RecruitingObservational

Optimizing epilepsy surgery

Around one in three people with epilepsy continue to have seizures despite trying different medications. For some, brain surgery to remove the area where seizures begin can offer long-term relief or even a cure. However, surgery carries risks to memory, language, and vision. This study, based at the National Hospital for Neurology and Neurosurgery in London, is testing smarter ways to plan and perform epilepsy surgery. Researchers are using advanced 3D computer models and scans to map the brain in extraordinary detail. This helps surgeons place recording wires safely and identify the exact seizure focus while avoiding healthy brain areas and blood vessels. The trial is open to adults aged 18 to 70 who are already being assessed for epilepsy surgery at the hospital. Taking part involves detailed scans and tests before surgery, followed by a review 3 to 4 months after the operation.

At a glance

Status

Recruiting

Sponsor

University College London

Enrolment target

300

Start

01 Oct 2020

Estimated completion

30 Jun 2028

Epilepsy

What is this study about?

For many people with epilepsy, anti-seizure medication works well to keep attacks under control. But for around a third of people, medications do not stop the seizures. Living with frequent, uncontrolled seizures can disrupt everyday life, increase the risk of injury, and cause understandable distress. In these situations, brain surgery can be a very effective option if doctors can pinpoint the exact spot where the seizures originate.

When surgery works well, it can be life-changing, allowing many people to become completely seizure-free. However, the brain is delicate. Removing brain tissue carries potential risks, including changes to memory, speech, or eyesight. Specialist teams want to make these operations as safe and precise as possible, giving each patient the highest chance of stopping seizures with the lowest possible risk of side effects.

This study uses advanced 3D computer imaging and detailed brain scans to give surgeons a clearer roadmap before they operate. By combining electrical recordings with brain scans, doctors can pinpoint where seizures start, plan the safest route to place temporary recording wires, and carefully steer clear of important blood vessels and vital brain networks.

Ultimately, this research aims to make epilepsy surgery more accurate and widely accessible across the NHS. By refining each step of the surgical journey, the team hopes to help more people achieve long-term freedom from seizures while safeguarding their everyday abilities.

Key takeaways

Aimed at adults aged 18-70 with drug-resistant focal epilepsy being considered for surgery at NHNN in London.
Uses advanced 3D computer mapping to pinpoint seizure zones and protect healthy brain tissue.
Designed to increase the chances of stopping seizures while reducing risks to memory, speech, and eyesight.
Works alongside your standard surgical care, with tests before surgery and a check-up 3 to 4 months afterwards.
Funded by the Wellcome Trust and Epilepsy Research UK.

Who may be eligible?

This study is open to adults aged between 18 and 70 who have focal epilepsy (seizures that start in one specific area of the brain) that has not responded to medication. You must already be under assessment for possible epilepsy surgery at the National Hospital for Neurology and Neurosurgery (NHNN) in London.

To take part, you need to be able to understand what the study involves and make your own decision to give consent. You must also be healthy enough to safely have neurosurgery.

You will not be able to take part if you have other medical conditions that make brain surgery unsafe. This includes active cancer, severe blood clotting disorders, advanced blood vessel disease in the brain, or dementia.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

I am aged between 18 and 70.
I have focal epilepsy that has not been controlled by medications.
I am currently being considered for epilepsy surgery at the National Hospital for Neurology and Neurosurgery (London).
I am able to give informed consent for my own treatment and research participation.
I do not have other major medical issues, such as severe bleeding problems or active cancer, that rule out brain surgery.

Answer every question to see your result.

What does participation involve?

Taking part in this study fits into the routine care you would receive when being assessed for epilepsy surgery. You will not be asked to take experimental medications. Instead, the team uses cutting-edge computer tools and advanced imaging to plan your operation.

Before surgery, you will have detailed brain scans (such as MRI scans) and electrical brainwave tests (EEG) to map your brain and track your seizure activity. If your doctors need to place fine recording wires into the brain to monitor your seizures, computer-assisted planning will be used to place them safely away from blood vessels.

After your operation, you will attend a follow-up assessment about 3 to 4 months later. During this visit, you will have follow-up scans and assessments to see how well the surgery has worked and check on your speech, memory, and vision. Your active involvement lasts from your pre-surgery planning through to your 3- to 4-month follow-up check.

Potential risks and benefits

The main benefit of taking part is that your surgery will be planned using the most advanced brain-mapping technology available, which aims to give you the best chance of becoming seizure-free while lowering the risk of damage to memory or speech. However, all brain surgery involves known risks, including bleeding, infection, and potential changes to memory, language, or vision. While these new tools are designed to reduce these risks, they cannot remove them completely. Taking part is entirely voluntary. You can choose to leave the study at any point, and your standard NHS surgical care will continue as normal.

Locations (1)

National Hospital for Neurology and Neurosurgery
Approximate
London, England

Common questions

Do I have to pay to take part in this research?

No. The study is funded by the Wellcome Trust and Epilepsy Research UK, and all assessments are carried out as part of your NHS specialist care.

Does this trial involve testing a new drug?

No. This study focuses entirely on improving brain scanning, surgical mapping, and surgical planning techniques, not new medications.

Can I take part if I am treated at another hospital?

The study takes place at the National Hospital for Neurology and Neurosurgery in London. If you are treated elsewhere, you would need to speak with your neurologist about whether a referral to this hospital is appropriate for you.

Does epilepsy surgery guarantee I will be seizure-free?

While surgery is often very successful, no operation has a 100% guarantee. In optimal cases, around 80% of patients are seizure-free for a year or more, and this study aims to improve those outcomes further.

What happens if I decide I do not want to take part?

You are free to say no or withdraw at any time. Your decision will not affect your relationship with your medical team or the quality of your NHS care.

How to find out more

John Duncan

j.duncan@ucl.ac.uk +44 (0)20 3448 8612 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.