Performance of the 5‐ <scp>SENSE</scp> score in a pediatric and young adult cohort of 100 consecutive stereoelectroencephalography cases

This study assesses the validity of the 5-SENSE score in a cohort of pediatric patients with epilepsy and evaluates associations between the score, ancillary testing, and surgical outcomes. We retrospectively calculated the 5-SENSE score in a single-center predominantly pediatric cohort and calculated the sensitivity and specificity for predicting a non-focal stereo-electroencephalography (SEEG). In addition, we examined the relationship between score and post-surgical outcome. Finally, we evaluated the association between ancillary testing and SEEG focality. One hundred cases were included. The 5-SENSE score had a sensitivity (95% confidence interval [CI]) of 49% (35.6-62.2), specificity of 75% (63.6-85.5), and area under the curve of 0.673 (0.567-0.780). The sensitivity and specificity were similar in children 13 years or younger compared to those older than 13 years. Ancillary testing lateralized in agreement with a focal SEEG finding in 61% of patients, with sensitivity of 43% and specificity of 76% (p = 0.045). Ancillary testing confirmed the 5-SENSE score but did not significantly improve sensitivity. Higher 5-SENSE scores were associated with better Engel outcomes (p = 0.037). The 5-SENSE score performed comparably to the published adult validation cohort. Use of the 5-SENSE score in pediatric patients may improve patient selection for SEEG but is not a sole predictor of result or outcome.