Refractory Epilepsy
Epilepsy is one of the most common neurological diseases, affecting approximately 70,000 people in Belgium. Amongst all chronic neurological diseases, it is the most stigmatized and is characterized by abnormal neuronal excitability leading to disabling seizures. These seizures can present with a variety of clinical signs, such as altered consciousness, significant anxiety, hallucinations, somatosensory symptoms, convulsions, depending on the seizure’s origin.
Approximately 30% of both adults and children with epilepsy do not respond adequately to anti-seizure medications and are considered refractory. These patients not only face significant social and professional challenges, but also are at risk of complications due to their epilepsy, such as head trauma, decreased cognitive abilities, status epilepticus, or premature sudden death (Sudden Unexpected Death in Epilepsy, or SUDEP).
Patients with refractory epilepsy should be referred to a specialized tertiary epilepsy center, such as the « Centre d’épilepsie réfractaire of Saint-Luc (CRE), » to assess the potential for resective or palliative brain surgery. However, if the epilepsy is generalized, multifocal, non-localizable, or if the seizure onset zone is located in eloquent brain cortex, neurostimulation techniques such as vagus nerve stimulation (VNS) or deep brain stimulation (DBS) may be considered.
Our goal is to improve the presurgical evaluation of patients with refractory epilepsy by utilizing various electrophysiological and imaging techniques, such as high-density EEG, Stereo EEG, advanced EEG connectivity analyses, and both functional and structural MRI analysis. Additionally, our laboratory focuses on optimizing vagus nerve stimulation (VNS) treatment for refractory epilepsy. We aim to understand the mechanisms of this therapy, enhance its anti-epileptic effects, develop strategies for better patient selection, and test new stimulation paradigms.
Our multidisciplinary team includes neurologists, neurosurgeons, biologists, biomedical scientists, and engineers, all united by a common goal: advancing research and fostering innovation in the field of refractory epilepsy
As a clinician trained at Ghent University Hospital, I began working at Cliniques Universitaires Saint-Luc in 2013. I quickly recognized the profound impact epilepsy has on our patients, the stigma associated with this condition, and the significant effects it can have on a child’s cognitive development. The sudden deaths of several patients due to SUDEP and the subsequent support provided to their families have been deeply impactful experiences. These events have motivated me to develop new diagnostic and therapeutic tools for managing refractory epilepsy.
IoNS Young Researcher’s day Awards!
» April 30, 2024, during the IoNS Young Researchers Day, our laboratory was honored by the achievements of two of our doctoral students. Inci Cakiroglu received the Best Blitz Talk Award for her outstanding work titled « Effect of blue light on tVNS induced pupil dilation » which captivated the audience with its originality and relevance. Auriane Apaire was awarded the Best Poster Prize for her innovative study on the « Characterization of Central Chemoreception and Cardioregulation in Sudden Unexpected Death in Epilepsy. » These awards reflect the dedication of our young researchers in the field of neuroscience. »