Epilepsy: could better brain scans enable more children to have life-changing surgery?
Published on 1 February 2014
Around 60,000 children and teenagers under 18 in the UK have epilepsy.1 Sadly, up to one third of these young people carry on having seizures despite trying medication, meaning life can be difficult and unpredictable.2-5 Brain surgery can totally transform some of these children’s lives by freeing them from seizures altogether, but important questions must be answered before children undergo such a major operation. Dr David Carmichael from the Institute of Child Health in London is investigating whether sophisticated new brain scans could provide answers, so more children can benefit from surgery.
How are children’s lives affected now?
“Seizures can be scary, for children and their families” says Dr Carmichael. “They can cause physical injury and even death, and make day-to-day life difficult. Activities that other children might take for granted, like riding a bike, can be dangerous if there is a chance of having a seizure. Epilepsy can also interrupt learning and disrupt development.”
Brain surgery can offer hope of a better life if children carry on having seizures despite trying medication. Estimates suggest over 400 children with epilepsy could benefit from brain surgery every year in the UK.6 Surgery can stop children’s seizures and limit the disability that epilepsy can cause.
“Unfortunately, we cannot offer surgery to all of the children who might benefit from it, as we can’t always pinpoint exactly which part of the brain is causing a child’s problems,” explains Dr Carmichael. “Also, it’s not always possible to tell children and their families exactly how successful surgery is likely to be.”
How could this research help?
Dr Carmichael and his team are hoping to improve brain scanning of children with epilepsy.
“We are focusing on a type of epilepsy called focal cortical dysplasia, which affects around half of the children who visit our centre to find out whether or not they can have surgery,” explains Dr Carmichael.
“We are investigating whether a new type of MRI scanning might improve both our ability to predict a child’s chances of benefiting from surgery and our ability to pinpoint the abnormal area in a child’s brain that is causing their problems,” continues Dr Carmichael. “This information is vital for families when making the difficult decision about whether or not to go ahead with surgery and for surgeons when carrying out operations.”
The new scans are also designed to work even if children move around a bit during the scanning process – an important advantage when young children are having a scan.
|Project Leader||Dr D W Carmichael MSci PhD MInstP|
|Location||Department of Imaging and Biophysics, Department of Radiology, Department of Neurosciences and Developmental Cognitive Neuroscience Unit UCL Institute of Child Health and Great Ormond Street Hospital for Children|
|Grant awarded||1 November 2013|
|Start date||9 March 2015|
|End date||28 February 2019|
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1. Epilepsy Society. Epilepsy in childhood. http://www.epilepsysociety.org.uk/epilepsy-childhood#.Uqm_r9HuPVI. Website accessed 16 December 2013.
2. Epilepsy Action. NHS England. A guide for Paediatricians: Children’s Epilepsy Surgery Service (CESS). Guidelines for children’s epilepsy brain surgery referrals in England. https://www.epilepsy.org.uk/sites/epilepsy/files/professionals/cess-prac... Website accessed 18 December 2013.
3. Epilepsy Society. Antiepileptic drugs for children. http://www.epilepsysociety.org.uk/anti-epileptic-drugs-children#.UqnFONH... Website accessed 16 December 2013.
4. Epilepsy Society. Treatment. http://www.epilepsysociety.org.uk/treatment#.Uq7wE9HuPVI Website accessed 16 December 2013.
5. Epilepsy Society. Anti-epileptic drugs for adults. http://www.epilepsysociety.org.uk/anti-epileptic-drugs-adults#.Uq7wd9HuPVI Website accessed 16 December 2013.
6. E09/S/e. 2013/14 NHS Standard contract for children’s epilepsy surgery service (CESS). Section B Part 1 – Service specifications. http://www.england.nhs.uk/wp-content/uploads/2013/06/e09-child-epilepsy-... Website accessed 16 December 2013.