Astner-Rohracher et al reported the 5-Sense score for predicting focality of a seizure onset zone based on findings on MRI and EEG. The authors are from multiple institutions in Europe and North America.
Patient selection: seizure disorder
Parameters:
(1) lesion extent on structural magnetic MRI
(2) interictal EEG extent in scalp electroencephalography
(3) neuropsychological deficit
(4) localizing semiology
(5) ictal scalp electroencephalography onset extent
Parameter |
Finding |
Points |
lesion extent |
focal |
0 |
|
no lesion |
-2.2636 |
|
all other lesions |
-2.1494 |
interictal EEG extent |
no IED |
1.8056 |
|
bilateral independent |
0 |
|
all others |
1.1807 |
neuropsychological deficit |
localizing |
0 |
|
non-localizing |
-0.2554 |
|
none |
1.1550 |
localizing semiology |
strong |
0.8489 |
|
weak |
0 |
|
not localizing |
0 |
ictal EEG onset extent |
focal or lobar |
0.8442 |
|
bilateral synchronous |
0 |
|
none |
-0.8124 |
|
multilobar |
-0.8124 |
|
diffuse |
-0.8124 |
where:
• In Figure 3B "all other lesions" for lesion extent is scored -1.15 instead of -2.15, but the 5-sense score is returned with -2.15.
value of X =
= SUM(points for all of the parameters) - 0.3135
probability of focality =
= 1 / (1 + EXP((-1) * X)) * 100
Interpretation:
• A focal seizure-onset zone (SOZ) is associated with a probability> 37.6.
Performance:
• The area under the ROC curves is 0.83 in the derivation and 0.66 in the validation cohort.
Specialty: Neurology