One percent of the world’s population has epilepsy and 30 percent of those are resistant to medication. Their seizures can be debilitating and life threatening. For some, the best option is surgery.
If the source of the seizures is unclear, surgeons may resort to placing electrodes into the brain to directly record from specific areas. If seizure activity is confined to an area around the electrodes, surgeons can create a lesion in the brain to stop the abnormal electrical activity that causes the seizure.
Unfortunately, the lesions created tend to be very small, often too small to permanently stop the seizures. Dr. Jeffery Hall and colleagues at The Neuro are working on perfecting a way to increase lesion size without damaging neighbouring brain tissue, which might cause physical or cognitive impairments. Additionally, they must navigate around blood vessels to avoid bleeding.
The Neuro was the first centre in Canada to employ robotic technology in this type of surgery, improving the precision and effectiveness of treatment. Dr. Hall’s research seeks to refine robotic targeting and allow larger lesions to permanently disrupt the source of seizures. By using neuroimaging data and developing advanced algorithms, he is striving to optimize the placement of electrodes to detect abnormal electrical activity. Once detected, a treatment may be offered by passing electrical current through the electrodes, coagulating the abnormal tissue to reduce or stop its capacity to generate further seizures.
Combined exploration and lesioning surgery
Epilepsy surgery is an invasive procedure that involves a hospital stay and recovery time. There are sometimes two surgeries required—one to find the source of the seizure and another to coagulate it. At The Neuro, surgeons like Dr. Hall believe one surgery is better than two. They combine both surgeries, reducing the risk of complication and impact on the patient’s life.
“If you have to do a second surgery, then you assume all the risks of a second intervention,” he says. “If it's possible to create lesions with the electrodes that are already implanted as part of the investigation, that is the best option.”
The goal is to minimize the toll epilepsy takes on people’s lives, both the seizures and interventions necessary to stop them, offering improved outcomes for individuals living with this condition.
