{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T14:57:26Z","timestamp":1785855446310,"version":"3.56.0"},"reference-count":32,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To study the current practice of epilepsy surgery in Italy and the relative impact of coronavirus disease 2019 (COVID\u201019) pandemic on it.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We 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\u201019 pandemic in Italy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A 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%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) and unilobar temporal lobectomy for adults (63.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Hemispheric surgeries were more frequent in children than in adults (11.5% vs 2.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), whereas interventions in unrevealing magnetic resonance (MRI) cases were more frequent in adults than in children (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.030). At the onset of COVID\u201019outbreak in Italy (March 2020), we observed a significant decrease in the total number of operations compared to 2019, especially for hemispheric interventions (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027). Surgical volumes resumed in 2021, particularly for temporal lobe epilepsies and in adult cohorts. Surgical complications increased significantly in 2020 (Incidence Rate Ratio [IRR]\u2009=\u200913.13), whereas seizure outcome did not change significantly between 2018 and 2022.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Advanced pre\u2010 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\u2010pandemic levels, albeit with a slight loss of complexity, whereas seizure outcome has remained stable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.18558","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T14:34:48Z","timestamp":1753713288000},"page":"4183-4197","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Trends in epilepsy surgery in Italy before and after the COVID\u201019 pandemic: A nationwide study"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4812-6310","authenticated-orcid":false,"given":"Giuseppe","family":"Didato","sequence":"first","affiliation":[{"name":"Epilepsy Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7513-0051","authenticated-orcid":false,"given":"Federico","family":"Vigevano","sequence":"additional","affiliation":[{"name":"Department of Paediatric Neurorehabilitation IRCCS San Raffaele  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Tassi","sequence":"additional","affiliation":[{"name":"\u201cC. Munari\u201d Epilepsy Surgery Center Niguarda Hospital  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7272-7079","authenticated-orcid":false,"given":"Renzo","family":"Guerrini","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Unit, Neuroscience and Human Genetics Department Meyer Children's Hospital IRCCS  Florence Italy"},{"name":"Neurofarba Department University of Florence  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7443-6737","authenticated-orcid":false,"given":"Marco","family":"de Curtis","sequence":"additional","affiliation":[{"name":"Epilepsy Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"De Palma","sequence":"additional","affiliation":[{"name":"Neurology, Epilepsy and Movement Disorders Unit Bambino Ges\u00f9 Children's Hospital, IRCCS, Full Member of European Reference Network EpiCARE  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giancarlo","family":"Di Gennaro","sequence":"additional","affiliation":[{"name":"IRCCS NEUROMED  Pozzilli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9317-5405","authenticated-orcid":false,"given":"Lino","family":"Nobili","sequence":"additional","affiliation":[{"name":"Child Neuropsychiatry Unit Full Member of European Reference Network EpiCARE, IRCCS Istituto Giannina Gaslini  Genoa Italy"},{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI) University of Genova  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Martinoni","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery IRCCS Istituto Delle Scienze Neurologiche di Bologna  Bologna Italy"},{"name":"IRCCS Istituto Delle Scienze Neurologiche di Bologna Full Member of the European Reference Network for Rare and Complex Epilepsies EpiCARE  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0334-539X","authenticated-orcid":false,"given":"Stefano","family":"Meletti","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Metabolic, and Neural Sciences University of Modena and Reggio Emilia  Modena Italy"},{"name":"Neuroscience Department, Neurophysiology Unit and Epilepsy Centre AOU Modena  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenica","family":"Battaglia","sequence":"additional","affiliation":[{"name":"Pediatric Neurology, Department of Woman and Child Health and Public Health, Child Health Area Fondazione Policlinico Universitario Agostino Gemelli, IRCCS  Rome Italy"},{"name":"Catholic University of the Sacred Heart  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Cesaroni","sequence":"additional","affiliation":[{"name":"U.O.Child Neurology and Psychiatric Unit, Pediatric Hospital G. 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