In this brief report published in June, Vezyroglou et al detail the results of epilepsy surgery for focal seizures in 8 patients carrying mutations in the SCN1A gene that were predicted to be causal. Three of the 8 patients had a clinical diagnosis of Dravet syndrome. The surgical procedures were successful in reducing or eliminating focal seizures in the 5 individuals that did not have a Dravet syndrome diagnosis. However, the three patients with Dravet syndrome either saw little improvement or worsening of seizures post-surgery. These results are consistent with two other reports of (2 and 6) patients with SCN1A mutations and a clinical diagnosis of Dravet syndrome (and one patient with GEFS+) that also had poorer outcomes following epilepsy surgery.

The authors highlight the need to understand the potential role of the SCN1A gene mutation in the presentation of the patient’s epilepsy before considering epilepsy surgery. Although the sample sizes are quite small, the authors conclude overall that carrying a genetic variant in the SCN1A gene should not preclude patients from consideration for epilepsy surgery, but patients with a clinical diagnosis of Dravet syndrome appear less likely to benefit from epilepsy surgery.

Vezroglou A. et al. Focal epilepsy in SCN1A-mutation carrying patients: is there a role for epilepsy surgery? Developmental Medicine and Child Neurology [June 2020]. DOI: 10.1111/dmcn.14588