Journal
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY
Volume 95, Issue -, Pages 4-10Publisher
W B SAUNDERS CO LTD
DOI: 10.1016/j.seizure.2021.12.004
Keywords
Epilepsy genetics; Epilepsy surgery; Developmental and epileptic encephalopathy; Sporadic and familial epilepsies; Next generation sequencing in epilepsy
Categories
Funding
- Federal Ministry of Education and Research program for rare diseases (Treat-ION) [01GM1907A]
- German Research Foundation (DFG) [WE 4896/4-1, WO 2385/2-1]
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This study aimed to investigate the practice of genetic testing in presurgical evaluation in epilepsy centers in Germany. The survey results showed that the majority of participants consider genetic testing to be useful in individuals with familial syndromes or phenotypic features suggesting a genetic etiology. The report of 25 cases demonstrated that a genetic diagnosis significantly affects both the decision-making process during presurgical evaluation and the postoperative outcome. The conclusion is that genetic testing is increasingly being incorporated into the presurgical workup in epilepsy centers across Germany.
Introduction: Genetic testing in people with epilepsy may support presurgical decision-making. It is currently unclear to what extent epilepsy centres use genetic testing in presurgical evaluation. Methods: We performed an exploratory survey among members of the German Society for Epileptology to study the current practice of genetic testing in presurgical evaluation at the respective sites. Survey participants contributed educational case reports. Results: The majority of participants consider genetic testing to be useful in individuals with familial syndromes or phenotypic features suggesting a genetic etiology. We report 25 cases of individuals with a confirmed genetic diagnosis that have previously undergone epilepsy surgery. Our cases demonstrate that a genetic diagnosis has an impact on both the decision-making process during presurgical evaluation, as well as the postoperative outcome. Conclusion: Genetic testing as part of the presurgical work-up is becoming increasingly established in epilepsy centres across Germany. mTORopathies and genetic hypothalamic hamartomas seem to be associated with a generally favourable surgical outcome. Synaptopathies and channelopathies may be associated with a worse outcome and should be considered on a case-by-case level. Prospective studies are needed to examine the impact of an established genetic diagnosis on postsurgical outcome.
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