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Surges, Rainer; Alber, Michael; Bast, Thomas; Baier, Hartmut; Bien, Christian G.; Borggraefe, Ingo; Boesebeck, Frank; Brandl, Ulrich; Hamer, Hajo M.; Hethey, Sven; Holtkamp, Martin; Jacobs, Julia; Kellinghaus, Christoph; Kerling, Frank; Knake, Susanne; Kunze, Albrecht; Kurlemann, Gerhard; Laufs, Helmut; Lerche, Holger; Mayer, Thomas; Moeddel, Gabriel; Neubauer, Bernd. A.; Noachtar, Soheyl; Panzer, Axel; Podewils, Felix von; Polster, Tilman; Rona, Sabine; Rosenow, Felix; Schmitz, Bettina; Schulze-Bonhage, Andreas; Spiczak, Sarah von; Staudt, Martin; Steinhoff, Bernhard J.; Stephani, Ulrich; Stodieck, Stefan R. G.; Straub, Hans-Beatus; Strzelczyk, Adam; Wellmer, Jörg; Elger, Christian E. (2018): Aufgaben und Struktur moderner Epilepsiezentren in Deutschland. In: Aktuelle Neurologie, Vol. 45, No. 7: pp. 513-533
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Abstract

There are about 600,000 patients suffering from epilepsy in Germany. The variety of seizure-related symptoms, the heterogeneous aetiologies of epilepsies and the individual course of the disease complicate both the correct diagnosis and the selection of appropriate treatments (anticonvulsant drugs, epilepsy surgery, neurostimulation devices and dietary treatments). Furthermore, disease-specific risks and frequently associated comorbidities often have severe psychosocial consequences. Therefore, comprehensive care of people with epilepsy aims at full seizure control without or at least only with minor side effects, maintenance of quality of life, and control or relief of associated comorbidities and risks. Epilepsy centres are defined as referral competence centres that offer specialised expertise and infrastructure allowing comprehensive and interdisciplinary care of people with epilepsy and related diseases. This article summarizes the diagnostic and therapeutic challenges encountered in the care of people with epilepsy, describes the essential services, personnel and facilities in epilepsy centres and reviews the current reimbursement modalities via G-DRG in Germany. Furthermore, characteristics of selected German epilepsy centres are outlined and possible ways to improve care of epilepsy patients are discussed.