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The ESC panels were most accurate in predicting seizure freedom at the extremes of the predicted probability spectrum and performed similarly to the SFS.
It is found that the association between early epilepsy surgery and seizure reduction in palliative procedures reflects the heterogeneity of the population, including different types of surgical procedures and lesional and nonlesional epilepsies.
Similar children evaluated at different institutions had significant differences in the odds of not being recommended surgery, suggesting that institutional decision-making contributes importantly to surgical candidacy.
Delays from DRE diagnosis were independently associated with reduced seizure freedom, supporting presurgical evaluation within 1 year as an evidence-based quality benchmark, and DRE-to-evaluation interval, not total epilepsy duration, predicted outcomes.
This review synthesizes advances in neuroimmunology, clinical phenotyping, diagnostics, immunomodulatory and antiseizure therapies, neuromodulation, and patient and family centered outcomes, and outlines future directions focused on biomarker-driven precision medicine, disease-modifying strategies, and interdisciplinar...
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