[Meta-analysis of surgery trials in refractory epilepsy].
OBJECTIVE
To examine the evidence for efficacy of surgery in the treatment of intractable epilepsy.


METHODS
Meta-analysis of randomized clinical trials.


RESULTS
One randomized clinical trial (n=80) and 3 observational studies are available.


CONCLUSIONS
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)


CONCLUSIONS
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.
Service de Biostatistique-CHU Lyon, EA 3736, Faculté de Médecine Lyon-Laennec, rue Guillaume-Paradin, 69008 Lyon, France. mcu@upcl.univ-Lyon1.fr.
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M
Cucherat
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D018849:Controlled Clinical Trials as Topic / Q000379:methods / Q000706:statistics & numerical data; D004351:Drug Resistance; D004828:Epilepsies, Partial / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D019635:Neurosurgical Procedures / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D000927:Anticonvulsants