Imaging and Seizure Surgery

Seizure surgery is a potential treatment option for people who have focal seizures – seizures that are localized to one area of the brain. However, Dr. Jorge Burneo and colleagues at Western University found that in Ontario, seizure surgery is an extremely underused treatment option and many people with epilepsy are not referred for surgery. In Dr. Burneo’s study, he found that only 1.2% of people had seizure surgery within two years of being diagnosed with drug-resistant epilepsy. In the next phase of research, it is hoped that we can understand why referral rates to epileptologists are so low, and continue to educate the public about surgery.

For people who are having seizure surgery, measuring and observing their brain activity can help us to identify where seizures are starting (epileptogenic regions) and how far they spread. Led by Dr. Burneo and Dr. Ali Khan, studies using high-resolution magnetic resonance imaging (MRI) techniques helped to identify lesions and abnormal structures in the brain not seen on conventional imaging. It is hoped that these findings will allow for better identification of potential epileptogenic regions in the brain, improving the outcomes of patients after surgery.

In other research by Dr. Mary Pat McAndrews and her team at Toronto Western Hospital, there have been advancements in identifying brain networks responsible for language and memory. In particular, these new models are being used to predict memory and language outcomes after surgery, and it is hoped that the dissemination of these new models will help influence clinical practice.

Researchers, including Dr. Douglas Cheyne, also started prototyping a novel technology for minimizing head motion artifacts in magnetoencephalography (MEG), a method of monitoring a person’s brain activity. A MEG helmet placed on the head can map out brain activity by identifying changes in magnetic fields. Improved MEG facilities are now available at SickKids and Toronto Western Hospital. This work has the potential to reduce or even eliminate the need for sedating young patients during standard MEG, increase the accuracy of preoperative imaging, and provide a less invasive, safer approach to finding where seizures start.