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June 2013

Google LogoMark Cook in his laboratory jpeg
Professor Mark Cook in his laboratory at St Vincent’s.

Seizure study success

A study led by St Vincent’s Chair of Medicine and Director of Neurology Mark Cook has demonstrated it is possible to predict the onset of seizures in adults with focal epilepsy.

More than 60 million people worldwide have epilepsy with 30 to 40 per cent of patients unable to control their seizures with existing treatments.

Focal epilepsy is a particular type of epilepsy, characterised by seizures that start in a specific area of the brain.

The St Vincent’s study included 15 people with focal epilepsy, aged between 20 and 62, who experienced between two and 12 seizures per month and had not had their seizures controlled despite use of at least two anti-epileptic drugs.

A small device was implanted between the skull and brain surface of each patient to continuously monitor the brain for abnormal electrical activity that occurs before a seizure.

The electrodes were connected to a second device implanted under the skin of the chest to transmit information wirelessly to a hand-held device which in turn calculated the probability of a seizure.

Three coloured lights warned patients of the high (red), moderate (white), or low (blue) risk of an impending seizure.

‘Knowing when a seizure might happen could dramatically improve the quality of life and independence of people with epilepsy and potentially allow them to avoid dangerous situations such as driving or swimming or to take drugs to stop seizures before they start, rather than continuously as at present,’ said Professor Cook.

As well as accurately predicting a seizure, the device demonstrated most participants greatly underestimated the number of seizures they were having – one patient who reported having 11 seizures per month actually had 102.

‘Our findings have pronounced implications for trials of new epilepsy treatments which often rely on patient-reported events as the primary efficacy endpoint,’ Professor Cook said.

The results of this proof of concept study were published online in The Lancet Neurology.

Professor Cook and his fellow researchers are optimistic that if the findings are replicated in larger, longer studies, this technology will improve management strategies including developing methods of preventing seizures using direct electrical stimulation or fast-acting drug therapies.