Article published by The Mirage
Seizures can be predicted more than 30 minutes before onset in patients with temporal lobe epilepsy, opening the door to a therapy using electrodes that could be activated to prevent seizures from happening, according to new research from UTHealth Houston.
The study, led by Sandipan Pati, MD, associate professor in the Department of Neurology with McGovern Medical School at UTHealth Houston, was recently published in NEJM Evidence, a publication of the New England Journal of Medicine.
“The ability to predict seizures before they occur is a major step forward in the field of epilepsy research,” said Pati, senior author of the study and a member of the Texas Institute for Restorative Neurotechnologies at UTHealth Houston Neurosciences. “These findings are significant because they suggest that we may be able to develop more effective therapies for epilepsy, which could greatly improve the quality of life for patients who suffer from this condition.”
Surgery is a common treatment for many patients with epilepsy. But when seizures affect larger areas of the brain, removing part of the brain surgically is not an option. Neuromodulation therapy could offer an alternative solution for patients with these seizures, Pati said.
Past studies of continuous electroencephalography (EEG) – the measurement and recording of electrical activity in different parts of the brain – have suggested that seizures in people with focal-onset epilepsies tend to occur during periods of heightened risk, represented by pathologic brain activities known as “pro-ictal states.” The EEG-based detection of pro-ictal states is critical to the success of adaptive neuromodulation, with the early detection of seizures allowing electrodes to be applied therapeutically to the brain’s seizure onset zone and thalamus.
To distinguish these pro-ictal states, Pati’s team studied a prospective, consecutive series of 15 patients with temporal lobe epilepsy who underwent limbic thalamic recordings in addition to routine intracranial EEG for seizure localization. In total, they analyzed 1,800 patient hours of continuous EEG.