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Related Concept Videos

Epilepsy and Seizures: Overview01:24

Epilepsy and Seizures: Overview

1.2K
Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
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Related Experiment Video

Updated: Jan 23, 2026

A Pipeline for 3D Multimodality Image Integration and Computer-assisted Planning in Epilepsy Surgery
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Surgery for epilepsy.

Siobhan West1, Sarah J Nevitt, Jennifer Cotton

  • 1Department of Paediatric Neurology, Royal Manchester Children's Hospital, Hathersage Road, Manchester, UK, M13 0JH.

The Cochrane Database of Systematic Reviews
|June 26, 2019
PubMed
Summary
This summary is machine-generated.

Epilepsy surgery can cure focal epilepsy in up to 64% of patients, but evidence quality is limited. Identifying prognostic factors like abnormal MRI can improve patient selection for better seizure control.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Clinical Trials

Background:

  • Focal epilepsies stem from localized brain dysfunction, affecting 20-70% of individuals unresponsive to medication.
  • Surgical resection offers a potential cure for epilepsy if the epileptogenic zone is precisely identified.
  • This review updates evidence on epilepsy surgery outcomes, focusing on randomized controlled trials (RCTs).

Purpose of the Study:

  • To assess epilepsy surgery outcomes using evidence from randomized controlled trials (RCTs).
  • To evaluate outcomes based on non-randomized evidence.
  • To identify factors predicting seizure remission after surgery.

Main Methods:

  • Searched multiple databases including Cochrane Register of Studies, MEDLINE, and ClinicalTrials.gov up to March 2019.
  • Included RCTs with ≥30 participants, defined populations, MRI in ≥90%, and ≥1-year follow-up for seizure control outcomes.
  • Assessed study quality using EPHPP and QUIPS tools; extracted data on seizure control and prognostic factors.

Main Results:

  • 182 studies with 16,855 participants were analyzed; 9 RCTs were included, with high or unclear risk of bias.
  • Surgery was superior to medical treatment in 2 RCTs; other RCTs showed no significant differences for various surgical approaches.
  • 64% of 16,756 surgical patients achieved good seizure control; outcomes varied widely (13.5%-92.5%).
  • Positive prognostic factors included abnormal pre-operative MRI, complete resection, and mesial temporal sclerosis.
  • Data quality on adverse events was very poor.

Conclusions:

  • Limited evidence exists due to study design issues and insufficient information, hindering patient selection and outcome prediction.
  • Future research requires high-quality, prospective, and adequately powered studies focusing on diagnostic tools and surgical approaches.
  • Standardized reporting of prognostic factors using multivariable regression and adverse events is crucial for advancing epilepsy surgery.