Brain 'Helmet' Helps Doctors Diagnose Epilepsy

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More than 3 million people in the United States have epilepsy. One in every 100 has experienced an unprovoked seizure. Surgery can eliminate the symptoms, but doctors can rarely get a clear enough image to figure out where to operate.

That's all changing with a new helmet-like device that gives doctors a picture-perfect view inside the brain.

"I feel like I am not living like a normal teenager,” said Victoriahope McCauliffe, epilepsy patient.

For McCauliffe, the seizures started when she was four, and they haven't stopped.

"I have like scars from where I've fallen down and crawled on the ground, and I’ve been in school where I’ve been all bloody,” McCauliffe said.

Growing up with epilepsy isn't easy. Medication doesn't always work, and it makes her groggy. Surgery is an option, if doctors know where to operate.

"Many patients with epilepsy could be helped if we could find the part of the brain that's actually the source of the epilepsy, but in many patients those parts of the brain are so small we just can't see them with our normal MRI," said Dr. Bruce Rosen, PhD., professor of radiology and health science & technology at Massachusetts General Hospital in Boston Mass.

Rosen is one of the first to use the brain bucket, a new scanner that sees inside the brain like never before.

"It's kind of like the difference between the picture you would take on your cell phone and the picture you would take with a good 10-megapixel camera,” Rosen said.

The helmet is filled with 96 metal coils and sensors that pick up signals from different areas of the brain and translate them into an image. A traditional MRI uses between two and 12 coils.

"With the brain bucket technology, we kind of put the whole process on steroids,” Rosen said.

The brain bucket' s clearer picture shows a small lesion that's causing seizures. In a study the device caught 50 percent more defects than traditional scans. Victoriahope wants the helmet sees what others have missed, so she can have surgery to stop the seizures.

Doctors believe the device could also be a powerful weapon in the fight against Alzheimer’s and brain tumors. With its resolution, the device can identify and follow changes in the brain, allowing doctors to prescribe more accurate treatments.

Medical Breakthroughs Research Summary

Topic: Brain Bucket For Epilepsy
Report: MB #3059

Background: Almost 3 million people living in the United States have some form of epilepsy, and 200,000 new cases are diagnosed every year, according to The Epilepsy Foundation.

A person is considered to have epilepsy if he or she suffers two or more spontaneous seizures. Seizures can last from a few seconds to a few minutes and present themselves in different ways, but they are all caused by a brief, strong surge of electrical activity in the brain.

While traditional symptoms of a seizure are convulsions and loss of consciousness, other, less recognizable symptoms include blank staring, lip smacking and jerking movements of the arms and legs.

Causes: An often mysterious condition, epilepsy has many possible causes.

According to the National Institute of Neurological Disorders and Stroke, about half of all seizures have no known cause. Anything that disturbs the normal pattern of neuron activity in the brain can lead to seizures.

Researchers believe some people with the condition have an abnormally high level of excitatory neurotransmitters, which increase the activity of neurons, while others have an abnormally low level.

Other events that can cause multiple seizure episodes are head injury and stroke. The problem lies in the brain's attempts to repair itself after such traumatic events, which sometimes causes problems in nerve connections.

Research suggests genetic abnormalities may be some of the most important risk factors for epilepsy.

Diagnosis: In addition to a medical history, physical exam and blood tests, the process of epilepsy diagnosis may include electroencephalograph (EEG), computerized tomography (CT) or magnetic resonance imaging (MRI) tests.

EEG machines record brain waves picked up by tiny wires taped to the head, and doctors analyze wave patterns. CT and MRI scans are used to search for growths or scars in the brain that may cause seizures. These abnormalities can be subtle and hard to detect even with MRI imaging.

A new technology developed at Massachusetts General Hospital in Boston could revolutionize the detection of epilepsy and other brain disorders, researchers said.

The multi-channel phased ray coil, or brain bucket, is a helmet containing sensors and coils connected to an MRI machine. In conjunction with the helmet, the MRI can put together high-resolution images of the brain up to 10-times faster than older machines. The images can show clear images of parts of the brain like blood vessels and abnormalities that an MRI would have missed completely.

In a study using an early prototype of the brain bucket on epilepsy patients, the device picked up abnormalities in the brain that previous scans missed in 50 percent of patients.

For More Information, Please Contact:
Bruce Rosen, MD, PhD
bruce@nmr.mgh.harvard.edu