Does Seizure Spread Impact IQ and the Interaction of Aeds Prescribed? A Preliminary Review of Pre-surgical Outcome Data
Abstract number :
3.315
Submission category :
9. Surgery / 9A. Adult
Year :
2022
Submission ID :
2204986
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:27 AM
Authors :
Isha Snehal, MD – University Of Nebraska Medical Center; Joshua Matyi, PhD – Department of Neurological Sciences, Neuropsychology – University Of Nebraska Medical Center; Matthew Garlinghouse, PhD – Assistant Professor, Department of Neurological sciences, Neuropsychology, University Of Nebraska Medical Center; Makayla Schissel, MPH – Department of Biostatistics – University Of Nebraska Medical Center; Olga Taraschenko, MD, PhD – Associate Professor, Director - Comprehensive Epilepsy Program, Neurology, University of Nebraska Medical Center
Rationale: Predicting odds of seizure freedom and risks for cognitive change post-surgically are major goals of advanced treatment for medically refractory epilepsy. Seizure recurrence after resection in focal epilepsy has been shown to be associated with wider seizure spread on pre surgical electroencephalograms(EEG) (JAMA Neurology.2019.76(4):462-469; Epilepsia. 2020.61(10):2163-2172). Inclusion of the area of early seizure spread in addition to that of ictal onset may result in an improved seizure control post-operatively (Epilepsia. 2010. 51(6):1010-1017). However, pre-surgically, it is unclear whether there a link between seizure spread, treatment factors such as number of anti-epileptic drugs (AEDs) prescribed, and patient’s performances on neuropsychological (NP) tests. We hypothesized that seizure spread in patients with focal epilepsy would be associated with lower NP test scores and higher number of prescribed AEDs.
Methods: Retrospective data were collected on 51 patients diagnosed with focal epilepsy, who underwent epilepsy surgery between 2008-2016. The dataset included results from Phase II or III pre surgical evaluations including: diagnosis, scalp EEG, intracranial EEG, MRI, MEG, number of AEDs, seizure spread, Engel and ILAE ratings and NP test scores. Descriptive statistics were used to summarize demographic and clinical data. Fisher’s Exact test, independent samples t-test and Kruskal -Wallis tests were used to assess for differences between different variables. All analysis were conducted in SAS version 9.4. P < 0.05 was considered statistically significant.
Surgery