M Cucherat1. 1. Service de Biostatistique-CHU Lyon, EA 3736, Faculté de Médecine Lyon-Laennec, rue Guillaume-Paradin, 69008 Lyon, France. mcu@upcl.univ-Lyon1.fr.
Abstract
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.
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.