Page 160 - MEGIN Book Of Abstracts - 2023

Underutilization of advanced presurgical studies tients (3.1%). Despite the low utilization rate of adjunc-
and high rates of vagus nerve stimulation for drug- tive studies, over half (56.3%) ultimately underwent
resistant epilepsy: a single-center experience and VNS alone, and 8.6% ultimately underwent definitive
recommendations (2022) intracranial resection or disconnection surgery.

Solli, Elena; Colwell, Nicole A; Markosian, Christopher; CONCLUSIONS The underutilization of appropriate
Johal, Anmol S; Houston, Rebecca; Iqbal, M Omar; Say, non-invasive, presurgical testing in patients with focal
Irene; Petrsoric, Joseph I; Tomycz, Luke D DRE may in part explain the continued underutiliza-
tion of definitive, resective/disconnective surgery. For
Department of Neurological Surgery, Rutgers New Jersey patients without access to a high-volume, multidisci-
Medical School, 90 Bergen Street, Suite 8100, Newark, NJ, plinary surgical epilepsy center, adjunctive presurgical
07103, USA; Department of Neurological Surgery, Desert Re- studies [e.g., PET, SPECT, MEG, electrical source imag-
gional Medical Center, Palm Springs, CA, USA; Department of ing (ESI), EEG-functional magnetic resonance imaging
Neurology, Holy Name Medical Center, Teaneck, NJ, USA; New (fMRI)], even when available, are rarely ordered, and
Jersey Brain and Spine, 70 Park Avenue, Montclair, NJ, 07042, this may contribute to excessive rates of VNS in lieu of
USA. tomyczluke@gmail.com definitive intracranial surgery.

INTRODUCTION Epilepsy surgery continues to be Keywords: DRE, MEG, PET, Preoperative studies, SPECT,
profoundly underutilized despite its safety and ef- Seizure surgery
fectiveness. We sought to investigate factors that may
contribute to this phenomenon, with a particular focus Acta neurochirurgica (2022), Vol. 164, No. 2 (34773497) (1
on the antecedent underutilization of appropriate citation)
preoperative studies.

METHODS We reviewed patient data from a pediatric Resting-State MEG Source Space Network Metrics
epilepsy clinic over an 18-month period. Patients with Associated with the Duration of Temporal Lobe
drug-resistant epilepsy (DRE) were categorized accord- Epilepsy (2021)
ing to brain magnetic resonance imaging (MRI) findings
(lesional, MRI-negative, or multifocal abnormalities) Zhang, Junpeng; Feng, Jingwen; Zhang, Yifan; Mo, Site;
and type of epilepsy diagnosis based on semiology and Dong, Jingjing; Zhu, Haitao; Zhang, Ling; Wu, Ting; Cui,
electroencephalography (EEG) (focal or generalized). Yuan; Chen, Duo
We then analyzed the rates of diagnostic test utiliza-
tion, surgical referral, and subsequent epilepsy surgery Department of Medical Information and Engineering, College
as well as vagus nerve stimulation (VNS). of Electrical Engineering, Sichuan University, Chengdu, China;
Rehabilitation Physiotherapy Department, Lintong Rehabili-
RESULTS Of the 249 patients with a diagnosis of epi- tation and Recuperation Center, PLA Joint Logistic Support
lepsy, 138 (55.4%) were found to have DRE. Excluding Force, Xi'an, China; Department of Neurosurgery, Brain Hos-
the 10 patients with DRE who did not undergo MRI, 76 pital Affiliated to Nanjing Medical University, Nanjing, China;
patients (59.4%) were found to be MRI-negative (non- School of Biomedical Engineering, Hubei University of Science
lesional epilepsy), 37 patients (28.9%) were found to and Technology, Xianning, China; Department of Radiology,
have multifocal abnormalities, and 15 patients (11.7%) Jiangsu Province Hospital of Chinese Medicine, Affiliated
were found to have a single epileptogenic lesion on Hospital of Nanjing University of Chinese Medicine, Nanjing,
MRI (lesional epilepsy). Positron emission tomography China. lvwu123@163.com; Department of Medical Informa-
(PET) and single-photon emission computed tomog- tion Engineering, Chengdu Medical College, Chengdu, China.
raphy (SPECT) were each completed in nine patients 12724649@qq.com; School of Artificial Intelligence and Infor-
(7.0%) and magnetoencephalography (MEG) in four pa- mation Technology, Nanjing University of Chinese Medicine,

 ontents  Index 139
C