NEUROIMAGING FOR EPILEPSY

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

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 Forbes3

1. 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 website

Publications

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):1-266

Posters

Whiting P, Gupta R, Burch J, Kleijnen J, Marson A, Forbes C. What to do with non 2x2 data from a diagnostic systematic review? An example from a review on identifying the seizure focus in patients with epilepsy. 12th Cochrane Colloquium; 2004 October; Ottawa, Canada

Presentations

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, UK

Funding

Commissioned by the HTA Programme