Dépasser l'enregistrement des crises dans l'unité de surveillance: vers un diagnostic de l'épilepsie meilleur et plus rapide

 

Birgit Frauscher

Centre universitaire de santé McGill [CUSM]

 

Domaine : neurosciences, santé mentale et toxicomanies

Programme Chercheurs-boursiers cliniciens - Junior 2

Concours 2018-2019

Epilepsy is characterized by recurrent unprovoked seizures accompanied by a severe negative impact on quality of life. Epilepsy can be focal or generalized. A correct localization of epilepsy is important given the large proportion of 30 % of epilepsy patients who do not respond to antiepileptic treatment and in whom epilepsy surgery is the therapy of choice.

There are three challenges for a correct localization of epilepsy. The first challenge is that the current gold standard for the definition of the epileptogenic zone is based on the onset of epileptic seizures. This marker, however, is known to be unreliable, and it is based on recording of spontaneous seizures, which requires up to 2-3 weeks of hospitalization. This is both time-consuming and expensive. The second challenge is that currently invasive EEG is the gold standard for defining the area of the brain where seizures start. Intracranial EEG has obvious limitations, as it is an invasive, risky and costly procedure. Therefore, there is a need for developing non-invasive markers. The third challenge is the absence of epileptic activity in some patients. This problem is not infrequently encountered in the types of epilepsy where the epileptic generator is localized deep in the brain and not accessible to scalp EEG.

This research program focuses on developing new seizure-independent one-day EEG markers for a more accurate and time-saving diagnosis of epilepsy. It also proposes to translate candidate markers identified in intracranial EEG to non-invasive scalp EEG.

This work will provide knowledge for an improved, time-saving and cost-effective localization of the epileptic focus. Currently pre-surgical epilepsy evaluation is very time-demanding. Ultimately, this program will improve the quality of life of people with epilepsy.