Seizure Semiology as a Tool for Epilepsy Presurgical Evaluation: Building the SemioBrain Atlas from a Systematic Review of over 4000 Patients
Abstract number :
893
Submission category :
3. Neurophysiology / 3A. Video EEG Epilepsy-Monitoring
Year :
2020
Submission ID :
2423226
Source :
www.aesnet.org
Presentation date :
12/7/2020 1:26:24 PM
Published date :
Nov 21, 2020, 02:24 AM
Authors :
Gloria Romagnoli, University College London; Ali Alim-Marvasti - Wellcome / EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London; Fernando Pérez-García - University College London; Matthew Clarkson - Wellcome / EPSRC Ce
Rationale:
Seizure semiology is a non-invasive instrument to localise the symptomatogenic zone, which is generally close to, or overlapping the epileptogenic zone. The diagnostic pathway would benefit from a decision support tool to aid clinicians in deducing the epileptogenic zone from seizure semiology, as surgical resection of this area may be curative for up to 50% of patients with refractory focal epilepsy. We present the first Semiology-to-Brain (SemioBrain) Atlas, based on a systematic literature review reporting patient-based semiologies with proven localising and lateralising value.
Method:
The review was conducted by two independent clinical researchers, in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The literature search was performed in PubMed in January 2019, and produced, after filtering, a total of 1208 papers (PRISMA Flow Chart in Figure 1). The abstract screening included only articles containing original data from epilepsy patients. The full-text screening further narrowed down the selection to those subjects presenting focal semiologies, whose localising and/or lateralising value was established according to one or more of the following ground-truth criteria: 1) successful epilepsy surgery, leading to seizure-freedom at a minimum follow-up of 12 months; 2) intracranial video-EEG monitoring and/or electrical brain stimulation; 3) multimodal concordance of at least two structural and functional techniques, among EEG, magnetoencephalography, MRI, fMRI, PET, single-photon emission CT. We excluded those patients whose seizures were reported as: primary generalised; non-epileptic; described without providing information about semiology (e.g. simple partial seizure); defined with a poor inter-rater agreement (Kappa < 0.4, if provided); non-localising, due to inconclusive presurgical investigations or unsuccessful surgery (not caused by the partial resection of the epileptogenic zone); localising to multiple distant and/or bilateral foci or to a broad unspecific brain region (e.g. extra-temporal).
Neurophysiology