The development of Stereo-Electroencephalography (SEEG) in Southeast Asia and Oceania: Challenges to equity across the region

Fong MWK 1 , Lim KS 2 , Fong SL 3 , Chen C 4 , Kwan SY 5 , Lee CC 6 Show all authors , Suwanpakdee P 7 , Nagangchang C 8 , Le MT 9 , Khine YM 10 , Gill D 11 , Wong CH 12

Affiliations 

  • 1 Westmead Comprehensive Epilepsy Centre, The University of Sydney, Sydney, Australia; T.Y. Nelson Department of Neurology and Neurosurgery, The Childrens Hospital at Westmead, Sydney, Australia. Electronic address: m.fong@sydney.edu.au
  • 2 Division of Neurology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia. Electronic address: kslimum@gmail.com
  • 3 Division of Neurology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia. Electronic address: fongsilei@gmail.com
  • 4 Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan. Electronic address: cchien0604@gmail.com
  • 5 Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan. Electronic address: sykwan@vghtpe.gov.tw
  • 6 Department of Neurosurgery, Neurological Institute, Taipei Veterans, General Hospital 17F, No. 201, Shih.Pai Road, Sec. 2, Beitou, Taipei, Taiwan. Electronic address: yfnaughty@gmail.com
  • 7 Department of Pediatrics, Phramongkutklao Hospital, Bangkok, Thailand. Electronic address: annkiddi@gmail.com
  • 8 Department of Pediatrics, Phramongkutklao Hospital, Bangkok, Thailand. Electronic address: charcrin409@gmail.com
  • 9 Department of Neurology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam; Department of Neurology, Nguyen Tri Phuong Hospital, Ho Chi Minh City, Vietnam. Electronic address: minhan0402@gmail.com
  • 10 Neuromedical Department, University of Medicine, Yangon, Myanmar. Electronic address: khineyee@gmail.com
  • 11 Westmead Comprehensive Epilepsy Centre, The University of Sydney, Sydney, Australia; T.Y. Nelson Department of Neurology and Neurosurgery, The Childrens Hospital at Westmead, Sydney, Australia. Electronic address: Deepak.Gill@health.nsw.gov.au
  • 12 Westmead Comprehensive Epilepsy Centre, The University of Sydney, Sydney, Australia; T.Y. Nelson Department of Neurology and Neurosurgery, The Childrens Hospital at Westmead, Sydney, Australia. Electronic address: Chong.Wong@health.nsw.gov.au
Neurophysiol Clin, 2024 Dec 06;55(1):103033.
PMID: 39644808 DOI: 10.1016/j.neucli.2024.103033

Abstract

BACKGROUND: Invasive/ intracranial EEG forms an important component of assessment for epilepsy surgery in many patients with Drug-Resistant Epilepsy (DRE). Intracranial EEG has been poorly utilized though Southeast Asia (SEA) and Oceania. This study aimed to document the development of stereo-EEG (SEEG) across the region and highlight regional barriers to utilization and access.

METHODS: A survey was developed by multicenter consensus. The survey captured institutional characteristics, geographic distributions, intracranial EEG utilization, and barriers to SEEG. Respondents were representative epilepsy centers across the region.

RESULTS: Four epilepsy centers with established intracranial/ SEEG and two centers from a country without any access to SEEG participated. The responses identified that 1. Access to SEEG remained highly restricted across the region with an estimated one capable epilepsy center per 100 million people; 2. The region includes over half a billion people living in countries with no access to SEEG; 3. Staffing/ financial constraints were universal factors that limited growth of services or development of new services; 4. SEEG numbers have plateaued as a result of these challenges.

CONCLUSION: The study puts into real numbers the challenges faced by the region in accessing SEEG. SEEG remains highly underutilized and future approaches should focus on regional training and referral pathways.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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