Furthermore, neurosurgeons increasingly use stereo-electroencephalography (SEEG) in pediatric epilepsy surgery to delineate the epileptogenic zone (EZ). Ultimately, this procedure guides the resection process. However, identifying which children will benefit from electrode implantation remains challenging. Consequently, the 5-SENSE score pediatric SEEG validation study provides a vital tool for clinicians. Specifically, this score integrates five noninvasive clinical variables to estimate the likelihood of identifying an EZ. For this reason, clinicians find it useful for managing complex cases. Moreover, the score considers MRI findings and EEG data. In light of this, researchers conducted a specific validation study in children.

In contrast, the original score was developed primarily for adult populations. Nevertheless, the current study represents the first validation of this tool in a purely pediatric cohort. Notably, researchers analyzed seventy-nine patients under 19 years old at a tertiary center. In addition, they calculated the score based on MRI findings, scalp video-EEG, and interictal discharges. Similarly, they evaluated clinical semiology and neuropsychological data. Consequently, the team reviewed SEEG outcomes to determine whether a focal EZ was found. As a result, they determined the accuracy of the score. Because of this, the study is highly significant for pediatric neurology. On the other hand, clinicians must be careful. To clarify, the score is one tool among many.

Performance of the 5-SENSE Score Pediatric SEEG Model

Moreover, the study found that the score accurately predicted favorable outcomes. Specifically, it demonstrated a sensitivity of 70.7% and a specificity of 71.4%. In addition, the area under the receiver operating characteristic curve was 0.72. Similarly, these results confirm that the score maintains its predictive value in children. Furthermore, the positive predictive value reached 87.2%, which is consistent with adult studies. In fact, the negative predictive value was 46.9%. To illustrate, the score works well for patient selection. Because of this, it assists in surgical planning. In essence, it improves care and manages parental expectations. Likewise, it streamlines the evaluation process.

However, clinicians should note that a low score does not exclude a patient from surgery. Instead, it suggests a lower probability of finding a focal seizure onset. Therefore, surgical teams must consider this score within a broader clinical context. Ultimately, the tool helps manage expectations and improves patient selection for invasive procedures. For example, it assists in counseling parents about surgical success rates. In essence, the score streamlines the presurgical evaluation process. Consequently, this study supports the use of the score in children.

Frequently Asked Questions

Can a child with a low 5-SENSE score still undergo SEEG?

Yes. Although a low score indicates a lower likelihood of identifying a focal area, it does not completely rule out a successful outcome.

Which specific variables comprise the 5-SENSE score?

The score includes focal MRI lesions, regional ictal onset on scalp EEG, absence of bilateral independent spikes, localizing semiology, and neuropsychological findings.

How does the 5-SENSE score help in MRI-negative cases?

Specifically, it integrates other clinical and electrophysiological data to provide a clearer estimate of success when neuroimaging is inconclusive.

Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice or a professional relationship. Always consult a qualified healthcare provider for diagnosis and treatment. Refer to the latest local and national guidelines for clinical practice.

References

1. Singh AS et al. Can the 5-SENSE score guide stereo-electroencephalography in children? First validation in a purely pediatric cohort. J Neurosurg Pediatr. 2026 May 15. doi: 10.3171/2025.12.PEDS25446. PMID: 42139735.


2. Astner-Rohracher A et al. Development and Validation of the 5-SENSE Score to Predict Focality of the Seizure-Onset Zone as Assessed by Stereoelectroencephalography. JAMA Neurol. 2022;79(1):1-10.