Researchers have demonstrated the efficacy of 3D modeling and MRI in epilepsy surgery.
Surgery for epilepsy is potentially curative for those individuals with focal epilepsy who continue to have seizures despite taking medication. The key to success is to remove the area of brain that is giving rise to the seizures, and sparing the parts of the brain that are necessary for important brain function, such as speech, motor control and sensation.
However, planning and carrying optimal brain resections to treat epilepsy is difficult, particularly if there is not an obvious lesion on a scan that can be targeted and removed, and if the area to be resected is not on the brain’s surface.
Professor John Duncan, corresponding author on the paper published in the British Journal of Neurosurgery, said: “We created 3D models of the brain showing normal structures, and the location of critical nerve pathways and of vital parts of the brain that subserve speech and motor control. We then used this model to precisely place recording electrodes in the brain and determine where epileptic seizures were starting. We then mapped the precise location of those electrode contacts at which seizures started, in the 3D-model of the brain, and their relation cortical structures, arteries, veins and the skull. This then allowed us to create in virtual really, a 3D volume of brain that needed to be removed, and to plan the best access to that part.”
The operation was carried out, and the part of the brain that was wished to be remove was taken away. The operation was a success and the patient had no deficit following the surgery.
Professor Duncan said: “We are now replicating this process in other patients and the technique is also very relevant to planning other brain operations, including those with brain cancer.”
