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Epilepsy Surgery - New Noninvasive Options Explored03/08/2012
Epilepsy medications designed to control the disease and prevent seizures do not work effectively for approximately 25% of patients suffering from the disorder. Although surgery is the best solution for some patients, the procedure involves a craniotomy, in which the patients skull is opened, in order to remove the brain lesion causing epilepsy.
Mark S. Quigg, M.D., a neurologist at the University of Virginia School of Medicine, is helping lead an international clinical trial in order to find out if Gamma Knife radiosurgery (a noninvasive procedure), could effectively treat individuals with mesial temporal lobe epilepsy - a certain type of the epilepsy.
Guided by MRI, the Gamma Knife transmits focused beams of radiation to the brain lesion in hopes of impairing the lesion and inhibiting it it from causing epileptic seizures.
Quigg, co-lead researcher of the study, explained:
"This trial could offer patients with the appropriate kind of epilepsy a choice of noninvasive surgery. Epilepsy surgery probably is underutilized, and an alternate method may bring the benefits of surgery to a wider group of patients."
The clinical trial will be supported by a grant of up to $20 million from the National Institutes of Health. 217 volunteer patients with mesial temporal lobe epilepsy will be randomly assigned to receive either craniotomy surgery or Gamma Knife treatment. Participants will receive follow-up for three years. At present, the noninvasive procedure is only available for epilepsy patients who volunteer for the human trial.
In order to compare the effectiveness of the two procedures, participants will keep a diary detailing when they have seizures after surgery. In addition the team will measure the patient's quality of life, such as their ability to drive and mood, and how well the participant's brain functions after the procedure.
The researchers will measure brain functions by analyzing specific kinds of memory, such as memory, used in recalling locations and finding directions. Additional measurements detail a participant's overall attention and speed of thought.
Furthermore, the team will analyze the cost of the procedure and follow-up treatment. According to Quigg, individuals who receive craniotomy can be hospitalized for 4 to 6 days after the surgery, including one or two nights in ICU. Although patients treated with the Gamma Knife procedure can usually return the same day, it can take 6 to 15 months for the treatment to prevent seizures.
In order to compare the overall costs for both treatments, participants will record their doctor visits over the three-year study period.
Written by Grace Rattue
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