Researchers have unveiled a new method for triggering and imaging seizures in epilepsy patients.
The breakthrough has the potential to revolutionise the approach to epilepsy surgery.
Traditionally, physicians in neurology and nuclear medicine faced significant challenges in capturing the onset of seizures – often having to wait for hours or even days.
However, this new method is convenient, resource-efficient and clinically feasible, marking a significant advancement in epilepsy treatment.
Dr Sabry L Barlatey, a resident in the Department of Neurosurgery at the University Hospital of Bern, Switzerland, emphasised the importance of precisely delineating epileptic brain tissue for successful surgeries. ‘Obtaining timely images of seizures may help formulate surgical plans with increased precision.’
The study builds upon the ictal SPECT method, which has been used since the 1990s to capture images of epileptic seizures propagating in the brain.
However, due to cost and time constraints in healthcare, many epilepsy centres discontinued its use.
Dr Maxime O Baud, a professor of neurology at the University Hospital of Bern, highlighted the study’s innovative approach: ‘Instead of waiting for spontaneous occurrences, we imaged planned seizures triggered with targeted electrical stimulation to the brain.’
The case study involved three adult participants with left temporal epilepsy. Using stereotactic electroencephalography (EEG) leads in targeted cerebral areas, researchers successfully triggered patient-typical seizures.
The radiotracer 99mTc-HMPAO was administered within seconds of ictal onset, and SPECT images were acquired within minutes.
Results showed that seizures were successfully triggered in each participant, replicating patient-typical seizure patterns without any adverse events.
Each triggered seizure was patient-specific, offering unique insights into early seizure propagation.
Dr Thomas Pyka, Privatdozent in the Department of Nuclear Medicine at the University Hospital of Bern, highlighted the study’s practical implications.
‘This innovative approach greatly facilitates the acquisition of ictal SPECT, potentially leading to higher-quality images. It could contribute to refining resection planning, ultimately improving seizure and cognitive outcomes in epilepsy surgery.’
The development of this new method represents a significant step forward in epilepsy treatment, offering hope for more precise and effective surgical interventions for individuals living with epilepsy and seizures.
Further research and clinical application of this technique are warranted to maximise its potential impact on patient care.
The study was published in the March issue of The Journal of Nuclear Medicine.
