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Imagine suddenly being unable to speak, seeing flashes of light, or passing out and waking up on the floor.
For many of those who suffer with epilepsy, this is what life is like.
Epilepsy is a chronic, neurological condition characterized by recurring seizures. It affects people of all ages and backgrounds as well as 1 in 100 Canadians.
Causes of epilepsy vary. Many forms occur for reasons that are unknown to experts. Others can result from brain trauma, genetics, brain tumours and, in the elderly, strokes.
With so many types of seizures, symptoms and causes, epilepsy can be very difficult to diagnose and treat. For some patients, there is little that can be done to alleviate their seizures.
As a result, epilepsy can take a severe toll on all aspects of a patient's life. For example, given that a seizure could strike at any time, those with epilepsy aren't allowed to drive within six months of their last seizure. People taking medication to treat epilepsy often feel tired and lethargic due to side effects. Seizures can interfere with a person's memory process. People living with epilepsy also face stigma socially and at work.
KNC: Changing the future of epilepsy
However, the Epilepsy Program at the Krembil Neuroscience Centre (KNC) is striving to change all of that. With leading neuroscientists at the helm, KNC is striving to provide the best care, advance research, provide more effective treatments, and raise awareness and understanding about this complex illness.
The Epilepsy Monitoring Unit (EMU)
KNC offers the only adult epilepsy monitoring services in Toronto.
At the EMU, patients are monitored for several days through video and electroencephalography (EEG) – the recording of the brain's electrical activity from the scalp. The recordings help to locate the source of a patient's seizure and epilepsy process with the results used to guide the best possible treatment plan for them.
Recently, the Ministry of Health and Long-Term Care designated KNC as a provincial Regional Epilepsy Treatment Centre to expand the epilepsy neurosurgery capacity and offer this treatment to more people living with epilepsy. As a result, the EMU is already under construction and will double its capacity from five to 10 beds by mid-2014.
Approximately 30 per cent of patients with epilepsy are candidates for surgery, where a portion of the brain is identified and removed with the hope that seizures will stop.
KNC is home to the largest number of people dedicated to epilepsy research in Ontario. Highlights include:
Studying brain tissue The research group at the Krembil Discovery Tower is one of few in the world to study tissue after it has been removed from an patient's brain. Even when studied outside the human body, brain tissue still generates brain waves – the electrical waves created by brain cells that are related to cognitive tasks for example, attention, memory, learning and problem solving – essentially, the things that make us human.
The removed brain tissue is also studied to better understand how and why seizures occur.
Genetics Genetics can play a role in the development of epilepsy. Genetically-determined epilepsy is often resistant to medication and can also be quite severe if a patient has had it since childhood.
Researchers in the Epilepsy Genetics Program at KNC are working to better understand the genes associated with epilepsy. This group has already identified one gene responsible for adult-onset neuronal ceroid lipofuscinosis, a fatal form of autosomal recessive epilepsy.
Functional neuroimaging Currently, there are no reliable tests that can predict how a patient's memory network might be affected by surgery to treat their seizures. Researchers are looking at functional neuroimaging – the imaging technology that measures an aspect of brain function – as a non-invasive way to characterize memory networks.
Improved mapping of these networks, in this case using MRI, can refine surgical practices to have less effect on a patient's memory.
Clinical trials Approximately 15 per cent of epilepsy patients can't be treated with medication. This leaves many people without any options. However, patients can enrol in clinical trials to test the efficacy of new drugs that could potentially help them.
Studies at KNC are actively testing new drugs to determine whether they might offer better seizure control, have fewer side effects, or be more effective for other variations of the disorder.
Clinical neurophysiology When patients are admitted to the EMU to have their seizures monitored, the patterns of their seizures can be affected by being in a new, stressful environment.
The team at KNC has developed a headset for seizures so that a patient can have their EEG readings monitored while they're at home. Allowing patients to be monitored at home not only means less alteration of their seizure patterns, but is also a way to increase the number of patients the EMU monitors especially for those living outside of Toronto.
Magnetoencephalography (MEG) and EEG are noninvasive imaging techniques for examining exactly where in the brain the electrical activity that causes seizures is located. Researchers are using these techniques to study how seizures spontaneously start and stop, with the hope of discovering changes in the electric and magnetic fields that might predict seizures before they occur.
Eventually, it is hoped this research will lead to better understanding of the how seizures arise and to better, safer ways to investigate and treat epilepsy.