Grant: Operating Grant

Some forms of epilepsy are caused by localized brain lesions such as tumors, vascular malformations, cysts and brain developmental abnormalities resulting from intra-uterine injury or genetic factors. Patients suffering from an epilepsy that is refractory to medical treatment can be helped by surgical treatment if the region generating seizures can be identified, localized and safely removed. The presence of such an epileptogenic region is assessed with brain imaging methods such as MRI and by recording the electrical activity of the brain (EEG). In many patients, however, no lesion can be seen on MRI or the relationship between the lesion and the epilepsy is uncertain. The EEG shows epileptic activity in most patients but it does not provide accurate localization. The combination of functional MRI and EEG is showing great promise to significantly improve our ability to find the epileptogenic region in a non-invasive way and to understand better the relationship between the lesion and the epileptic disorder. We propose to establish the clinical parameters for which the method can be used practically and to develop exciting new MRI technology that will render this approach simpler and even more powerful. We also propose studies that will help us understand better the relationship between this method and the neurophysiological mechanisms underlying epileptic discharges in the brain.