Recent Advances, Future Developments in Epilepsy Surgery: Imad Najm, MD

WATCH TIME: 5 minutes

“I think the good news here, [is that] the epilepsy surgery field is in the maturity stage, where we really know certain pathologies quite well—to a point that we know how to design the surgical operation and to plan the surgery ahead. This is based on data generated in the last 70 years, since modern epilepsy surgery took off.”

In recent years, surgery for patients with epilepsy has become safer, as clinicians now have the ability to operate on patients that do not have visible lesions on MRI, also known as patients with MRI-negative epilepsy. Imad Najm, MD, commented on this advance in the field in conversation with NeurologyLive® at the 2021 American Epilepsy Society (AES) Annual Meeting, December 3-7, in Chicago, Illinois, calling specific attention to stereo electroencephalography (SEEG) technology, a minimally invasive surgical procedure that identifies where seizures originate in the brain. Prior to the introduction of SEEG, experts were unable to determine where epilepsy was stemming from in the absence of a lesion visible on an MRI or to the naked eye.

In terms of future development, Najm, who is the director of Cleveland Clinic’s Epilepsy Center at the Cleveland Clinic Neurological Institute, highlighted new imaging technology as well as processing of the imaging, which he believes not only improved patient selection for surgery, but also improved outcomes following epilepsy surgery. The next phase he anticipates is in the field of gene therapy and a move towards understanding different pathologies that contribute to seizures.