Brain links point the way to cutting epileptic seizures

Researchers discover connections in the brain linked to epileptic seizures, raising hopes of better treatment for drug-resistant epilepsy.

An MRI scan of the brain of a patient with epilepsy. Drugs work for only two thirds of people with the condition. Picture: Supplied

Researchers appear to have discovered connections in the brain linked to epileptic seizures, raising hopes of better treatments for people whose epilepsy does not respond to medication.

The study looked at the outcomes of operations where patients had lesions - damaged or scarred tissue - removed from the frontal lobe to reduce seizures. In some operations the position of the lesion meant that the surgeon had cut links between the frontal lobe and deeper parts of the brain, the thalamus and striatum, which are responsible for relaying sensory and motor signals, motor control and emotion.

Cutting the links had not been an aim of the surgery, but the analysis showed that when this had happened patients were free from seizures for longer. Nearly 90 per cent were seizure free after three years and 80 per cent were seizure free at five years, compared with about 30 per cent for all treatments involving the frontal lobe.

About 35,000 people whose epilepsy involves a frontal lobe lesion could be candidates for surgery. The researchers found that cutting connections did not have negative effects on language or executive functions.

Dr Davide Giampiccolo, of the UCL Queen Square Institute of Neurology, in London, who led the research, which is published in the journal Brain, said: “Neurosurgery can be very effective for people with epilepsy that is not controlled with medication. However, in some patients, seizures recur years after surgery and, until now, it has not been clear why this happens.”

He said that if the latest findings were correct surgeons could “redesign neurosurgical operations and personalise the operations for each patient, ensuring that the right connections are cut”.

The Times