Funded by the Wellcome Trust and the Department of Health, we have developed software EpiNav™ (Epilepsy Navigator) that enables even more sophisticated and accurate brain surgery for epilepsy, which will increase the numbers of people who can become seizure free and reduce the risk of damage to language, memory, movement and vision.
EpiNav™ is an interactive 3D-neuronavigation system that simultaneously displays the anatomy of the brain and any abnormal areas, critical brain functions, arteries, veins, blood vessels and the white matter tracts that connect the different areas of the brain.
Using computer-assisted guidance, this pioneering system enables the precise planning of the trajectories of electrodes into the brain in order to pinpoint the areas where seizures arise from. These plans are now being used to direct a robotic system for placing the electrodes through the skull and into the brain.
When recording electrodes have been placed in the brain, and seizures recorded, EpiNav™ will display the onset and spread of epileptic activity in the brain in 3 dimensions. This enables the understanding of which part needs to be removed to cure the epilepsy. By integrating this with the 3D maps of critical brain areas and tracts that must not be damaged, we can devise the optimal surgery.
The 3D maps are used during the operation to guide the surgery and to increase its precision and accuracy, so that surgeons can remove the area that gives rise to seizures without damaging any vital structures.
We have introduced EpiNav™ into epilepsy surgery in clinical trials at the UCLH National Hospital for Neurology and Neurosurgery and it is currently being evaluated by MedTronic Neuronavigation, in Colorado.
As well as benefiting people with epilepsy, these advances will have wider application for those undergoing brain surgery for tumours and will be rolled out across the UK and globally.