Consensus Guideline on the Management of Epilepsy in Egypt: A National Delphi Consensus Study

• Published in: Epilepsia open Vol. 9; no. 4; pp. 1233 - 1251
• Main Authors: Kishk, Nirmeen, Hosny, Hassan, Badry, Reda, Elmenshawi, Ibrahim, Hamdy, Mohamed M., Shaker, Ehab, Shehata, Hatem S., Magdy, Rehab, Ramzy, Gihan M., Hemeda, Mahmoud, Gaber, Ahmed, Abdelhamed, Mohamed, Abohagar, Ahmed, Yassine, Imane A., Abbas, Mohammed, Shaheen, Hala A., Abdel Moety, Mahmoud, Metwally, Hussein M. H., Saeed, Mohammad Ali, Essmat, Ahmed, Abdou, Ashraf, Soliman, Rasha Hassan, Oraby, Mohammed I., Morad, Abd El‐Naser, Kasem, Shaimaa Mohammed, Aidaros, Magdy, El Heneedy, Yasser, ElNemr, Ahmed, Elkady, Ahmed, Amin, Ramy, Abdel Ghany, Walid A., Morsy, Ahmed A., Hamdi, Hussein, Shamloul, Reham
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01-08-2024; John Wiley and Sons Inc; Wiley
• Subjects: Age groups; Anticonvulsants - therapeutic use; antiseizure medication; Classification; Conflicts of interest; Consensus; Convulsions & seizures; Curricula; Delphi method; Delphi Technique; Developing countries; Disease Management; drug resistant epilepsy; Egypt; Electroencephalography; Epilepsy; Epilepsy - diagnosis; Epilepsy - therapy; epilepsy surgery; Humans; LDCs; Original; Patients; Practice Guidelines as Topic; status epilepticus; Steering Committee; Egypt; consensus; epilepsy; epilepsy surgery; status epilepticus; Steering Committee; epilepsy diagnosis; Egypt; antiseizure medication; drug resistant epilepsy; Delphi method
• ISSN: 2470-9239; 2470-9239
• DOI: 10.1002/epi4.12922

Objective
In epilepsy, early diagnosis, accurate determination of epilepsy type, proper selection of antiseizure medication, and monitoring are all essential. However, despite recent therapeutic advances and conceptual reconsiderations in the classification and management of epilepsy, serious gaps are still encountered in day‐to‐day practice in Egypt as well as several other resource‐limited countries. Premature mortality, poor quality of life, socio‐economic burden, cognitive problems, poor treatment outcomes, and comorbidities are major challenges that require urgent actions to be implemented at all levels. In recognition of this, a group of Egyptian epilepsy experts met through a series of consecutive meetings to specify the main concepts concerning the diagnosis and management of epilepsy, with the ultimate goal of establishing a nationwide Egyptian consensus.
Methods
The consensus was developed through a modified Delphi methodology. A thorough review of the most recent relevant literature and international guidelines was performed to evaluate their applicability to the Egyptian situation. Afterward, several remote and live rounds were scheduled to reach a final agreement for all listed statements.
Results
Of 278 statements reviewed in the first round, 256 achieved ≥80% agreement. Live discussion and refinement of the 22 statements that did not reach consensus during the first round took place, followed by final live voting then consensus was achieved for all remaining statements.
Significance
With the implementation of these unified recommendations, we believe this will bring about substantial improvements in both the quality of care and treatment outcomes for persons with epilepsy in Egypt.
Plain Language Summary
This work represents the efforts of a group of medical experts to reach an agreement on the best medical practice related to people with epilepsy based on previously published recommendations while taking into consideration applicable options in resource‐limited countries. The publication of this document is expected to minimize many malpractice issues and pave the way for better healthcare services on both individual and governmental levels.