A Nomogram to Predict Seizure Outcomes after Resective Epilepsy Surgery

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Project Summary: A patient currently considering epilepsy surgery receives counseling about his/her expected chances of seizure-freedom based on generic overall rates of success in large surgical cohorts. Answering the question of how “a patient like me” will do after surgery essentially depends on the physician's interpretation of complex pre-surgical testing: in fact, there is no objective, reproducible, and validated method to comprehensively combine the results of the pre-surgical work-up into an individualized outcome prediction. This uncertainty delays the initiation of surgical work-ups in patients who may benefit from epilepsy surgery, and may lead to redundant, risky, and futile testing in others who may actually not be good surgical candidates. This is a multi- center project building on an already developed statistical model, adding information from the fundamental components of any pre-surgical evaluation, including EEG, brain imaging, and clinical characteristics to develop an enhanced online tool called the “Epilepsy Surgery Nomogram” (ESN) allowing a tailored outcome prediction. Using the ESN, the physician treating a patient's epilepsy will be better able to assess the chances of seizure-freedom following epilepsy surgery, and will have a tool to assist decision-making by providing personalized and customized counseling. The goal will be to improve the care of patients with epilepsy by:1)- identifying surgical candidates earlier, and 2)- identifying complex cases needing a dedicated comprehensive epilepsy center more efficiently.