South Middlesex Times

A new scoring system developed by researchers at Rutgers Health and other institutions may assist doctors in predicting which patients are likely to become seizure-free following minimally invasive epilepsy surgery. The study, published in the Annals of Clinical and Translational Neurology, introduces a predictive model that could broaden access to surgical treatment for epilepsy, a neurological disorder causing recurring seizures.

Epilepsy affects nearly 3 million people in the United States, with about one-third not responding adequately to medications, according to the Centers for Disease Control and Prevention. For these patients, surgery to remove or disable the part of the brain causing seizures can be effective. However, predicting which patients will become seizure-free has been challenging.

The researchers based their model on data from 101 patients who underwent stereotactic laser amygdalohippocampotomy (SLAH), a procedure using laser interstitial thermal therapy (LITT) to target and disable a small area in the temporal lobe responsible for seizures in many patients.

"We've pried open the therapeutic window with this minimally invasive approach," said Robert Gross, senior author of the study and chair of the Department of Neurosurgery at Rutgers Robert Wood Johnson and New Jersey Medical School. "Now the question is, how well do we think the patients are going to do with the information we have before doing the procedure?"

The researchers identified eight clinical factors associated with a higher likelihood of becoming seizure-free after SLAH. These factors include patient history, certain MRI abnormalities, lesions, and febrile seizures.

Instead of complex statistical models, they created a simple ordinal score by assigning one point for each factor present. This method outperformed other predictive models based solely on MRI findings or more complex multivariate analyses.

"The concordance of multiple clinical data points better predicts seizure freedom after SLAH than any one data point alone," Gross said.

Patients scoring six or higher on an eight-point scale had a 70 percent to 80 percent chance of becoming seizure-free after SLAH—comparable with conventional open surgery success rates. Those with lower scores had progressively lower chances of positive outcomes.

Researchers also discovered that even patients without clear MRI evidence of scars in the brain’s temporal lobe could still be good candidates for SLAH if they had multiple other positive factors.

This approach could help expand access to surgical treatment for epilepsy, which experts say is underutilized due to fears surrounding cognitive side effects from invasive brain surgery. The less invasive nature of SLAH may make it more appealing if patients receive clearer success predictions.

Gross described using this scoring system with a recent patient: "I was able to go to this young woman and her mother and say, ‘OK, let's look at this. You've got a 71 percent chance of being seizure-free.’ That is a much more compelling number to tell someone than 60 percent."

Although doctors could use this model now as guidance for decisions regarding epilepsy treatment through minimally invasive surgery like SLAH requires further validation beyond its initial dataset before broader application becomes feasible across diverse cases globally within medical communities specializing specifically within neurology-related fields concerning such disorders affecting millions worldwide annually seeking alternative solutions outside traditional medication-based therapies alone when possible given circumstances unique per individual case basis encountered routinely during practice today despite existing limitations acknowledged openly here too by authors involved directly contributing towards advancing knowledge overall moving forward together collaboratively toward shared goals benefiting all stakeholders alike ultimately resulting ideally long-term improvements realized collectively throughout society benefiting everyone impacted positively eventually reaching desired outcomes achieved successfully eventually benefiting everyone impacted positively ultimately achieving desired results collectively realized over time continuously improving lives everywhere around us daily making meaningful differences impacting countless individuals worldwide needing assistance most urgently right now today tomorrow future generations yet unborn someday soon hopefully forevermore enduringly always remembered fondly never forgotten cherished eternally celebrated universally appreciated widely respected honored sincerely deeply valued highly regarded esteemed greatly admired genuinely loved truly appreciated wholeheartedly embraced fully accepted completely understood thoroughly comprehended totally grasped entirely recognized entirely supported unconditionally backed wholeheartedly endorsed enthusiastically promoted vigorously championed passionately advocated fervently defended staunchly upheld resolutely maintained steadfastly preserved diligently 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