Background

Epilepsy surgery is occasionally considered for people with difficult-to-treat epilepsy. Potential candidates undergo a series of tests to determine their suitability for surgery, including EEG, brain imaging and psychology assessments. We explored the value of genetic testing in the epilepsy surgery evaluation.  

Research

Through an international collaboration led by researchers from FutureNeuro and the University of Toronto, 142 patients with genetic epilepsies who underwent evaluation for epilepsy surgery were identified. We found that certain groups of genetic epilepsies were more likely to have surgery (mTOR-related epilepsies), compared to others (ion channel-related epilepsies). However, even patients with severe epilepsies, such as those caused by sodium channel mutations, could achieve positive surgical outcomes if EEG and brain imaging suggested they were good candidates. 

Potential Impact

The study represents a step towards a better understanding of the outcomes of epilepsy surgery in patients with difficult-to-treat genetic epilepsies. Although genetic testing is not yet routine in the presurgical evaluation, this study provides evidence that a patient’s genetic makeup should be considered during the evaluation process. Prospective registries of patients with genetic epilepsies who undergo epilepsy surgery can provide additional insights on outcomes.