Development and Validation of a Nomogram for Predicting Seizure Outcomes After Epilepsy Surgery for Children with Focal Cortical Dysplasia.

ABSTRACT

AIM: To construct a prediction nomogram model for the postoperative seizure outcomes in children with focal cortical dysplasia (FCD). MATERIAL AND METHODS: We retrospectively reviewed the clinical data of 97 children with epilepsy secondary to FCD who had undergone resection surgery at Children's Hospital of Chongqing Medical University from June 2013 to September 2019. Univariate and multivariate Cox proportional hazards regression were used to explore the predictors of postoperative persistent seizure, and a nomogram prediction model for postoperative seizure outcome was developed. The C-index was chosen to evaluate the discriminability of the nomogram with internal validation. Calibration curves and decision curve analysis were used to evaluate consistency and clinical efficacy, respectively. RESULTS: The complete resection of epileptogenic focus and the pathological type of FCD were independent predictors of persistent seizure in children with epilepsy secondary to FCD after surgery. Based on multivariate Cox proportional hazard regression, a predictive nomogram for epilepsy outcome was established and validated via the bootstrap method with 1000 resamples. The nomogram showed superior prediction accuracy (C-index = 0.883); by drawing and reviewing the calibration curve and decision curve, the nomogram presented good consistency and clinical efficacy. CONCLUSION: A nomogram prediction model of postsurgery seizure outcome in children with epilepsy secondary to FCD was constructed based on four variables, providing a reliable and convenient tool for individual seizure outcome prediction.