Epilepsy
This programme of research has been developed with the benefit of input from individuals who have had or are considering epilepsy surgery for themselves or a loved one. This is the BrainBuddyUK group that meets every 2-3 months at NHNN. A key feature of the output of the research is to develop clinical decision support tools to enable better decisions to be made, faster, but with experienced consultants remaining in control of the process. The different aspects of this research will be appropriate at different points along the pathway of considering epilepsy surgery. The pathway for considering epilepsy surgery, with all the steps considered, may extend over 2 years. 150-200 patients per year consider epilepsy surgery at NHNN. Of these, approximately 40 per year may be offered resection without intracranial EEG, another 30 will require intracranial EEG, and the remainder will not proceed past the initial phase 1 investigations of MRI, scalp video-EEG telemetry, neuropsychology and neuropsychiatry assessments. Potential participants will be those 70-100 per year who are eligible to proceed past phase 1 investigations, and who wish to do so. They will be identified by the clinical team and informed of the study and asked if they wish to know more. If the individual is interested, they will be notified to the research team who will make contact and explain the research study, sending written information about the study and asked to contact the research team if they wish to participate. If, after discussion and asking questions they wish to do so they will be asked to indicate their consent in writing on a consent form. Individuals at the start of the evaluation of their epilepsy for possible epilepsy surgery will be asked a structured questionnaire of the symptoms. This will be supplemented by the account of a witness and of video recordings of seizures in the Hospital, which is standard clinical practice. The planning of the strategy of brain areas to be implante
1. Considering epilepsy surgery for drug-resistant focal epilepsy, at National Hospital for Neurology and Neurosurgery (NHNN) 2. Any gender, age 18-70 years 3. Has capacity to give informed consent 4. No contra-indication to neurosurgical intervention
1. Lack of capacity to give informed consent 2. Comorbidities that would make neurosurgical intervention inappropriate (e.g., active neoplasia, cerebrovascular disease, dementia, coagulopathy)