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.
