Can epilepsy be tackled through surgery?

Posted May 7, 2017 by Tim Sandle
New technology, based on a computational approach, makes surgery a more viable option for patients with epilepsy. This is for situations where standard medications are not proving to be effective.
Scientists at Imperial College London have gained a unique insight into how LSD affects the human br...
Scientists at Imperial College London have gained a unique insight into how LSD affects the human brain.
Imperial/Beckley Foundation
Epilepsy is not a single condition. The term refers to a group of neurological disorders which share the commonality of epileptic seizures. Epileptic seizures are episodes, of different lengths of time and of different intensities, ranging from brief, almost undetectable moment of ‘blanking out’ to long periods of vigorous shaking. The more extensive seizures carry risk of physical injuries, such as bruising and broken bones.
What makes epilepsy hard to treat is the fact that the cause of most cases of epilepsy is unknown. There is some association with brain injury or stroke, brain tumors; other people appear to be born with the condition, which is perhaps linked to birth defects. Many medics think there is a genetic cause. The condition can be medically diagnosed through an electroencephalogram.
Researchers from Boston Children's Hospital have harnessed new technology to explore the condition further and perhaps to offer a surgical intervention that might lead to a cure for some forms of epilepsy.
The new technology has been developed by Dr. Joseph Madsen who is a computational biophysicist. This is through applying a special algorithm to analyze patients' interictal electroencephalogram data (this means the state of the patient as measured between their seizures). To test out the approach the researchers used 25 patients with hard-to-treat epilepsy and looked at data relating to the first 20 seizure-free minutes that each patient experienced. Th3e algorithm is called ‘Granger causality analysis.’
What’s interesting about the algorithm is that it was originally developed for economic forecasting. The medic has turned the model to a program that can calculate the probability that activity at one brain location predicts subsequent activity at other brain locations. Such an approach produces a map of a patient's epileptogenic network. This reveals the brain regions predicted to be causing seizures and would allow for, should it be medically necessary, surgical interventions.
Here Dr. Masden notes: “We still need to validate and refine our approach before it can be used clinically. But we are hopeful that these advanced computer applications can help us treat more children with epilepsy -- with less risk and lower cost.”
Then research has been published in the journal Neurosurgery, under title “Granger Causality Analysis of Interictal iEEG Predicts Seizure Focus and Ultimate Resection.”