The epidemiology of drug-resistant epilepsy: A systematic review and meta-analysis

Epilepsia ◽  
2018 ◽  
Vol 59 (12) ◽  
pp. 2179-2193 ◽  
Author(s):  
Linda Kalilani ◽  
Xuezheng Sun ◽  
Barbara Pelgrims ◽  
Matthias Noack-Rink ◽  
Vicente Villanueva
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy

scholarly journals A protocol of systematic review and meta-analysis of Mozart's Music for drug-resistant epilepsy

Medicine ◽  
2020 ◽  
Vol 99 (29) ◽  
pp. e21090
Author(s):  
Ke-Jian Wang ◽  
Shi-Hua Zhang ◽  
Jia-Nan Yu ◽  
Guang-Tao Sun ◽  
Shu-Xin Dong
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy

Seizure Outcome After Surgery for MRI-Diagnosed Focal Cortical Dysplasia: A Systematic Review and Meta-analysis

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013066
Author(s):  
Anna Willard ◽  
Ana Antonic-Baker ◽  
Zhibin Chen ◽  
Terence John O'Brien ◽  
Patrick Kwan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Focal Cortical Dysplasia ◽  
Meta Analysis ◽  
Cortical Dysplasia ◽  
Favorable Outcome ◽  
Seizure Outcome ◽  
Drug Resistant ◽  
Resective Surgery ◽  
Post Surgery ◽  
Drug Resistant Epilepsy

Objective:Focal cortical dysplasia (FCD) has been associated with poorer post-surgical seizure outcomes compared to other pathologies. FCD surgical series have been assembled on the basis of a histological diagnosis, including patients with abnormal as well as normal pre-operative MRI. However, in clinical workflow, patient selection for surgery is based on pre-operative findings, including MRI. We performed a systematic review and meta-analysis of the literature to determine the rate and predictors of favorable seizure outcome after surgery for MRI-detected FCD.Methods:We devised our study protocol in accordance with PRISMA guidelines and registered the protocol with PROSPERO. We searched MEDLINE, EMBASE, and Web of Science for studies of patients followed for ≥12 months after resective surgery for drug-resistant epilepsy with MRI-detected FCD. Random-effects meta-analysis was used to calculate the proportion of patients attaining a favorable outcome, defined as Engel Class I, ILAE Classes 1-2, or “seizure-free” status. Meta-regression was performed to investigate sources of heterogeneity.Results:Our search identified 3,745 references. Of these, 35 studies (total of 1,353 patients) were included. Most studies (89%) followed patients for ≥24 months post-surgery. The overall post-surgical favorable outcome rate was 70% (95% CI: 64-75). There was high inter-study heterogeneity. Favorable outcome was associated with complete resection of the FCD lesion [risk ratio, RR=2.42 (95% CI: 1.55-3.76), p<0.001] and location of the FCD lesion in the temporal lobe [RR=1.38 (95% CI: 1.07-1.79), p=0013], but not lesion extent, intracranial EEG use, or FCD histological type. The number of FCD histological types included in the same study accounted for 7.6% of the observed heterogeneity.Conclusions:70% of patients with drug-resistant epilepsy and MRI features of FCD attain a favorable seizure outcome following resective surgery. Our findings can be incorporated in routine pre-operative counselling and reinforce the importance of resecting completely the MRI-detected FCD where this is safe and feasible.

scholarly journals A protocol of systematic review and meta-analysis of acupuncture for drug resistant epilepsy

Medicine ◽  
2020 ◽  
Vol 99 (28) ◽  
pp. e21073
Author(s):  
Ze-Yu Wang ◽  
Yao-Jia Jiang ◽  
Zeng-Mian Wang ◽  
Ming-Yu Ren
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy

scholarly journals P.023 Neurostimulation in Drug-Resistant Epilepsy: Systematic Review and Meta-Analysis from the ILAE Evidence-Based Epilepsy Surgery Task Force

