orcid.org/0000-0002-7272-7079
Marco de CurtisEpilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.ORCID https://orcid.org/0000-0001-7443-6737
Luca De PalmaNeurology, Epilepsy and Movement Disorders Unit, Bambino Gesù Children's Hospital, IRCCS, Full Member of European Reference Network EpiCARE, Rome, Italy.
Giancarlo Di GennaroIRCCS NEUROMED, Pozzilli, Italy.
Lino NobiliChild Neuropsychiatry Unit, Full Member of European Reference Network EpiCARE, IRCCS Istituto Giannina Gaslini, Genoa, Italy.ORCID https://orcid.org/0000-0001-9317-5405
Matteo MartinoniDivision of Neurosurgery, IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy.
Stefano MelettiDepartment of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.ORCID https://orcid.org/0000-0003-0334-539X
Domenica BattagliaPediatric Neurology, Department of Woman and Child Health and Public Health, Child Health Area, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy.
Elisabetta CesaroniU.O.Child Neurology and Psychiatric Unit, Pediatric Hospital G. Salesi, AOU delle Marche, Ancona, Italy.
Roberta VittoriniSSD Neurologia Pediatrica, AOU Città Della Salute e Della Scienza di Torino, Turin, Italy.
Laura GrisottoDepartment of Environmental Science and Prevention, University of Ferrara, Ferrara, Italy.
Giuseppe d'OrsiNeurology Unit, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, FG, Italy.
Robertino DilenaNeurophysiopathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Valeria PingueDepartment of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.ORCID https://orcid.org/0000-0001-9376-4699
Antonio NardoneDepartment of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
Federica RanzatoCentro per la Diagnosi e Il Trattamento Delle Epilessie, Vicenza, Italy.
Claudio ZuccaClinical Neurophysiology Unit, Scientific Institute IRCCS E. Medea, Bosisio Parini, Italy.
Paolo BonanniEpilepsy and Clinical Neurophysiology Unit, Scientific Institute, IRCCS Eugenio Medea, Treviso, Italy.
Pietro MattioliDepartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genova, Genoa, Italy.
Gianpiero TamburriniPediatric Neurosurgery, Institute of Neurosurgery, Fondazione Policlinico Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Michela QuintilianiPediatric Neurology, Department of Woman and Child Health and Public Health, Child Health Area, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy.ORCID https://orcid.org/0000-0002-8278-6953
Michele LuziDepartment of Hospital Neurosurgery, AOU Ospedali Riuniti, Ancona, Italy.
Roberto TrignaniDepartment of Hospital Neurosurgery, AOU Ospedali Riuniti, Ancona, Italy.
Francesca TortaSSD Neurologia Pediatrica, AOU Città Della Salute e Della Scienza di Torino, Turin, Italy.
Giovanni MoranaDivision of Neuroradiology, Department of Diagnostic Imaging and Radiotherapy, "Città Della Salute E Della Scienza" University Hospital, Turin, Italy.
Matteo PugnaghiNeuroscience Department, Neurophysiology Unit and Epilepsy Centre, AOU Modena, Modena, Italy.
Anna Elisabetta VaudanoDepartment of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Francesca BisulliIRCCS Istituto Delle Scienze Neurologiche di Bologna, Full Member of the European Reference Network for Rare and Complex Epilepsies EpiCARE, Bologna, Italy.ORCID https://orcid.org/0000-0002-1109-7296
Elena PasiniIRCCS Istituto Delle Scienze Neurologiche di Bologna, Full Member of the European Reference Network for Rare and Complex Epilepsies EpiCARE, Bologna, Italy.ORCID https://orcid.org/0000-0001-6298-455X
Alessandro ConsalesDepartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genova, Genoa, Italy.ORCID https://orcid.org/0000-0002-4354-6906
Giulia NobileChild Neuropsychiatry Unit, Full Member of European Reference Network EpiCARE, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Vincenzo EspositoIRCCS NEUROMED, Pozzilli, Italy.
Pier Paolo QuaratoIRCCS NEUROMED, Pozzilli, Italy.
Elena FreriDepartment of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Carlo Efisio MarrasNeurosurgery Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Flavio GiordanoPediatric Neurology Unit, Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS, Florence, Italy.
Veronica Pelliccia"C. Munari" Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy.
Laura Castana"C. Munari" Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy.
Nicola SpecchioNeurology, Epilepsy and Movement Disorders Unit, Bambino Gesù Children's Hospital, IRCCS, Full Member of European Reference Network EpiCARE, Rome, Italy.ORCID https://orcid.org/0000-0002-8120-0287
Umberto CostantinoNeurology Unit, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, FG, Italy.ORCID https://orcid.org/0000-0003-2325-4137
Mauro PluderiUnit of Neurosurgery, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Michele RizziFunctional Neurosurgery Unit, Department of Neurosurgery Fondazione, IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.ORCID https://orcid.org/0000-0002-7936-6536
Diana PoloCentro per la Diagnosi e Il Trattamento Delle Epilessie, Vicenza, Italy.
Stefania ZambranoClinical Neurophysiology Unit, Scientific Institute IRCCS E. Medea, Bosisio Parini, Italy.
Alberto DanieliEpilepsy and Clinical Neurophysiology Unit, Scientific Institute, IRCCS Eugenio Medea, Treviso, Italy.
Flavio VillaniDivision of Neurophysiology and Epilepsy Centre, IRCCS San Martino Policlinic Hospital, Genoa, Italy.
Carmen BarbaPediatric Neurology Unit, Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS, Florence, Italy.ORCID https://orcid.org/0000-0001-5445-5842
Italian Epilepsy Surgery Collaborative Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo study the current practice of epilepsy surgery in Italy and the relative impact of coronavirus disease 2019 (COVID-19) pandemic on it.

