Grant winner 2017

‘Routine, low-risk access to electrical activity in deep-seated brain areas will improve not only the diagnostic yield of EEGs, but also aid our understanding of seizure subtypes and neuronal networks involved in their generation.’ Dr Dora Lozadi (pictured)

Grant type: Pilot grant

Principal investigator: Dr Dora Lozsadi

Institution: St George’s Hospital, London

Amount: £30,000

Duration: 12 months

Scientific title: Naso-ethmoidal EEG recording – pilot study

When someone is suspected to have epilepsy, they are usually referred for an electroencephalogram (EEG). The test records electrical activity in the brain via electrodes attached to the scalp. Though EEG is a very useful tool, it is poor at detecting focal abnormalities originating in deep brain areas (e.g. the inner, lower region of the frontal lobe), because the scalp electrodes are too far away. Current methods to bring the electrodes closer to the seizure source are invasive and sometimes require surgery.

The study
Here, Dr Lozsadi and colleagues will assess the tolerability and benefit of a minimally invasive technique in which recording electrodes are placed in the nose (the nasal cavity).

During the study the team plans to recruit 30 people with brain abnormalities affecting areas close to the top of the nasal cavity. They will approach people who have routine sleep deprived EEG planned, or who are awaiting video EEG monitoring. All subjects will undergo a standard EEG, and in addition a hair-thin EEG wire (attached to an amplifier) will be inserted into their nose. The investigations will last a maximum of 48 hours and will take place in a neurophysiology department or neurology ward.

The researchers will examine the data in two stages: first routine EEGs alone and then EEGs in combination with nasal recordings. They will be interested in finding out whether any additional information on deep brain structures can be obtained using nasal electrodes.

If this is the case, its impact on routine diagnosis and advanced management of people with frontal lobe epilepsy will be significant. The new technique will not only facilitate more accurate and prompt diagnosis and earlier access to treatment, it will reduce the need for invasive follow-up investigations.

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