[Meta-analysis of Surgery Trials in Refractory Epilepsy]
Overview
Authors
Affiliations
Objective: To examine the evidence for efficacy of surgery in the treatment of intractable epilepsy.
Method: Meta-analysis of randomized clinical trials.
Results: One randomized clinical trial (n=80) and 3 observational studies are available.
Interpretation: Compared to medical treatment, the surgery increases the proportion of patients who were free of seizure impairing awareness at 1 year (relative risk: 7.67, IC 95% 2.5 à 23.51)
Conclusion: The available evidence about the clinical efficacy of surgery for patient with intractable epilepsies is limited to an unique open randomized clinical trial, that enrolled patient in a single centre, without concealment of the randomization and with a partially subjective primary endpoint. However, this trial shows a substantial effect corresponding to a 8 fold increase in the number of patient without seizure at 1 year. The informational situation will be better when the results of a currently ongoing trial will be available.
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