NEUROIMAGING FOR EPILEPSY
A systematic review of the effectiveness and cost-effectiveness of neuroimaging assessments used to visualise the seizure focus in people with refectory epilepsy being considered for surgery
Background
This review aimed to assess the effectiveness and/or accuracy of different methods of imaging the cerebral cortex to visualise the seizure focus in people with refractory epilepsy being considered for surgery. The ability to predict patient outcomes following surgery, and the cost effectiveness of the different methods were also assessed.Findings
Owing to the limitations of the included studies, the results of this review do little to inform clinical practice. We are unable to provide evidence for effectiveness or cost-effectiveness of imaging techniques in the work-up for epilepsy surgery. Results of diagnostic accuracy studies are confounded by limitations in the reference standard used, and studies are subject to both clinical and statistical heterogeneity.
Conducted by: P Whiting1, R Gupta2, J Burch3, RE Mujica Mota4, K Wright3, A Marson2, U Weishmann2, A Haycox4, J Kleijnen3, C Forbes31. MRC HSRC, Department of Social Medicine, Bristol; 2. Walton Centre, Liverpool; 3. Centre for Reviews and Dissemination; 4. Department of Pharmacology, University of Liverpool
Further details
Project page on HTA Programme websitePublications
Whiting P, Gupta R, Burch J, Mujica Mota RE, Wright K, Marson A, Welshmann U, Haycox A, Kleijnen J, Forbes C. A systematic review of the effectiveness and cost-effectiveness of neuroimaging assessments used to visualise the seizure focus in people with refractory epilepsy being considered for surgery. Health Technol Assess. 2006;10(4):1-266Presentations
Forbes C. Neuroimaging in the pre-surgical evaluation of candidates for epilepsy surgery: a systematic review. Vice Chancellors Interdisciplinary Seminar Series -Neuroscience; 2004 November; York, UKFunding
Commissioned by the HTA Programme