Improving EPilepsy Surgery Management and progNOsis Using Virtual Epileptic Patient Software (VEP)
Improving EPilepsy Surgery Management and progNOsis Using Virtual Epileptic Patient Software (VEP)
Every year, thousands of patients worldwide with drug resistant focal epilepsy (DRE) undergo
 resective brain surgery with the aim of achieving seizure freedom.

 Despite technical advances over the last 50 years, the success rate of epilepsy surgery in
 terms of seizure freedom has not greatly improved, remaining overall at around 50%. Depending
 on features of individual cases, presurgical evaluation includes a first phase of
 non-invasive data including video-EEG recordings, magnetoencephalography, structural and
 functional neuroimaging and neuropsychological evaluation. If these investigations do not
 allow adequate localization of likely region of seizure organization in the brain (the
 epileptogenic zone, EZ), then a second invasive phase using intracerebral EEG recording may
 be necessary (stereoelectroencephalography, SEEG). Interpretation of SEEG remains difficult
 in many cases, in particular since seizure onset is often characterized by discharges that
 very rapidly involve several distinct brain regions.

 No reliable measuring instrument currently exists to combine the various prognostic factors
 for a given patient. This leads to great uncertainty on an individual scale in predicting the
 effects of surgery. The mapping of epileptic networks in patients with DRE is an innovative
 scientifically-validated and clinically-tested method to significantly improve accuracy of
 SEEG and presurgical interpretation and guide surgical strategies in patients with DRE.
 Therefore, we developed the Virtual Epilepsy Patient software. Retrospective study already
 demonstrated the pertinence of this approach in improving the anatomical mapping of
 epileptogenic networks. Now, we aim to prospectively demonstrate the role of VEP during
 presurgical evaluation of DRE patients
Inclusion Criteria:

 -  Patient or pediatric patient suffering from drug-resistant focal epilepsy.

 -  Standardized presurgical evaluation including medical history, scalp video-EEG, 3T MRI
 (DTI and rsMRI), FDG-PET, Neuropsychological tests.

 -  Inpatient in one of the participating centers for recording seizure during long term
 SEEG-monitoring.

 Exclusion Criteria:

 -  Epilepsy surgery performed without the requirement of SEEG or contra-indication to
 epilepsy surgery.