Optimizing epilepsy surgery V1
Research type
Research Study
Full title
Optimizing epilepsy surgery
IRAS ID
278210
Contact name
John S Duncan
Contact email
Sponsor organisation
UCL
ISRCTN Number
ISRCTN72646265
Clinicaltrials.gov Identifier
IRAS, 278210
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
Sixty million people have epilepsy and a third continue to have seizures despite medication, with risks of fatality, brain damage, physical harm and psychosocial disorders. Neurosurgery can control epilepsy if the responsible part of the brain is removed. We have treated 1074 individuals with epilepsy surgery since February 1990. In optimal circumstances 80% have remissions of 1 year or more, and 40% never have another seizure. There may, however, be adverse effects. After temporal lobe surgery 30% of individuals develop increased difficulty with memory and language, and 10-20% may lose part of their field of vision.
Over the last decade we have worked to improve the outcome of epilepsy surgery: to increase the numbers of suitable individuals, improve the chances of remission and reduce risks of adverse effects, by using sophisticated brain imaging methods to guide neurosurgery.
Over the next 4 years we will implement methods to improve epilepsy surgery, streamline the pathway and so improve access by:
1. Implementing systematic analysis of seizure symptoms to better implicate the areas of brain involved in each individual. This information is combined with results of MRI and other brain scans and electrical recordings from the scalp (EEG) and viewed in 3-dimensions to plan a resection or, if needed, the placement of recording electrodes in the brain to define the sites of seizure onset.
2. Use computer-assisted analysis of brain scans to define the best trajectories for recording electrodes in the brain at sites thought to be giving rise to seizures, avoiding blood vessels.
3. Analyse the electrical signals recorded from electrodes in the brain, integrating this with analysis of MRI and other brain scans to determine which parts need to be removed to control the epilepsy.
4. Plan surgery so that there is the optimal chance of stopping seizures, and minimized risk of collateral damage.REC name
London - Queen Square Research Ethics Committee
REC reference
20/LO/0966
Date of REC Opinion
10 Sep 2020
REC opinion
Further Information Favourable Opinion