Hi, I’m Dr. Chris Plummer, Consultant Neurologist at St. Vincent’s Hospital, Melbourne. I joined the Editorial Advisory Board at the Virtual Neuro Centre 1 year ago and today I would like to share with you my insights on epilepsy and the methods to localise seizures.

My main clinical research interest is epilepsy. This disorder is diagnosed approximately 600,000 Australians and is one of the leading neurological conditions affecting young people. Many people with epilepsy are therefore diagnosed when most of their life is in front of them. It is this along with the inherent unpredictability of determining the next epileptic attack or seizure that compels one to admire the courage of these patients.

Unfortunately, a diagnosis of epilepsy still carries a significant social stigma and the sufferer must come to terms with the potential injustices born out of this. On a more positive front, the majority of patients diagnosed with epilepsy have their seizures controlled with a single medication. Approximately 20% of patients may be troubled by persistent seizures despite the use of multiple different medications. For these patients, the option of surgery might be considered, that is an operation to remove that area of the brain that might be responsible for the origin of a patient’s seizures.

As one may imagine the localisation of such areas is a very challenging exercise. At this point in time there exists no single test that can identify the so-called “epileptogenic area or zone” without fail. Epileptic specialists rely on multiple kinds of tests to help decide on the most likely location in the brain from which the individual patient’s seizures arise. Sometimes multiple areas in the brain are involved.

The kinds of tests used can be basically separated into 2 types: anatomical and functional. The main anatomical test is the MRI scan while the main functional test is the electroencephalogram or EEG, otherwise known as a brain wave trace. New research methods are currently trying to better marry the 2 types of testing such that seizures can be recorded from the brain, from the EEG, and placed in direct reference to an image of the brain, by the MRI. Such methods may further our understanding of so-called epileptogenic networks in the brain and ultimately improve the lives of patients suffering from difficult to control seizures.

Thank you for watching and have a great day.

More information

The human brain For more information on the symptoms, diagnosis and treatment of this condition, see Epilepsy.

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