Better futures for young lives with epilepsy and associated conditions

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Improving epilepsy surgery in childhood using fMRI and EEG

Surgery in childhood can dramatically improve the lives of those with epilepsy by stopping seizures and limiting disability caused by disrupted development. This is because epilepsy can spread over time to involve more of the brain and interrupt learning.

The aim of tests before surgery are to identify brain areas which must be removed to stop seizures and those which are necessary for functions such as walking and talking. This process can be more difficult in children because it is harder to perform many of the tests and procedures that an adult will understand and tolerate.

Therefore there is a need for developing a better child-friendly evaluation for surgery using EEG-fMRI, a method for mapping epileptic activity.

Aim

To have a better understanding of the feasibility and the utility of EEG-fMRI in the presurgical evaluation of children with drug resistant focal epilepsy.

Outline plan

The project will use a new brain imaging technique, which combines magnetic resonance imaging (MRI) and electroencephalogram (EEG) in the presurgical evaluation of children with drug resistant focal epilepsy, and apply a child-centred approach to obtaining scans.

Update

Led by the clinical research fellow, Dr Maria Centeno, 47 patients undergoing presurgical evaluation at Great Ormond Street Hospital and 21 control subjects have been scanned. Preliminary results show EEG-fMRI maps are concordant with the presumed epileptic focus, assessed clinically in around two-thirds of cases. Tolerance of the children to EEG-fMRI is very good so far. EEG-fMRI activations will be validated with the surgical outcome of these patients. So far 16 of these patients have proceeded to surgery and an additional three have had intracranial EEG implantations to evaluate further.

Investigators

David Carmichael, Maria Centeno, Daniel Konn, Chris Clark, Jonathan Clayden, Ronit Pressler, Helen Cross.

Cyber EssentialsFundraising RegulatorYoung Epilepsy is the operating name of The National Centre for Young People with Epilepsy (NCYPE).
Registered Charity number 311877 (England and Wales)

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