methodsWe launched a survey through the Italian National Virtual Epilepsy Institute, to identify centers with epilepsy surgery programs and collect data on the current preoperative and surgical practices. We reported changes in surgical volumes and complications and seizure outcomes between 2018 and 2022, that is, before and after the COVID-19 pandemic in Italy.

resultsA total of 21 of the 26 surveyed centers (80.7%) responded. Eleven centers (52.4%) reported having an established epilepsy surgery program, with most performing complex procedures, such as multilobar, disconnective, and hemispheric interventions. However, only a few carry out minimally invasive surgeries. Presurgical evaluation protocols vary across centers, but in keeping with international standards. Globally, 618 surgeries were performed in children and 621 in adults (total 1239) between 2018 and 2022. The most frequent type of surgery was unilobar extratemporal lobectomy for children (38.7%, p < 0.0001) and unilobar temporal lobectomy for adults (63.3%, p < 0.0001). Hemispheric surgeries were more frequent in children than in adults (11.5% vs 2.1%, p = 0.001), whereas interventions in unrevealing magnetic resonance (MRI) cases were more frequent in adults than in children (p = 0.030). At the onset of COVID-19outbreak in Italy (March 2020), we observed a significant decrease in the total number of operations compared to 2019, especially for hemispheric interventions (p = 0.027). Surgical volumes resumed in 2021, particularly for temporal lobe epilepsies and in adult cohorts. Surgical complications increased significantly in 2020 (Incidence Rate Ratio [IRR] = 13.13), whereas seizure outcome did not change significantly between 2018 and 2022. SIGNIFICANCE: Advanced pre- and postsurgical evaluation protocols are currently implemented across Italy, with a great variability between centers. Starting in 2021, epilepsy surgery volumes have regained their pre-pandemic levels, albeit with a slight loss of complexity, whereas seizure outcome has remained stable.

Indexed as

COVID-19EpilepsyNeurosurgical ProceduresAdultChildFemaleHumansItalyMalePostoperative ComplicationsSurveys and Questionnairesadultschildrenoutcomesurgical volumessurvey

Identifiers

PMID40719747
PMCPMC12661257

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.