Background:
- Medically intractable epilepsy is the term used to describe epilepsy that cannot be
controlled by medication. Many people whose seizures do not respond to medication will
respond to surgical treatment, relieving seizures completely or almost completely in one-half
to two-thirds of patients who qualify for surgery. The tests and surgery performed as part of
this treatment are not experimental, but researchers are interested in training more
neurologists and neurosurgeons in epilepsy surgery and care in order to better understand
epilepsy and its treatment.
Objectives:
- To use surgery as a treatment for medically intractable epilepsy in children and adults.
Eligibility:
- Children and adults at least 8 years of age who have simple or complex partial seizures
(seizures that come from one area of the brain) that have not responded to medication, and
who are willing to have brain surgery to treat their medically intractable epilepsy.
Design:
- Participants will be screened with a medical history, physical examination, and
neurological examination. Imaging studies, including magnetic resonance imaging and
computer-assisted tomography (CT), may also be conducted as part of the screening.
Participants who do not need surgery or whose epilepsy cannot be treated surgically will
follow up with a primary care physician or neurologist and will not need to return to
the National Institutes of Health for this study.
- Prior to the surgery, participants will have the following procedures to provide
information on the correct surgical approach.
- Video electroencephalography monitoring to measure brain activity during normal
activities within a 24-hour period. Three to four 15-minute breaks are allowed within
this period.
- Wada test to evaluate speech, comprehension, and memory centers of the brain, using a
contrast dye to study the blood vessels of the brain and a short-term anesthetic
administration procedure to test the effects on areas of speech and memory.
- Depth electrodes and/or brain surface electrodes to measure brain activities and
determine the part of the brain that is responsible for the seizures (seizure focus).
- Participants will have a surgical procedure at the site of their seizure focus. Brain
lesions, abnormal blood vessels, tumors, infections, or other areas of brain abnormality
will be either removed or treated in a way that will stop or help prevent the spread of
seizures without affecting irreplaceable brain functions, such as the ability to speak,
understand, move, feel, or see.
- Participants will return for outpatient visits and brain imaging studies 2 months, 1
year, and 2 years after surgery.
Clinical Trials in the Spotlight
NINDS Clinical Trials features descriptions of a selected group of actively-recruiting NINDS-sponsored trials organized by neurological disorder.
Epilepsy and Seizures
Background:
Some people with brain tumors have seizures related to the tumor. This is called
tumor-related epilepsy. Usually brain tumors are treated by removing as much of the brain
tumor as possible without causing problems. Researchers think this may improve the outcome
for people with brain tumors. It may completely relieve or greatly reduce the number of
seizures they have.
Objectives:
To evaluate people with brain tumors that are associated with seizures and to offer surgical
treatment. Also, to study how surgery affects seizures.
Eligibility:
People age 8 and older who have a brain tumor with associated seizures. They must be willing
to have brain surgery to treat their epilepsy.
Design:
Participants will be screened with a review of their medical records.
Participants will have a medical history and physical exam.
Participants will be admitted to the hospital at NIH. They will have
Medical history
Physical exam
Neurological exam
Tests of memory, attention, and thinking
Questions about their symptoms and quality of life
Blood drawn
They may also have:
MRI or CT scan. They will lie on a table that slides in and out of a machine that takes
pictures. For part of the MRI, they will get a dye through an intravenous (IV) catheter.
Video electroencephalography monitoring. Electrodes will be placed on the scalp. The
participant s brain waves will be recorded while doing normal activities. Participants will
be videotaped.
Participants will keep a seizure diary before and after surgery.
Participants will have surgery to remove their brain tumor and the brain area where their
seizures start.
They will stay in the hospital up to a week after surgery.
Participants have for follow-up visits at NIH.