Robot Reduces Need for Open Brain Surgery to Map Epileptic Seizures

The AHA! Team — Fri, 03 Jan 2025 07:38:39 +0000

Debbe Geiger via Duke Health – A Medical Advance for People with Epilepsy. A robotic device is allowing doctors to pinpoint the origins of a person’s seizures through minimally invasive surgery. The device, in use at Duke and some epilepsy centers across the country, allows neurosurgeons to implant hundreds of recording electrodes into the brain through about 10 to 20 small incisions. The procedure is highly precise, and it takes less time than traditional surgical options for seizure localization. People also recover faster and have less pain. Diagnosing the Origin of Epilepsy Seizures When medications fail to stop epileptic seizures, a person’s best hope for gaining control of their seizures is often epilepsy surgery. That can only happen if doctors can identify the area of the brain responsible for the seizures and remove it safely. To identify that spot, neurosurgeons may perform a craniotomy, creating a large opening in the skull, and then place a plastic grid of electrodes on the surface of the brain to record seizures and identify where they originate. However, the electrodes can’t access the folds or the parts of the brain between the two hemispheres and its deep structures. Shorter, More Precise Brain Mapping The team at Duke’s epilepsy center has another tool in their arsenal. Robot-assisted stereoelectroencephalography (SEEG) is a minimally invasive procedure that rapidly places thin electrode wires in precise locations to map the brain and identify seizure origins. A 3D reconstruction of the brain guides where the dozen or more electrodes will be placed. The neurosurgeon uses a robotic arm to make small, two- or three-millimeter holes in the scalp through which the rigid electrode wire is passed. As opposed to grid electrodes, which sit on the surface of the brain, the wires are placed into the brain tissue with robotic assistance. The procedure takes about two to three hours. “The robot improves the efficiency of the procedure, and it reduces some of the possibility for human error. Depending on the patient’s condition, robot-assisted SEEG can be very useful for localizing seizures in a way that is more comfortable for patients,” said Duke neurosurgeon Derek Southwell, MD, PhD, of the Duke Comprehensive Epilepsy Center. Due to its minimally invasive nature, placing depth electrodes this way is much better tolerated by patients than placing grid electrodes. Once the seizure origin is identified, the electrodes are removed, and people recover quickly. That is a huge benefit over recuperating from a craniotomy. The procedure is also better for cases where the exact location of the seizure cannot be identified, or the seizure origin is in a part of the brain that is inoperable. To read the original article click here.

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AI Algorithm That Detects Brain Abnormalities Could Help Cure Epilepsy

AHA Publisher — Mon, 15 Aug 2022 07:00:16 +0000

University College London via Newswise – An artificial intelligence (AI) algorithm that can detect subtle brain abnormalities which cause epileptic seizures has been developed by a UCL-led team of international researchers. The Multicentre Epilepsy Lesion Detection project (MELD) used over 1,000 patient MRI scans from 22 global epilepsy centres to develop the algorithm, which provides reports of where abnormalities are in cases of drug-resistant focal cortical dysplasia (FCD) – a leading cause of epilepsy. FCDs are areas of the brain that have developed abnormally and often cause drug-resistant epilepsy. It is typically treated with surgery, however identifying the lesions from an MRI is an ongoing challenge for clinicians, as MRI scans in FCDs can look normal. To develop the algorithm, the team quantified cortical features from the MRI scans, such as how thick or folded the cortex/brain surface was, and used around 300,000 locations across the brain. Researchers then trained the algorithm on examples labelled by expert radiologists as either being a healthy brain or having FCD – dependant on their patterns and features. The findings, published in Brain, found that overall the algorithm was able to detect the FCD in 67% of cases in the cohort (538 participants). Previously, 178 of the participants had been considered MRI negative, which means that radiologists had been unable to find the abnormality – yet the MELD algorithm was able to identify the FCD in 63% of these cases. This is particularly important, as if doctors can find the abnormality in the brain scan, then surgery to remove it can provide a cure. Co-first author, Mathilde Ripart (UCL Great Ormond Street Institute of Child Health) said: “We put an emphasis on creating an AI algorithm that was interpretable and could help doctors make decisions. Showing doctors how the MELD algorithm made its predictions was an essential part of that process.” Co-senior author, Dr Konrad Wagstyl (UCL Queen Square Institute of Neurology) added: “This algorithm could help to find more of these hidden lesions in children and adults with epilepsy, and enable more patients with epilepsy to be considered for brain surgery that could cure the epilepsy and improve their cognitive development. Roughly 440 children per year could benefit from epilepsy surgery in England.” Around 1% of the world’s population have the serious neurological condition epilepsy, that is characterised by frequent seizures. In the UK some 600,000 people are affected. While drugs treatments are available for the majority of people with epilepsy, 20-30% do not respond to medications. In children who have had surgery to control their epilepsy, FCD is the most common cause, and in adults it is the third most common cause. Additionally, of patients who have epilepsy that have an abnormality in the brain that cannot be found on MRI scans, FCD is the most common cause. Co-first author, Dr. Hannah Spitzer (Helmholtz Munich) said: “Our algorithm automatically learns to detect lesions from thousands of MRI scans of patients. It can reliably detect lesions of different types, shapes and sizes, and even many of those lesions that were previously missed by radiologists.” Co-senior author, Dr Sophie Adler (UCL Great Ormond Street Institute of Child Health) added: “We hope that this technology will help to identify epilepsy-causing abnormalities that are currently being missed. Ultimately it could enable more people with epilepsy to have potentially curative brain surgery.” This study on FCD detection uses the largest MRI cohort of FCDs to date, meaning it is able to detect all types of FCD. The MELD FCD classifier tool can be run on any patient with a suspicion of having an FCD who is over the age of 3 years and has an MRI scan. The MELD project is supported by the Rosetrees Trust. To read the original article click here.

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brain waves that cause epilepsy Archives - Amazing Health Advances

Robot Reduces Need for Open Brain Surgery to Map Epileptic Seizures

AI Algorithm That Detects Brain Abnormalities Could Help Cure Epilepsy