Ordinal Score Predicts Freedom From Epilepsy One Year After Surgery

TUESDAY, Nov. 5, 2024 (HealthDay News) — An ordinal score incorporating eight independent binary clinical variables shows good performance for predicting seizure freedom one year after surgery for mesial temporal lobe epilepsy, according to a study published in the September issue of the Annals of Clinical and Translational Neurology.

Adam S. Dickey, M.D., Ph.D., from Emory University in Atlanta, and colleagues predicted one-year seizure freedom using a combination of eight relevant clinical variables. The analysis included 101 patients undergoing stereotactic laser amygdalohippocampotomy (SLAH) for mesial temporal lobe epilepsy.

The researchers found that significant predictors for seizure freedom were evidence of mesial temporal sclerosis and unitemporal interictal discharges in a univariate analysis. The ordinal SCORE model, built using a 0- to 8-point ordinal score awarding 1 point for each binary predictor, had a significantly higher area under the curve (AUC, 0.70) than the other three models: mesial temporal sclerosis (AUC, 0.54), FULL, using all eight binary predictors (AUC, 0.62), or Akaike information criteria, using backwards selection of variables (AUC, 0.53).

“Our overall conclusion is that the concordance of multiple clinical datapoints better predicts seizure freedom after SLAH than any one datapoint alone,” the authors write. “Future research will incorporate additional data — such as semiology and neuropsychological profile — into the ordinal score described here.”

Several authors disclosed ties to Medtronic, and SLAH was performed using a Medtronic laser ablation system.

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