Authors :
Presenting Author: Pavel Pichardo-Rojas, MD – University of Texas Health Science Center at Houston
Aldo Barrón Lomelí, MS – Universidad Nacional Autónoma de México; Yoshua Esquenazi, MD – University of Texas Health Science Center; Ernesto Gutierrez Herrera, MS – Universidad Autónoma de Baja California; Amir Hjeala Varas, MS – Universidad Católica Boliviana “San Pablo” Regional Santa Cruz; Diego Pichardo Rojas, MS – Universidad Autónoma de Baja California; Roberto Sanchez Velez, MS – Universidad Católica de Santiago de Guayaquil; Nitin Tandon, MD – University of Texas Health Science Center; Mario Torres Chávez, MS – Universidad Autónoma de Baja California; Oswaldo Torres Madrid Palacios, MS – Universidad Del Valle de Atemajac; Carlos Zarate, MD – Universidad Autónoma de Baja California
Rationale:
The utilization of stereo-electroencephalography-guided radiofrequency thermocoagulation (sEEG-guided RF-TC) in patients with drug-resistant epilepsy (DRE) remains controversial due to inconsistent findings regarding seizure outcomes across the available literature. Thus, an updated meta-analysis is warranted to provide a more comprehensive and reliable assessment of sEEG-guided RF-TC in patients with DRE.
Methods:
Databases were searched until May 28th, 2023, to identify published studies reporting on the effectiveness of sEEG-guided RF-TC in patients with DRE. The primary outcomes of interest were the percentage of patients who were seizure-free at one year and the percentage of patients who had at least a 50% seizure reduction at one year. These outcomes were pooled using the inverse variance, logit transformation of proportions, and a random-effects model was fit to the resulting data.
Results:
Initially, 187 articles were identified, and, after applying the inclusion criteria, a total of 10 retrospective studies involving 401 patients were included. The pooled seizure-free rate after one year was found to be 24% (95% Confidence Interval [CI] [12.3%,41.5%]) (Figure 1), while the seizure reduction rate after one year was 56.2% (95% CI [41%,70.3%]) (Figure 2). However, there was a high degree of statistical heterogeneity among the included studies.
Conclusions:
The existing evidence regarding the efficacy of sEEG-guided RF-TC in patients with DRE remains limited. To gain a deeper understanding of the impact and effectiveness of sEEG-guided RF-TC, well-designed randomized controlled trials are needed. Such studies would provide valuable guidance in determining the necessity of more invasive surgical approaches. Future research should focus on directly comparing the outcomes of sEEG-guided RF-TC with more traditional surgical approaches such as open resections and ablations in individuals with DRE.
Funding:
No external funding was required for this research study.