Evidence map›Paper›PMID 32944952›Full record

SynthesisEpilepsia2020

Early seizure spread and epilepsy surgery: A systematic review.

John P Andrews, Simon Ammanuel, Jonathan Kleen, Ankit N Khambhati, Robert Knowlton, Edward F Chang

Open access · greenAbstract readSystematic Review
In one paragraph

Synthesis in Epilepsia, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
0.8field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 25 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Can electrical stimulation replace spontaneous seizures in epilepsy surgery?medRxiv : the preprint server for health sciences · 2025
    Article
  7. Article
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

John P AndrewsDepartment of Neurological Surgery, School of Medicine, University of California-San Francisco, San Francisco, California, USA.ORCID 0000-0002-8025-1525
Simon AmmanuelDepartment of Neurological Surgery, School of Medicine, University of California-San Francisco, San Francisco, California, USA.
Jonathan KleenDepartment of Neurology, School of Medicine, University of California-San Francisco, San Francisco, California, USA.
Ankit N KhambhatiDepartment of Neurological Surgery, School of Medicine, University of California-San Francisco, San Francisco, California, USA.
Robert KnowltonDepartment of Neurology, School of Medicine, University of California-San Francisco, San Francisco, California, USA.
Edward F ChangDepartment of Neurological Surgery, School of Medicine, University of California-San Francisco, San Francisco, California, USA.
University of California, San Francisco · US

Funding

Hippocampal-cortical networks underlying memory retrieval of linguistic knowledgeK23NS110920 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KLEEN, JONATHAN · 2019 to 2023
$1.0M
NINDS NIH HHS K23 NS110920
6 · The paper itself

Abstract

objectiveA fundamental question in epilepsy surgery is how to delineate the margins of cortex that must be resected to result in seizure freedom. Whether and which areas showing seizure activity early in ictus must be removed to avoid postoperative recurrence of seizures is an area of ongoing research. Seizure spread dynamics in the initial seconds of ictus are often correlated with postoperative outcome; there is neither a consensus definition of early spread nor a concise summary of the existing literature linking seizure spread to postsurgical seizure outcomes. The present study is intended to summarize the literature that links seizure spread to postoperative seizure outcome and to provide a framework for quantitative assessment of early seizure spread.

methodsA systematic review was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A Medline search identified clinical studies reporting data on seizure spread measured by intracranial electrodes, having at least 10 subjects and reporting at least 1-year postoperative outcome in the English literature from 1990 to 2019. Studies were evaluated regarding support for a primary hypothesis: Areas of early seizure spread represent cortex with seizure-generating potential.

resultsThe search yielded 4562 studies: 15 studies met inclusion criteria and 7 studies supported the primary hypothesis. The methods and metrics used to describe seizure spread were heterogenous. The timeframe of seizure spread associated with seizure outcome ranged from 1-14 seconds, with large, well-designed, retrospective studies pointing to 3-10 seconds as most likely to provide meaningful correlates of postoperative seizure freedom. SIGNIFICANCE: The complex correlation between electrophysiologic seizure spread and the potential for seizure generation needs further elucidation. Prospective cohort studies or trials are needed to evaluate epilepsy surgery targeting cortex involved in the first 3-10 seconds of ictus.

Indexed as

Cerebral CortexElectrodes, ImplantedElectroencephalographyEpilepsyHumansProspective StudiesRetrospective StudiesSeizuresTreatment Outcomeepilepsyictal spreadseizureseizure propagationseizure spread

Identifiers

PMID32944952
PMCPMC8139824
OpenAlexW3087312598

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.