SEEG is an invasive procedure that requires a one-to-two-week hospital stay and comes with risk of infection, bleeding and stroke in 0.5-2 per cent of procedures. Furthermore, in up to 42 per cent of case series, SEEG does not result in an epilepsy surgical intervention as no focal epileptic focus can be identified. To reduce the amount of people undergoing an unnecessary SEEG, researchers studied epilepsy patients to determine if a series of non-invasive tests could predict which patients would not benefit from SEEG.
The team followed 128 patients at The Neuro who had SEEG, analyzing their demographic, clinical, electroencephalography, neuroimaging, and neuropsychological data. They developed a regression model based on different modalities, called the "5-SENSE-score", that differentiated patients whose SEEG identified a defined seizure source from those that did not. They then validated this score on a larger cohort of 207 patients from nine different tertiary epilepsy centres, finding that it reliably predicted the patients in whom SEEG was unable to identify a focal seizure onset zone.
"Many epilepsy centres face the challenging decision of whether a patient should undergo implantation for identifying a focal-seizure onset zone," says Dr. Birgit Frauscher, neurologist at The Neuro and the study's senior author. "The 5-SENSE-score provides an easily applicable tool to guide clinicians in predicting patients where SEEG is unlikely to identify a focal seizure onset zone. Patients unlikely to benefit from this invasive and resource-intensive procedure can then be identified earlier, avoiding unnecessary burden on patients and overutilization of hospital resources."
MEDICA-tradefair.com; Source: McGill University
