Diagnostic and prognostic value of noninvasive long ‐term video‐electroencephalographic monitoring in epilepsy surgery: A systematic review and meta‐analysis from the E‐PILEPSY consortium

SummaryObjectiveThe European Union –funded E‐PILEPSY network (now continuing within the European Reference Network for rare and complex epilepsies [EpiCARE]) aims to harmonize and optimize presurgical diagnostic procedures by creating and implementing evidence‐based guidelines across Europe. The present study evaluates the curr ent evidence on the diagnostic accuracy of long‐term video‐electroencephalographic monitoring (LTM) in identifying the epileptogenic zone in epilepsy surgery candidates.MethodsMEDLINE, Embase, CENTRAL, and ClinicalTrials.gov were searched for relevant articles. First, we used random ‐effects meta‐analytical models to calculate pooled estimates of sensitivity and specificity with respect to postsurgical seizure freedom. In a second phase, we analyzed individual patient data in an exploratory fashion, assessing diagnostic accuracy within lesional and nonlesional temporal lobe epilepsy (TLE) and extratemporal lobe epilepsy (ETLE) patients. We also evaluated seizure freedom rate in the presence of “localizing” or “nonlocalizing” LTM within each group. The quality of evidence was assessed using the QUADAS‐2 tool and the GRADE approach.ResultsNinety ‐four studies were eligible. Forty‐four were included in sensitivity meta‐analysis and 34 in specificity meta‐analysis. Pooled sensitivity was 0.70 (95% confidence interval [CI] = 0.60‐0.80) and specificity was 0.40 (95% CI = 0.27‐0.54). Subgroup analysis was based on individua...

Source: Epilepsia - November 22, 2018 Category: Neurology Authors: Teia Kobulashvili, Giorgi Kuchukhidze, Francesco Brigo, Georg Zimmermann, Julia H öfler, Markus Leitinger, Judith Dobesberger, Gudrun Kalss, Alexandra Rohracher, Caroline Neuray, Antonia Wakonig, Florian Ernst, Kees P. J. Braun, Brian E. Mou Tags: FULL ‐LENGTH ORIGINAL RESEARCH Source Type: research