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Severe epilepsy: could a new type of brain scan enable more children to benefit from life-changing surgery?

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Epilepsy affects around 70,000 babies, children and young people under 18 years old in the UK.[1],[2] Sadly, medications don’t work for up to one in three of these young people, meaning that their lives can be difficult and unpredictable.[3] Many children with severe, drug-resistant epilepsy have abnormal areas of brain tissue known as focal cortical dysplasia (FCD). Professor Chris Clark of UCL Great Ormond Street Institute of Child Health is investigating whether a new scanning technique can help to improve the detection of FCD. If successful, it would mean that more young people with severe epilepsy could benefit from potentially curative surgery – transforming the lives of these children and their families affected by this devastating condition.

This project is funded by a generous donation from the Garfield Weston Foundation.

How are children’s lives affected now?

Focal cortical dysplasia (FCD) is a term used to describe a specific area of abnormal brain tissue containing disorganised nerve cells. Children with FCD are at an increased risk of seizures, which can often start before their fifth birthday.

“Seizures can be extremely distressing for children and their families – and can put them at risk of injury or even death,” says Professor Clark. “They sometimes also lead to wider damage to the brain, which can cause problems with a child’s learning and behaviour.”

Surgery to remove the affected area of the brain may be an option for some children with FCD who continue to have seizures despite trying medication. But doctors can only consider this treatment if the affected tissue can be detected using a scanning method such as magnetic resonance imaging (MRI).

“Surgery offers the possibility of a cure for children with FCD,” says Professor Clark. “But unfortunately, some children may be missing out on the opportunity to have this potentially life-changing treatment due to the current limitations of MRI scans.”

How could this research help?

“We’re aiming to improve the ability of doctors to reliably detect brain changes that are causing severe epilepsy in children,” says Professor Clark.

The researchers have recently developed an advanced MRI technique – which can detect and measure abnormal changes occurring in brain cells at a microscopic level – and tested this in healthy adults.

“We will now compare the results of our new technique with the current gold standard MRI scan in 20 children with severe epilepsy – to find out whether it can reliably identify brain changes that would otherwise remain undetected,” says Professor Clark.

The team will also examine brain tissue collected from five children with FCD who have gone on to have surgery – to assess the accuracy of the new technique and also to look for any changes in the cells that may help shed light on the underlying causes of epilepsy.

“If successful, this new tool could help doctors to pinpoint the exact area of a child’s brain that’s causing their problems,” says Professor Clark.

This would open the possibility of transformative surgery to more children with FCD – which could dramatically improve their quality of life.

Professor Clark

Research table

Project details

Project Leader Professor Chris A Clark, BSc MSc PhD
Location Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health
Project Team Professor Helen Cross, MD PhD FRCP OBE
Professor Tom Jacques, BSc MA MBS PhD MRCP
Professor Torsten Baldeweg, MD
Mr Martin Tisdall, MD
Professor Danny Alexander, BSc MSc PhD
Dr Felice D’Arco, MD
Other Locations Developmental Biology and Cancer, UCL Great Ormond Street Institute of Child Health
Department of Neurosurgery, Great Ormond Street Hospital, London
Computer Science, University College London Department of Radiology, Great Ormond Street Hospital, London
Grant Awarded
Grant Amount £123,799
Start Date
End Date
Duration 24 months
Grant Code (GN number) GN2981

References

  1. Young Epilepsy: Information about epilepsy; www.youngepilepsy.org.uk/what-we-do/health-research/information-about-epilepsy [website accessed 19 June 2023]
  2. Office for National Statistics; Estimates of the population for the UK, England and Wales, Scotland and Northern Ireland - Office for National Statistics (ons.gov.uk) [website accessed 19 June 2023]
  3. NHS Epilepsy treatment: https://www.nhs.uk/conditions/epilepsy/treatment/ [website accessed 19 June 2023]

 

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