2021 ◽  
Vol 48 (s3) ◽  
pp. S26-S26
Author(s):  
L Touma ◽  
B Dansereau ◽  
D Englot ◽  
MR Keezer
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Meta Analysis ◽  
Case Series ◽  
Current Evidence ◽  
Drug Resistant ◽  
Seizure Reduction ◽  
Drug Resistant Epilepsy

Background: Drug-resistant epilepsy (DRE) can affect up to one third of individuals with epilepsy. We conducted a systematic review and meta-analysis of vagus nerve stimulation (VNS), responsive neurostimulation (RNS), and deep brain stimulation (DBS) in patients with DRE to summarize the current evidence on efficacy and tolerability for these neuromodulation modalities. Methods: We searched three online databases with a pre-specified search strategy. We included published randomized controlled trials (RCT) and their open-label extension studies, as well as prospective case series, with samples greater than 20 participants, reporting efficacy and tolerability. Results: We identified 31 studies, six of which are RCTs and 25 prospective observational studies. At long term follow-up, five observational studies for VNS reported a pooled mean decrease in seizure frequency at last follow-up of 35%. In the extension studies for RNS, the median seizure reduction was 53%, 66% and 75.0% at two, five and nine years respectively. For DBS, the median reduction was then 56%, 69% and 75% at two, five and seven years respectively. Conclusions: Neurostimulation modalities are effective for the treatment of DRE, with improving outcomes over time and few major complications. Higher quality long-term data on DBS and RNS suggest larger seizure reduction rates than VNS.

scholarly journals Efficacy and safety of VNS therapy or continued medication management for treatment of adults with drug-resistant epilepsy: systematic review and meta-analysis

2022 ◽  
Author(s):  
Sarah Batson ◽  
Rohit Shankar ◽  
Joan Conry ◽  
Jane Boggs ◽  
Rodney Radtke ◽  
...  
Keyword(s):  
Systematic Review ◽  
Seizure Frequency ◽  
Meta Analysis ◽  
Medication Management ◽  
Cochrane Library ◽  
Seizure Freedom ◽  
Drug Resistant ◽  
Serious Adverse Events ◽  
Drug Resistant Epilepsy ◽  
The Cochrane Library

AbstractVagus nerve stimulation (VNS) Therapy® is an adjunctive neurostimulation treatment for people with drug-resistant epilepsy (DRE) who are unwilling to undergo resective surgery, have had unsuccessful surgery or are unsuitable for surgery. A systematic review and meta-analysis were conducted to determine the treatment effects of VNS Therapy as an adjunct to anti-seizure medications (ASMs) for the management of adults with DRE. A literature search was performed in August 2020 of the Medline®, Medline® Epub Ahead of Print, Embase, and the Cochrane library databases. Outcomes examined included reduction in seizure frequency, seizure freedom, ASM load, discontinuations, and serious adverse events (SAEs). Comparators included best medical practice, ASMs, low-stimulation or sham VNS Therapy. Four RCTs and six comparative observational studies were identified for inclusion. Against comparators, individuals treated with VNS had a significantly better odds of experiencing a ≥ 50% reduction in seizure frequency (OR: 2.27 [95% CI 1.47, 3.51]; p = 0.0002), a ≥ 75% reduction in seizure frequency (OR: 3.56 [95% CI 1.59, 7.98]; p = 0.002) and a reduced risk for increased ASM load (risk ratio: 0.36 [95% CI 0.21, 0.62]; p = 0.0002). There was no difference in the odds of discontinuation or the rate of SAEs between VNS versus comparators. This meta-analysis demonstrated the benefits of VNS Therapy in people with DRE, which included improvement in seizure frequency without an increase in the rate of SAEs or discontinuations, thereby supporting the consideration of VNS Therapy for people who are not responding to ASMs and those unsuitable or unwilling to undergo surgery.

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