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Can a brain implant predict epilepsy seizures?

May 02, 2013
Research published today in The Lancet Neurology describes the first small human clinical study involving a brain implant to predict when a patient with epilepsy will have a seizure. Professor Mark Cook and colleagues from the University of Melbourne in Australia used an implanted electronic device that measured the brain’s electrical activity to decide whether seizure risk was low, moderate or high. Dr Rebecca Liu, Consultant Neurologist at The Physicians’ Clinic and an expert in epilepsy has reviewed the research and explains its significance.

Epilepsy seizures and their impact

Dr Liu: “Epilepsy is the most common serious neurological condition affecting up to 600,000 people in the UK. Although many patients with epilepsy have an excellent response to medication and become seizure-free, a third are less fortunate. A few benefit from epilepsy surgery, but the rest have a reduced quality of life because their seizures are frequent but unpredictable.” Every seizure carries the risk of accidental injury, complications of prolonged seizures (status epilepticus) and Sudden Unexpected Death in Epilepsy (SUDEP) can occur. Dr Liu: “Improving seizure control is the only way of effectively reducing these risks. Predicting when seizures are imminent is important because it allows patients to be more in control and for acute treatments to be used at the right time.”

An overview of the epilepsy study

  • Fifteen patients were studied. All had frequent disabling seizures (2-12 per month) that did not respond to drug therapy.
  • Surgery was carried out to implant a small device into the brain of each patient. This implant stayed in place for several months and monitored brain waves from inside the skull.
  • The first question asked by the study was about safety. Adverse events did occur but they were resolved in 11 patients.
  • In those 11 patients, the device was able to predict seizures with a performance estimate sensitivity of 65-100%.
  • The general health of patients with the implanted device remained stable.

Implications for epilepsy patients

Dr Liu: “Professor Cook’s group has used an innovative device for predicting seizures. This works on the premise that individual brain wave patterns leading up to a clinical seizure can be reliably differentiated from normal brain wave activity.” Although the device was able to detect seizures with great accuracy in some patients with poorly controlled epilepsy, results were more mixed in the others, and there were some side effects. More work is now needed to increase the accuracy of prediction so that patients do not experience repeated false alarms, which can be upsetting and worrying. Dr Liu: “The potential benefits of this device are, however, huge. Patients will be able to regain a greater sense of independence and reduce their risks of seizure-related injury. The development of responsive treatments in the form of fast-acting medication and targeted deep brain stimulation before a seizure actually occurs holds great promise.

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