Probabilistic landscape of seizure semiology localizing values

• DOI: 10.1093/braincomms/fcac130
• Publication Date: 2022-05-19T09:51:18Z
• Authors: Ali Alim-Marvasti; Gloria Romagnoli; Karan Dahele; Hadi Modarres; Fernando Pérez-Ga...; Rachel Sparks; Sébastien Ourselin; Matthew J. Clarkson; Fahmida Chowdhury; Beate Diehl; John S. Duncan
• Keywords: Semiology; Insular cortex

Semiology describes the evolution of symptoms and signs during epileptic seizures contributes to evaluation individuals with focal drug-resistant epilepsy for curative resection. varies in complexity from elementary sensorimotor arising primary cortex complex behaviours automatisms emerging distributed cerebral networks. Detailed semiology interpreted by expert epileptologists may point towards likely site seizure onset, but this process is subjective. No study has captured variances semiological localizing values a data-driven manner allow objective probabilistic determinations implicated networks nodes. We curated an open data set literature, accordance Preferred Reporting Items Systematic Reviews Meta-Analyses guidelines, linking hierarchical brain localizations. A total 11 230 points were collected 4643 patients across 309 articles, labelled using ground truths (postoperative seizure-freedom, concordance imaging neurophysiology, and/or invasive EEG) designation method that distinguished between semiologies predefined cortical region descriptions neuroanatomical localizations responsible generating particular semiology. This allowed us mitigate temporal lobe publication bias filtering studies preselected based on prior knowledge their foci. Using set, we describe landscape as forest plots at resolution seven major regions: temporal, frontal, cingulate, parietal, occipital, insula, hypothalamus, five subregions. evaluated intrinsic value any one over all other ictal manifestations. For example, epigastric auras 83% probability when not accounting favoured epilepsies. Unbiased results distribution revised prevalence epilepsies 66% 44%. Therefore, about presence updates localization odds ratio (OR) 2.4 [CI95% (1.9, 2.9); specifically, mesial structures OR: 2.8 (2.3, 2.9)], attesting auras. As further although head version thought implicate frontal lobes, it did add compared [OR: 0.9 (0.7, 1.2)]. Objectification 12 most common provides complementary view dysfunction lesion-deficit mappings, instead regions phenotypic-deficits, phenotypes are linked back sources. work enables coupling propagation manifestations, clinical support algorithms phenotypes.