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Updated: Jan 15, 2026
Stereo-Electro-Encephalo-Graphy SEEG With Robotic Assistance in the Presurgical Evaluation of Medical Refractory Epilepsy: A Technical Note
Published on: June 13, 2016
Seizure outcomes in persons with autism spectrum disorder undergoing epilepsy surgery: A systematic review and
Varun R Subramaniam1,2, Jonathan Goldstein1,3, Ali Rafati4
1Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Objectives:
Autism spectrum disorder (ASD) and epilepsy commonly co-occur. Surgical interventions are viable treatment options for individuals with drug-resistant epilepsy. However, past research in patients with ASD and epilepsy has yielded mixed results regarding seizure outcomes following epilepsy surgery.
Methods:
We adhered to the Preferred Reporting Item for Systematic reviews and Meta-Analyses (PRISMA) standards. Medline, Embase, and PsycInfo were queried from inception to November 2024. Included studies reported seizure frequency following epilepsy surgery in persons with ASD. Forty-six studies reporting on 325 patients with ASD and epilepsy were included for analysis. A total of 137 patients underwent resective surgery, 167 underwent neuromodulation (138 vagus nerve stimulation [VNS], 27 responsive neurostimulation [RNS], 2 deep brain stimulation [DBS]), and 21 underwent other palliative procedures (17 corpus callosotomy and 4 laser interstitial thermal therapy). Outcomes were stratified into four categories based on a combination of Engel classification and percentage seizure reduction at latest follow-up.
Results:
Resections yielded seizure freedom in 54% of patients, whereas neuromodulation led to >80% seizure reduction in 33.5% of patients. The incidence proportion of seizure freedom after surgery was higher in patients with MRI abnormalities was .55 (95% confidence interval [CI]: .34-.75) vs patients without MRI abnormalities (.19, 95% CI: .01-.81). Incidence proportion of seizure freedom after temporal resection was .80 (95% CI: .50-.94) vs .66 (95% CI: .48-.80) for extratemporal resection. Improvement in neuropsychiatric or quality of life outcomes was reported in the majority of patients after surgery.
Significance:
Our study provides the most comprehensive review to date of epilepsy surgery in ASD. Based on past work, there is potential for properly selected patients with ASD and epilepsy to experience a significant reduction in seizure frequency or seizure freedom, as well as improved quality of life, following epilepsy surgery.
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