Predictors of longitudinal seizure outcomes after epilepsy surgery in childhood

Ka, Amy; Taher, Amir; D’Souza, Stephanie; Barnes, Elizabeth H; Gupta, Sachin; Troedson, Christopher; Wade, Fiona; Teo, Olga; Dale, Russell C.; Wong, Chong; Bleasel, Andrew; Dexter, Mark; Kothur, Kavitha; Gill, Deepak

doi:10.1016/j.ebr.2022.100561

Cited by 4 publications

(5 citation statements)

References 40 publications

(55 reference statements)

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“…Due to the extended timespan of the inclusion, MR techniques, pathological diagnostic criteria, and presurgical evaluation have evolved substantially during this period and, therefore, potential heterogeneity may occur. The seizure outcome in the present study is better than in previous studies 27–29 . As previous studies reported, the seizure freedom rate of FCD may decrease with the extension of the follow‐up time.…”

Section: Discussioncontrasting

confidence: 47%

“…The seizure outcome in the present study is better than in previous studies. 27 , 28 , 29 As previous studies reported, the seizure freedom rate of FCD may decrease with the extension of the follow‐up time. Some patients in this study have only been followed up for 1 year, and cannot obtain follow‐up results for 2 years or even longer, which may lead to bias in determining the seizure freedom rate.…”

Section: Discussionmentioning

confidence: 84%

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Multimodal non‐invasive evaluation in MRI‐negative epilepsy patients

Wang,

Huang,

Zhou

et al. 2024

Epilepsia Open

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Presurgical evaluation is still challenging for MRI‐negative epilepsy patients. As non‐invasive modalities are the easiest acceptable and economic methods in determining the epileptogenic zone, we analyzed the localization value of common non‐invasive methods in MRI‐negative epilepsy patients. In this study, we included epilepsy patients undergoing presurgical evaluation with presurgical negative MRI. MRI post‐processing was performed using a Morphometric Analysis Program (MAP) on T1‐weighted volumetric MRI. The relationship between MAP, magnetoencephalography (MEG), scalp electroencephalogram (EEG), and seizure outcomes was analyzed to figure out the localization value of different non‐invasive methods. Eighty‐six patients were included in this study. Complete resection of the MAP‐positive regions or the MEG‐positive regions was positively associated with seizure freedom (p = 0.028 and 0.007, respectively). When an area is co‐localized by MAP and MEG, the resection of the area was significantly associated with seizure freedom (p = 0.006). However, neither the EEG lateralization nor the EEG localization showed statistical association with the surgical outcome (p = 0.683 and 0.505, respectively). In conclusion, scalp EEG had a limited role in presurgical localization and predicting seizure outcome, combining MAP and MEG results can significantly improve the localization of epileptogenic lesions and have a positive association with seizure‐free outcome.Plain Language SummaryDue to the lack of obvious structure abnormalities on neuroimaging examinations, the identification of epilepsy lesions in MRI‐negative epilepsy patients can be difficult. In this study, we intended to use non‐invasive examinations to explore the potential epileptic lesions in MRI‐negative epilepsy patients and to determine the results accuracy by comparing the neuroimaging results with the epilepsy surgery outcomes. A total of 86 epilepsy patients without obvious structure lesions on MRI were included, and we found that the combinations of different non‐invasive examinations and neuroimaging post‐processing methods are significantly associated with the seizure freedom results of epilepsy surgery.

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Section: Discussioncontrasting

confidence: 47%

Section: Discussionmentioning

confidence: 84%

Multimodal non‐invasive evaluation in MRI‐negative epilepsy patients

Wang,

Huang,

Zhou

et al. 2024

Epilepsia Open

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“…In contrast, extratemporal FCD had a less than 50 % chance of being seizure free. Previous studies on pediatric epilepsy surgery report that 29–57 % of patients have focal temporal lobe epilepsy [4] , [11] , [26] . Similarly, studies on FCD have reported that 12–75 % of patients with FCD have temporal lesions, with worse overall outcomes seen in studies with a lower proportion of TLE FCD [14] , [20] , [27] .…”

Section: Discussionmentioning

confidence: 99%

“…Surgical treatment of such tumors historically has one of the highest favorable post-operative outcomes in epilepsy surgery, with 70–83 % of patients achieving seizure freedom [4] , [6] , [7] , [8] . Similarly, surgical resection of FCD is highly effective but has worse overall seizure outcomes, with 53–59 % of pediatric patients achieving seizure freedom [2] , [9] , [10] , [11] . Among pediatric epilepsy, strong predictive factors for favorable seizure outcomes following surgery are complete resection of the epileptogenic zone [6] , [9] , [12] and an abnormal preoperative MRI [12] , [13] .…”

Section: Introductionmentioning

confidence: 99%

Predictive factors for seizure freedom after epilepsy surgery for pediatric low-grade tumors and focal cortical dysplasia

Hornak,

Bolton,

Tsuboyama

et al. 2024

Epilepsy & Behavior Reports

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“…However, it should be considered that most epilepsy surgeries have been performed on the adult population with specific histopathologic features, and the long-term consequences of such surgeries are not usually devoid of unwanted consequences. Furthermore, in 7–35% of children, seizures recur with an increased duration of follow-up after epilepsy surgery [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Potential of Mesenchymal Stem Cells in the Treatment of Epilepsy and Their Interaction with Antiseizure Medications

Tesiye

Gol

Fadardi

et al. 2022

Cells

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Epilepsy is a life-threatening neurological disease that affects approximately 70 million people worldwide. Although the vast majority of patients may be successfully managed with currently used antiseizure medication (ASM), the search for alternative therapies is still necessary due to pharmacoresistance in about 30% of patients with epilepsy. Here, we review the effects of ASMs on stem cell treatment when they could be, as expected, co-administered. Indeed, it has been reported that ASMs produce significant effects on the differentiation and determination of stem cell fate. In addition, we discuss more recent findings on mesenchymal stem cells (MSCs) in pre-clinical and clinical investigations. In this regard, their ability to differentiate into various cell types, reach damaged tissues and produce and release biologically active molecules with immunomodulatory/anti-inflammatory and regenerative properties make them a high-potential therapeutic tool to address neuroinflammation in different neurological disorders, including epilepsy. Overall, the characteristics of MSCs to be genetically engineered, in order to replace dysfunctional elements with the aim of restoring normal tissue functioning, suggested that these cells could be good candidates for the treatment of epilepsy refractory to ASMs. Further research is required to understand the potential of stem cell treatment in epileptic patients and its interaction with ASMs.

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Predictors of longitudinal seizure outcomes after epilepsy surgery in childhood

Cited by 4 publications

References 40 publications

Multimodal non‐invasive evaluation in MRI‐negative epilepsy patients

Multimodal non‐invasive evaluation in MRI‐negative epilepsy patients

Predictive factors for seizure freedom after epilepsy surgery for pediatric low-grade tumors and focal cortical dysplasia

Therapeutic Potential of Mesenchymal Stem Cells in the Treatment of Epilepsy and Their Interaction with Antiseizure Medications

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