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

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机构: [1]Department of Neurosurgery, Saint Justine University Hospital Centre, Montreal, Quebec, Canada [2]Neurology Centre of Toronto, Toronto, Ontario, Canada [3]Division of Pediatric Neurosurgery, Sick Kids Toronto, University of Toronto, Toronto, Ontario, Canada [4]Department of Neurosurgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA [5]Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA [6]Department of Biostatistics, Fielding School of Public Health at, University of California, Los Angeles, Los Angeles, CA, USA [7]Department of Functional Neurosurgery, Xiamen Humanity Hospital, Xiamen, China [8]Pediatric Epilepsy Center, Peking University First Hospital, Beijing, China [9]Department of Epilepsy Center, Yuquan Hospital, Tsinghua University, Beijing, China [10]Department of Neurological Surgery, St. Louis Children's Hospital, St. Louis, Missouri, USA [11]Department of Neurosurgery, Children's Hospital Colorado, Aurora, Colorado, USA [12]Division of Neurosurgery, Department of Pediatric Surgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada [13]Department of Neurosurgery, Nicklaus Children's Hospital, Miami, Florida, USA [14]Department of Neurosurgery, University Medical Center Freiburg and Medical Faculty, University of Freiburg, Freiburg, Germany [15]Department of Neuropediatrics, University Children's Hospital Zurich, Zurich, Switzerland [16]Department of Neurosurgery, Seattle Children's Hospital, Seattle, Washington, USA [17]Department of Neurosurgery, Medical University of Vienna, Vienna, Austria [18]Department of Pediatrics, Medical University of Vienna, Vienna, Austria [19]Division of Pediatric Neurosurgery, Department of Neurosurgery, Primary Children's Hospital, Salt Lake City, Utah, USA [20]Department of Functional Neurosurgery, Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China [21]Department of Pediatrics, BC Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada [22]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China [23]Division of Pediatric Neurosurgery, Department of Surgery, Hassenfeld Children's Hospital, NYU Langone Health, New York, New York, USA [24]Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA [25]Division of Child Neurology and Epilepsy, Mayo Clinic College of Medicine, Rochester, Minnesota, USA [26]Division of Neurology, Department of Medicine, University of Montreal Hospital Centre, Montreal, Quebec, Canada [27]Department of Neurology, All India Institute of Medical Sciences and National Brain Research Center, New Delhi, India [28]Department of Neurosurgery (Center of Excellence for Epilepsy & Magnetoencephalography), All India Institute of Medical Sciences and National BrainResearch Center, New Delhi, India [29]Division of Neurosurgery, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada [30]Division of Epilepsy Surgery, Shenzhen Children's Hospital, Shenzhen, China [31]Department of Neurosurgery, Guangdong Sanjiu Brain Hospital, Guangzhou Shi, China [32]Department of Neurosurgery, Niño Jesus University Children's Hospital, Madrid, Spain [33]Department of Neurophysiology, Niño Jesus University Children's Hospital, Madrid, Spain [34]Department of Neurosurgery, Brussels Saint-LucUniversity Hospital, Brussels, Belgium [35]Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland [36]Department of Neurosurgery, Zurich University Hospital and Clinical Neuroscience Center, University of Zurich, Zurich, Switzerland [37]Academic Neurosurgery, Department of Neurosciences, University of Padua, Padua, Italy [38]Department of Neurosurgery, Pontifical Catholic University of Chile, Sotero del Rio Hospital, Santiago, Chile [39]Epilepsy Department, Fleni Epilepsy Neurology and Neurophysiology Service, Buenos Aires, Argentina [40]Department of Neurosurgery, University Hospital Bochum, Bochum, Germany [41]Department of Neurosurgery, Brandenburg Medical School, Neuruppin, Germany [42]Department of Neurosurgery, Children's National Medical Center, Washington, District of Columbia, USA [43]Divisions of Child Neurology and Epilepsy and Neurophysiology, Children's National Medical Center, Washington, District of Columbia, USA [44]Department of Neurosciences, King Faisal Specialist Hospital and Research Center, Alfaisal University, Riyadh, Saudi Arabia [45]Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA
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关键词: hemispheric surgery prognostication tool seizure outcomes

摘要:
To develop and validate a model to predict seizure freedom in children undergoing cerebral hemispheric surgery for the treatment of drug-resistant epilepsy. 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. 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. 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. © 2021 International League Against Epilepsy.

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出版当年[2020]版:
大类 | 2 区 医学
小类 | 2 区 临床神经病学
最新[2025]版:
大类 | 1 区 医学
小类 | 1 区 临床神经病学
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出版当年[2019]版:
Q1 CLINICAL NEUROLOGY
最新[2023]版:
Q1 CLINICAL NEUROLOGY

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第一作者机构: [1]Department of Neurosurgery, Saint Justine University Hospital Centre, Montreal, Quebec, Canada
通讯作者:
通讯机构: [*1]Department of Neurosurgery, David Geffen School of Medicine at UCLA, 300 Stein Plaza, Suite 525, Los Angeles, CA 90095, USA
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