Research: treating epilepsy with precision radiation

In the Netherlands there are approximately 130,000 patients with chronic epilepsy that develops at a specific location in the brain (focal epilepsy). About 30% of these patients do not respond to medication. They are investigating whether brain surgery can cure epilepsy. However, this operation is not possible for some of these patients. In that case, there is as yet no curative treatment available. That is why Maastro and Maastricht UMC+ are starting a study into the possibilities of precision radiation in collaboration with the two epilepsy centers in the Netherlands, Kempenhaeghe and SEIN, and Amsterdam UMC and UMC Utrecht.

Precision irradiation can improve quality of life

Epilepsy has a major impact on quality of life. It therefore has a huge impact if not treated properly and can even lead to social exclusion. “For the group of patients for whom there is currently no curative treatment available, we will go into this study see if we can offer a different treatment”, says radiotherapist Dr. Daniëlle Eekers. “It involves precision irradiation of the part of the brain where the epilepsy originates. This treatment is not yet reimbursed by the health insurer in the Netherlands, which is why we have applied for a subsidy from Highly Promising Care, so that reimbursement becomes possible after successful completion of this study.”

The research gives patients with epilepsy a new chance to improve the quality of life, because the application of precision radiation abroad is promising. The research group includes radiotherapist Dr Daniëlle Eekers from the radiotherapy center Maastro, neurosurgeon Dr Olaf Schijns from Maastricht UMC+ and neurologist Dr Albert Colon from the Kempenhaeghe expertise center for epileptology.

Comparing two groups of patients

The Dutch regional working groups for epilepsy surgery meet monthly to determine which patients are eligible for brain surgery. These working groups will now also register patients for this study. The researchers from Maastro, MUMC+ and the epilepsy centers are assessing whether they are eligible for precision radiation. This is expected to be approximately 30 patients per year. Patients participating in the study will be randomly divided into two groups. Half of the patients undergoing the precision radiation treatment will be compared with the other half receiving the current standard treatment which may include continuing with drugs and placing an electrode around the 10th cranial nerve or in the brain to reduce the seizures. After the division into two groups, the patients are followed for a minimum of two years to monitor the results of the treatment.

Epilepsy & AI

Another first for the Netherlands regarding epilepsy was recently in the Medisch Spectrum Twente (MST). There, two Dutch epilepsy patients have a implant behind the ear that can continuously measure brain signals (EEG). The signals are analyzed using artificial intelligence (AI). With this analysis, the treatment can then be improved by means of the administration of stimuli to a nerve in the neck.