New brain scans could give more children with epilepsy the chance of surgery
Researchers at the Institute of Child Health in London are investigating sophisticated new scanning methods to map the brains of children with epilepsy. The pioneering technique will help identify more children with the serious neurological disorder who will benefit from surgery, which can dramatically improve their lives.
Dr David Carmichael and team were awarded a three year grant of £190,057 from children’s charity Action Medical Research for their investigations.
A quarter of the 60,000 children and teenagers with epilepsy in the UK have seizures that existing drugs fail to control.1,2
Seizures can be scary and unpredictable. They can cause physical injury and death, and make day-to-day life difficult. Brain surgery can dramatically improve life for some of these children, by removing the part of the brain that triggers their seizures, but important questions must be answered before they undergo such a major operation.
“It is vital that essential areas of the brain, such as those that control talking and walking, remain undamaged,” explains Dr Carmichael. “But existing pre-surgical tests to identify these areas are often difficult to carry out or inconclusive in children, meaning we cannot offer surgery to everyone who may benefit.”
The researchers are developing a way to map the brains of children with epilepsy using a pioneering brain-imaging technique called EEG-fMRI. “We hope this can identify which children are most likely to benefit from surgery, so that the children, their families and their doctors are more informed when making the life-changing decision about whether to go ahead with surgery,” Dr Carmichael says.
Forty children with epilepsy and 20 children without epilepsy are taking part in the study. The team hopes to find out how well the new technique works if children are allowed to wear headphones and watch cartoons inside the brain scanner, making it an easier experience for each child. The benefits of using fMRI alone are also being investigated, as this is more widely available.
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Case study: Kian Clayden (Essex)
As a tiny newborn baby Kian Clayden suffered seizures and was admitted to the neonatal unit. His earliest years were then seizure free, but sadly a diagnosis of epilepsy followed a severe seizure when Kian was just eight.
“To be honest I was completely heartbroken, it turned our world upside down,” says mum Sarah. Seizures can be scary and unpredictable. Even riding a bike can be dangerous if a child suffers a seizure. “I wanted to wrap him in bubble wrap and keep him next to me at all times so that I knew he would be safe and unable to hurt himself,” says his mum.
Kian is now 16. He is a kind, caring, thoughtful young man who enjoys the usual teenage things. He suffers from seizures at least each fortnight and sometimes every week.
Although medication has meant the seizures are milder, these still disrupt Kian’s daily life. His mum explains: “All he wants is to be independent and to not have seizures any more. He can become very down and withdrawn.”
“Our son has had a lot of tough times. As a family we feel that the research will not only potentially benefit Kian, but also other children and their families who are going through the same thing as we are,” his mum says.
NOTES TO EDITORS:
• EEG - Electroencephalography
• fMRI - functional magnetic resonance imaging
• Dr Carmichael has received two prestigious personal awards for his work using EEG and fMRI – CNT young investigator of the year and BCISMRM Sir Peter Mansfield Prize.
• The team is collaborating with researchers in Geneva, UCL Institute of Neurology (who have also received previous support from Action Medical Research) and the developmental cognitive neuroscience unit at the UCL Institute for Child Health.
1. Epilepsy Society. http://www.epilepsysociety.org.uk/AboutEpilepsy/Epilepsyandyou/Childrena... Accessed June 2012
2. Berg AT, Mathern GW, Bronen RA, Fulbright RK, DiMario F, Testa FM, Levy SR. Frequency, prognosis and surgical treatment of structural abnormalities seen with magnetic resonance imaging in childhood epilepsy. Brain. 2009;132:2785-97.
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Action Medical Research - the leading UK-wide medical research charity dedicated to helping babies and children - is celebrating 60 years of vital research in 2012. We’ve been funding medical breakthroughs since we began in 1952 and have spent more than £100 million on research that has helped save thousands of children’s lives and changed many more. Today, we continue to find and fund the very best medical research to help stop the suffering of babies and children caused by disease and disability. We want to make a difference in:
• tackling premature birth and treating sick and vulnerable babies
• helping children affected by disability, disabling conditions and infections
• targeting rare diseases that together severely affect many forgotten children.
But there is still so much more to do. Make 2012 a special year and help fund more life-changing research for some of the UK’s sickest babies and children.