Hemispherectomy Outcome Prediction Scale: Development and validation of a seizure freedom prediction tool

Publication

Hemispherectomy Outcome Prediction Scale: Development and validation of a seizure freedom prediction tool

Journal Paper/Review - Mar 13, 2021

Fallah Aria, Finet Patrice, Raftapoulos Christian, Pérez-Jiménez Maria Angeles, Budke Marcelo, Li Shao-Chun, Guo Qiang, Olivier Champagne Pierre, Yao Yi, Wang Feng-Peng, Hader Walter, Sarat Chandra Poodipedi, Tripathi Manjari, Lapalme-Remis Samuel, Wong-Kisiel Lily, Michel Pauline, Schaller Karl, Stienen Martin N., Pearl Phillip L, Bolton Jeffrey, Krayenbühl Niklaus, Al Otaibi Faisal, Al Khateeb Mashael, Gaillard William D, Oluigbo Chima, Vieker Silvia, von Lehe Marec, Muro Valeria L, Chamorro Noelia, Pociecha Juan, Cantillano Malone Christian, Baro Valentina, Weiner Howard L, Hidalgo Eveline Teresa, Dudley Roy, O'Neill Brent R, Smyth Matthew D, Mathern Gary W, Zhou Wen-Jing, Lin Jiu-Luan, Liu Qing-Zhu, Cai Li-Xin, Lin Kao-Min, Zhou Xinkai, Tseng Chi-Hong, Kola Olivia, Ibrahim George M, Lewis Evan C, Ragheb John, Bhatia Sanjiv, Delev Daniel, Zhang Kai, Zhang Jian-Guo, Steinbok Paul, Connelly Mary, Zhu Hongwei, Issabekov Galymzhan, Bollo Robert J, Czech Thomas, Feucht Martha, Dorfer Christian, Wang Anthony C, Ojemann Jeffrey, Zentner Josef, Ramantani Georgia, Weil Alexander G

Citation

Fallah A, Finet P, Raftapoulos C, Pérez-Jiménez M, Budke M, Li S, Guo Q, Olivier Champagne P, Yao Y, Wang F, Hader W, Sarat Chandra P, Tripathi M, Lapalme-Remis S, Wong-Kisiel L, Michel P, Schaller K, Stienen M, Pearl P, Bolton J, Krayenbühl N, Al Otaibi F, Al Khateeb M, Gaillard W, Oluigbo C, Vieker S, von Lehe M, Muro V, Chamorro N, Pociecha J, Cantillano Malone C, Baro V, Weiner H, Hidalgo E, Dudley R, O'Neill B, Smyth M, Mathern G, Zhou W, Lin J, Liu Q, Cai L, Lin K, Zhou X, Tseng C, Kola O, Ibrahim G, Lewis E, Ragheb J, Bhatia S, Delev D, Zhang K, Zhang J, Steinbok P, Connelly M, Zhu H, Issabekov G, Bollo R, Czech T, Feucht M, Dorfer C, Wang A, Ojemann J, Zentner J, Ramantani G, Weil A. Hemispherectomy Outcome Prediction Scale: Development and validation of a seizure freedom prediction tool. Epilepsia 2021

Type

Journal Paper/Review (English)

Journal

Epilepsia 2021

Publication Date

Mar 13, 2021

Issn Electronic

1528-1167

Brief description/objective

OBJECTIVE
To develop and validate a model to predict seizure freedom in children undergoing cerebral hemispheric surgery for the treatment of drug-resistant epilepsy.

METHODS
We analyzed 1267 hemispheric surgeries performed in pediatric participants across 32 centers and 12 countries to identify predictors of seizure freedom at 3 months after surgery. A multivariate logistic regression model was developed based on 70% of the dataset (training set) and validated on 30% of the dataset (validation set). Missing data were handled using multiple imputation techniques.

RESULTS
Overall, 817 of 1237 (66%) hemispheric surgeries led to seizure freedom (median follow-up = 24 months), and 1050 of 1237 (85%) were seizure-free at 12 months after surgery. A simple regression model containing age at seizure onset, presence of generalized seizure semiology, presence of contralateral 18-fluoro-2-deoxyglucose-positron emission tomography hypometabolism, etiologic substrate, and previous nonhemispheric resective surgery is predictive of seizure freedom (area under the curve = .72). A Hemispheric Surgery Outcome Prediction Scale (HOPS) score was devised that can be used to predict seizure freedom.

SIGNIFICANCE
Children most likely to benefit from hemispheric surgery can be selected and counseled through the implementation of a scale derived from a multiple regression model. Importantly, children who are unlikely to experience seizure control can be spared from the complications and deficits associated with this surgery. The HOPS score is likely to help physicians in clinical decision-making.