MRI gives hope to people stricken with seizures

Epilepsy sufferers who do not respond to drugs have been given new hope by a team of researchers.

Experts have been honing their techniques to analyse MRI scans with the aim of identifying which part of a patient's brain is causing fits.

Until now, around one in four brain scans of epileptic patients not responding to drugs mistakenly gives the "all clear".

But Professor John Duncan and his team have been reprogramming scanners and finding new ways to analyse images with the aim of finding out more about these people's brains.

The hope is that hundreds more patients will be able to undergo surgery to remove the part of their brain that causes their seizures.

Professor Duncan, who is medical director of the National Society for Epilepsy and works at University College London, said one of the new techniques involved watching how water moves around the brain.

Another involves examining how water "sticks" to proteins in the brain, which can show up areas of abnormality not revealed in normal scans.

"It takes a long time and a lot of practice to perfect these techniques," he said.

"We are trying to find that abnormal area of the brain that is causing the epilepsy."
"Then there is the prospect of taking away that area of the brain in an operation."

"The first MRI scans were used for epilepsy about 20 years ago and technology is advancing year on year."

"In about one in four patients who do not do well with medicines, we don't see an abnormality."
"If one can make the scans more sensitive to find the abnormalities, this opens up the possibility of more operations."

The new methods have detected abnormalities in the brain in 29% of patients whose brains appeared normal using conventional MRI scanning.

The team has also looked at changes in the brain immediately following an epileptic episode to see whether it causes any damage.

Prof Duncan said his team was now spreading its knowledge across the UK through talks and conferences and by publishing papers in medical journals.

Around 450,000 people in the UK suffer from epilepsy, which is characterised by repeated seizures.

These seizures are often spontaneous but can be triggered by a lack of sleep, flickering lights or a high fever.

Prof Duncan said: "Epilepsy can be controlled by medication in 60 to 70% of cases and, for a quarter of the remainder, surgery may be the best treatment."

"It is crucial that we have an accurate picture of what is happening in the brain to allow the best possible outcome for the patient."

"Our work has found that in 29% of patients whose brains appeared normal using conventional MRI scanning, our new techniques have found changes suggesting an epileptic seizure."

"This would have been missed without our new techniques."

"Improving our diagnostic techniques and our understanding of the effects of an epileptic seizure means that more people could benefit from curative surgery."

The charity Action Medical Research has funded Professor Duncan's work for 16 years.

Its spokesman, Andrew Proctor, said: "This is a real leap forward in the treatment of epilepsy and it could mean life-changing surgery for many more people."

"The potential benefit to patients is tremendous."