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Standing Together for Epilepsy Awareness

24 March 2022

14 years ago, motivated by her own epilepsy struggles, nine-year-old epilepsy patient Cassidy Megan initiated Purple Day1. Since then, on the 26th March each year, patients, caregivers and advocates around the world unite to raise epilepsy awareness by wearing purple and holding educational and fundraising events.

While the true global incidence of epilepsy is unknown due to insufficient data collection in low-income countries, it is estimated that around 50 million people have epilepsy2 and as many as 20% - 40% are suspected to have drug-resistant or refractory epilepsy3.

With the pressure on healthcare systems at an all-time high as a result of the COVID-19 pandemic, it has never been more important to raise awareness to ensure patients with refractory epilepsy are treated in a timely manner for the greatest chance of seizure-freedom.

At Renishaw, were committed to playing our part in the fight against refractory epilepsy. We know the potential for seizure-freedom increases the sooner an accurate diagnosis is made and surgical resection is offered. And, with the effectiveness of anti-seizure drugs dropping to less than 5% after two previously unsuccessful treatment programmes4, we believe that minimally invasive surgical intervention could be a better solution.

Collaborations that drive success

One of the most successful minimally invasive interventions for the detection and treatment of refractory epilepsy is stereoelectroencephalography (SEEG). SEEG offers several advantages over standard surgical procedures including reduced intra-operative and post-operative blood loss. As a result, shorter hospital stays and lower care costs are possible5.

With almost 50 years of engineering expertise, Renishaw is uniquely positioned to help the fight against refractory epilepsy. Our advanced robotic technologies - neuromatestereotactic robot and neuroinspire neurosurgical planning software - support more accurate and efficient placement of implanted devices for SEEG.

Working together with our healthcare partners, weve made significant advancements in SEEG to improve patient outcomes, making a huge impact on the lives of epilepsy patients globally.

Here are just a few of the projects where were helping to make a difference:

  • In 2017, as part of a collaboration between Clinical Services, the BRAIN Unit and Renishaw, The University Hospital of Wales carried out their first SEEG procedure with the assistance of a neuromate robot. As a result, the team were able to accurately identify and operate on the epileptogenic zone in just 55 minutes, cutting the procedure time dramatically compared to the typical four hours, and the patient has remained seizure free ever since6.


  • After undertaking several large-scale studies to demonstrate the safety and accuracy of robot-guided SEEG7,8, the Niguarda Hospital, Milan, Italy,now use neuromate-guided SEEG routinely for presurgical assessment of the epileptogenic zone. One of the many success stories is that of a paediatric patient, Stella Mkinen. Stella went from suffering 100 life-limiting seizures per day to seizure freedom following a neuromate-guided SEEG procedure whereby neurosurgeons were able to perform highly accurate and tailored resection surgery.


  • In 2020, after the successful installation of a neuromate robot and neuroinspire software at Great Ormond Street Hospital, researchers and neurosurgeons were able to successfully identify seizures originating in the insula/operculum (I/O)cortex9 in 64% of paediatric SEEG cases. This deep area of the brain where seizures can originate is notoriously difficult to pinpoint.

In addition, weve also collaborated with many other hospitals worldwide, including Thomas Jefferson University Hospital, US, Childrens Wisconsin, US, King's College Hospital, UK and Centro Mdico Teknon, Spain.

For further information on about how were paving the way for more effective and minimally invasive epilepsy interventions visit www.renishaw.com/epilepsy

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References

  1. March 26 Marks Purple Day. St Elizabeths Medical Center. Available at: https://www.semc.org/newsroom/2021-03-26/march-26-marks-purple-day-4
  2. Epilepsy. World Health Organization. 2022. Available at: https://www.who.int/health-topics/epilepsy
  3. Sirven, J, MD. Evaluation and management of drug-resistant epilepsy. UpToDate. 2021 Dec.Available at: https://www.uptodate.com/contents/evaluation-and-management-of-drug-resistant-epilepsy

  4. Chen, Z., Brodie, M, J., Liew, D., Kwan, P. Treatment Outcomes in Patients With Newly Diagnosed Epilepsy Treated With Established and New Antiepileptic Drugs: A 30-Year Longitudinal Cohort Study [published correction appears in JAMA Neurol. 2018 Mar 1;75(3):384]. JAMA Neurol. 2018;75(3):279-286. doi:10.1001/jamaneurol.2017.3949

  5. Fiani, B., Jarrah, R., Doan, T., Shields, J., Houston, R., & Sarno, E. (2021). Stereoelectroencephalography versus Subdural Electrode Implantation to Determine Whether Patients with Drug-resistant Epilepsy Are Candidates for Epilepsy Surgery. Neurologia medico-chirurgica, 61(6):347355. DOI: https://doi.org/10.2176/nmc.ra.2020-0361
  6. Renishaw, University Hospital of Wales and Cardiff University celebrate the first robotic assisted neurosurgery procedure for epilepsy in Wales. 2017 April. Assessed at: /en/renishaw-university-hospital-of-wales-and-cardiff-university-celebrate-the-first-robotic-assisted-neurosurgery-procedure-for-epilepsy-in-wales--41305
  7. Cardinale F, Cossu M, Castana L, Casaceli G, Schiariti MP, Miserocchi A, Fuschillo D, Moscato A, Caborni C, Arnulfo G, Lo Russo G. Stereoelectroencephalography: surgical methodology, safety, and stereotactic application accuracy in 500 procedures. Neurosurgery. 2013 Mar;72(3):353-66; discussion 366. doi: 10.1227/NEU.0b013e31827d1161. PMID: 23168681.
  8. Cardinale F et al. Stereoelectroencephalography: retrospective analysis of 742 procedures in a single centre. Brain 2019;142:2688-2704
  9. Kappen, P., Eltze, C., Tisdall, M., Cross, H, J., Thornton, R., Moeller, F. (2020) Stereo-EEG exploration in the insula/operculum in paediatric patients with refractory epilepsy, Seizure, 78:63-70

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