Associations between testing and treatment pathways in lesional temporal or extratemporal epilepsy: A census survey of NAEC center directors.
drug-resistant epilepsy (DRE)
epilepsy surgery
temporal lobe epilepsy (TLE)
Journal
Epilepsia
ISSN: 1528-1167
Titre abrégé: Epilepsia
Pays: United States
ID NLM: 2983306R
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
revised:
17
01
2023
received:
12
10
2022
accepted:
17
01
2023
medline:
14
4
2023
pubmed:
20
1
2023
entrez:
19
1
2023
Statut:
ppublish
Résumé
The evaluation to determine candidacy and treatment for epilepsy surgery in persons with drug-resistant epilepsy (DRE) is not uniform. Many non-invasive and invasive tests are available to ascertain an appropriate treatment strategy. This study examines expert response to clinical vignettes of magnetic resonance imaging (MRI)-positive lesional focal cortical dysplasia in both temporal and extratemporal epilepsy to identify associations in evaluations and treatment choice. We analyzed annual report data and a supplemental epilepsy practice survey reported in 2020 from 206 adult and 136 pediatric epilepsy center directors in the United States. Non-invasive and invasive testing and surgical treatment strategies were compiled for the two scenarios. We used chi-square tests to compare testing utilization between the two scenarios. Multivariable logistic regression modeling was performed to assess associations between variables. The supplemental survey response rate was 100% with 342 responses included in the analyses. Differing testing and treatment approaches were noted between the temporal and extratemporal scenarios such as chronic invasive monitoring selected in 60% of the temporal scenario versus 93% of the extratemporal scenario. Open resection was the most common treatment choice; however, overall treatment choices varied significantly (p < .001). Associations between non-invasive testing, invasive testing, and treatment choices were present in both scenarios. For example, in the temporal scenario stereo-electroencephalography (SEEG) was more commonly associated with fluorodeoxyglucose-positron emission tomography (FDG-PET) (odds ratio [OR] 1.85; 95% confidence interval [CI] 1.06-3.29; p = .033), magnetoencephalography (MEG) (OR 2.90; 95% CI 1.60-5.28; p = <.001), high density (HD) EEG (OR 2.80; 95% CI 1.27-6.24; p = .011), functional MRI (fMRI) (OR 2.17; 95% CI 1.19-4.10; p = .014), and Wada (OR 2.16; 95% CI 1.28-3.66; p = .004). In the extratemporal scenario, choosing SEEG was associated with increased odds of neuromodulation over open resection (OR 3.13; 95% CI 1.24-7.89; p = .016). In clinical vignettes of temporal and extratemporal lesional DRE, epilepsy center directors displayed varying patterns of non-invasive testing, invasive testing, and treatment choices. Differences in practice underscore the need for comparative trials for the surgical management of DRE.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
821-830Informations de copyright
© 2023 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.
Références
Zack MM, Kobau R. National and state estimates of the numbers of adults and children with active epilepsy - United States, 2015. MMWR Morb Mortal Wkly Rep. 2017;66(31):821-5.
Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med. 2000;342(5):314-9.
Taylor RS, Sander JW, Taylor RJ, Baker GA. Predictors of health-related quality of life and costs in adults with epilepsy: a systematic review: quality of life and costs in epilepsy. Epilepsia. 2011;52(12):2168-80.
Ryvlin P, Cross JH, Rheims S. Epilepsy surgery in children and adults. Lancet Neurol. 2014;13(11):1114-26.
Ostendorf AP, Ahrens SM, Lado FA, Arnold ST, Bai S, Bensalem Owen MK, et al. United States epilepsy center characteristics: a data analysis from the National Association of epilepsy centers. Neurology. 2021;98:e449-58. https://doi.org/10.1212/WNL.0000000000013130
Rosenow F, Bast T, Czech T, Feucht M, Hans VH, Helmstaedter C, et al. Revised version of quality guidelines for presurgical epilepsy evaluation and surgical epilepsy therapy issued by the Austrian, German, and swiss working group on presurgical epilepsy diagnosis and operative epilepsy treatment. Epilepsia. 2016;57(8):1215-20.
Bernasconi A, Cendes F, Theodore WH, Gill RS, Koepp MJ, Hogan RE, et al. Recommendations for the use of structural magnetic resonance imaging in the care of patients with epilepsy: a consensus report from the international league against epilepsy neuroimaging task force. Epilepsia. 2019;60(6):1054-68.
Guerrini R, Scerrati M, Rubboli G, Esposito V, Colicchio G, Cossu M, et al. Commission for Epilepsy Surgery of the Italian league against epilepsy. Overview of presurgical assessment and surgical treatment of epilepsy from the Italian league against epilepsy. Epilepsia. 2013;54(Suppl 7):35-48.
