Incidence and prevalence of major epilepsy-associated brain lesions

Javier A. López-Rivera; Victoria Smuk; Costin Leu; Gaelle Nasr; Deborah Vegh; Arthur Stefanski; Eduardo Pérez-Palma; Robyn Busch; Lara Jehi; Imad Najm; Ingmar Blümcke; Dennis Lal

Epilepsy & Behavior Reports (Jan 2022)

Incidence and prevalence of major epilepsy-associated brain lesions

Javier A. López-Rivera,
Victoria Smuk,
Costin Leu,
Gaelle Nasr,
Deborah Vegh,
Arthur Stefanski,
Eduardo Pérez-Palma,
Robyn Busch,
Lara Jehi,
Imad Najm,
Ingmar Blümcke,
Dennis Lal

Affiliations

Javier A. López-Rivera: Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, USA; Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, USA; Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
Victoria Smuk: Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, USA; Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
Costin Leu: Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, USA; Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
Gaelle Nasr: Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
Deborah Vegh: Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
Arthur Stefanski: Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, USA; Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
Eduardo Pérez-Palma: Universidad del Desarrollo, Centro de Genética y Genómica, Facultad de Medicina Clínica Alemana. Santiago, Chile
Robyn Busch: Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA; Department of Psychiatry and Psychology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
Lara Jehi: Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA; Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
Imad Najm: Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA; Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
Ingmar Blümcke: Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany
Dennis Lal: Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, USA; Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA; Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA; Cologne Center for Genomics, University of Cologne, Cologne, NRW, Germany; Corresponding author at: Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.

Journal volume & issue: Vol. 18
p. 100527

Abstract

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Epilepsy surgery is an effective treatment option for drug-resistant focal epilepsy patients with associated structural brain lesions. However, little epidemiological data are available regarding the number of patients with these lesions. We reviewed data regarding (1) the prevalence and incidence of epilepsy; (2) the proportion of epilepsy patients with focal epilepsy, drug-resistant epilepsy, and drug-resistant focal epilepsies; and (3) the number of epilepsy presurgical evaluations and surgical resections. We also assessed the relative proportion of brain lesions using post-surgical histopathological findings from 541 surgical patients from the Cleveland Clinic and 9,523 patients from a European multi-center cohort. Data were combined to generate surgical candidate incidence and prevalence estimates and the first lesion-specific estimates for hippocampal sclerosis (HS), low-grade epilepsy-associated brain tumors (LEAT), malformations of cortical development (MCD), glial scars, vascular malformations, and encephalitis. The most frequently diagnosed brain lesions were HS (incidence = 2.32 ± 0.26 in 100,000, prevalence = 19.40 ± 2.16 in 100,000) for adults and MCD (incidence = 1.15 ± 0.34 in 100,000, prevalence = 6.52 ± 1.89 in 100,000) for children. Our estimates can guide patient advocacy groups, clinicians, researchers, policymakers in education, development of health care strategy, resource allocation, and reimbursement schedules.

Published in Epilepsy & Behavior Reports

ISSN: 2589-9864 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry: Neurology. Diseases of the nervous system; Science: Physiology: Neurophysiology and neuropsychology
Website: https://www.journals.elsevier.com/epilepsy-and-behavior-reports

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