Simple web-based applications can save patients from costly, invasive procedures

A new study from The Neuro (Montreal Neurological Institute–Hospital) and eight epilepsy centers working together has produced an easy-to-use web-based application that doctors can use to the prediction of which patients won’t benefit. This avoids unnecessary, invasive procedures, which saves time and frees up resources for health.

For those suffering from epilepsy that is drug-resistant surgery is the only method to treat seizures. When assessing patients for surgery, physicians must pinpoint the brain region the seizures originate from. The way to do this in patients with more complex epilepsy is through stereo-electroencephalography (SEEG), a technique by which a surgeon implants electrodes into the brain to find the source of the seizures.

SEEG is an invasive procedure that can require a one-to two-week hospital stay. There is a chance of bleeding, stroke and infection in 0.5-2 percent of procedures. SEEG is not a surgical procedure for epilepsy in 42 percent of cases. This is due to the fact that there is no epileptic focal point that can be determined. To decrease the number of people undergoing an unnecessary SEEG, researchers studied epilepsy patients to determine if a series of non-invasive tests could predict which patients will 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 devised an equation for regression based on different modalities, known as the “5-SENSE-score”, that differentiated patients whose SEEG revealed a specific seizure source from those who did not. They then validated this score using a larger sample of 207 patients from nine different tertiary epilepsy centres, finding that it reliably identified patients for whom SEEG was unable to identify the focal seizure onset area.

Many epilepsy centers face the daunting decision of whether to implant a patient in order to determine a focal seizure zone. The 5-SENSE-score is an effective tool that can be used to guide clinicians in predicting patients for whom SEEG is not likely. This allows for earlier identification of patients who are not likely to benefit from this invasive and resource-intensive procedure. This avoids unnecessary burden on patients and helps reduce the amount of time spent in hospitals.

Dr. Birgit Frauscher is a neurologist at The Neuro and the study’s principal author.

This study, published in the Journal of the American Medical Association on Dec. 6 2021, was supported by the Montreal Neurological Institute, the Fonds of Research du Quebec and the Fonds de Recherche du Quebec Sante, and the Austrian Chapter of the International League against Epilepsy.

Journal reference:

Astner-Rohracher, A., et al. (2021) Development and Validation of the 5-SENSE Score to Predict Focality of the Seizure-Onset Zone as Assessed by Stereoelectroencephalography. JAMA Neurology.

Content Source:

Gemma Wilson

Gemma is a journalism graduate with keen interest in covering business news – specifically startups. She has as a keen eye for technologies and has predicted quite a few successful startups over the last couple of years.

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