Jayakar P, Gaillard WD, Tripathi M, Libenson MH, Mathern GW, Cross JH, et al. Diagnostic test utilization in evaluation for resective epilepsy surgery in children. Epilepsia. 2014;55(4):507-18.
Gaillard WD, Cross JH, Duncan JS, Stefan H, Theodore WH, Task Force on Practice Parameter Imaging Guidelines for International League Against Epilepsy, Commission for Diagnostics. Epilepsy imaging study guideline criteria: commentary on diagnostic testing study guidelines and practice parameters. Epilepsia. 2011;52(9):1750-6.
Arredondo KH, Ahrens SA, Bagic A, Bai S, Chapman KE, Ciliberto MA, et al. Relationships between National Association of epilepsy centers member characteristics and volumes of epilepsy surgery types. Neurology. 2022. https://doi.org/10.1212/WNL.0000000000201526.
Ahrens SM, Arredondo KH, Bagić AI, Bai S, Chapman KE, Ciliberto MA, et al. Epilepsy center characteristics and geographic region influence presurgical testing in the United States. Epilepsia. 2022;64(1):127-38.
Labiner DM, Bagic AI, Herman ST, Fountain NB, Walczak TS, Gumnit RJ, et al. Essential services, personnel, and facilities in specialized epilepsy centers-revised 2010 guidelines: guidelines for specialized epilepsy centers. Epilepsia. 2010;51(11):2322-33.
Ahrens SM, Ostendorf AP, Lado FA, Arnold ST, Bai S, Bensalem Owen MK, et al. Impact of the COVID-19 epidemic on epilepsy center practice in the United States. Neurology. 2022;98:e1893-901. https://doi.org/10.1212/WNL.0000000000200285
Jones AL, Cascino GD. Evidence on use of neuroimaging for surgical treatment of temporal lobe epilepsy: a systematic review. JAMA Neurol. 2016;73(4):464-70.
Kwon CS, Chang EF, Jetté N. Cost-effectiveness of advanced imaging Technologies in the Presurgical Workup of epilepsy. Epilepsy Curr. 2020;20(1):7-11.
Desai A, Bekelis K, Thadani VM, Roberts DW, Jobst BC, Duhaime AC, et al. Interictal PET and ictal subtraction SPECT: sensitivity in the detection of seizure foci in patients with medically intractable epilepsy. Epilepsia. 2013;54(2):341-50.
Graham D, Tisdall MM, Gill D. Corpus callosotomy outcomes in pediatric patients: a systematic review. Epilepsia. 2016;57(7):1053-68.
Ryvlin P, Rheims S, Hirsch LJ, Sokolov A, Jehi L. Neuromodulation in epilepsy: state-of-the-art approved therapies. Lancet Neurol. 2021;20(12):1038-47.
Ghaffari-Rafi A, Leon-Rojas J. Investigatory pathway and principles of patient selection for epilepsy surgery candidates: a systematic review. BMC Neurol. 2020;20(1):100.
Peterson K, LaRoche S, Cummings T, Woodard V, Moise AM, Munger CH. Addressing the epilepsy surgery gap: impact of community/tertiary epilepsy center collaboration. Epilepsy Behav Rep. 2020;14:100398.
Kaur K, Garg A, Tripathi M, Chandra SP, Singh G, Viswanathan V, et al. Comparative contribution of magnetoencephalography (MEG) and single-photon emission computed tomography (SPECT) in pre-operative localization for epilepsy surgery: a prospective blinded study. Seizure. 2021;86:181-8.
Vinton AB, Carne R, Hicks RJ, Desmond PM, Kilpatrick C, Kaye AH, et al. The extent of resection of FDG-PET hypometabolism relates to outcome of temporal lobectomy. Brain. 2007;130(Pt 2):548-60.
Dwivedi R, Ramanujam B, Chandra PS, Sapra S, Gulati S, Kalaivani M, et al. Surgery for drug-resistant epilepsy in children. N Engl J Med. 2017;377(17):1639-47.
McCarus SD, Wiercinski K, Heidrich N. Shared decision-making to improve patient engagement in minimally invasive hysterectomy. Surg Technol Int. 2019;34:265-8.
Marathe K, Alim-Marvasti A, Dahele K, Xiao F, Buck S, O'Keeffe AG, et al. Resective, ablative and radiosurgical interventions for drug resistant mesial temporal lobe epilepsy: a systematic review and meta-analysis of outcomes. Front Neurol. 2021;12:777845.