This study will collect brain tissue samples for research purposes from patients undergoing
surgery to treat epilepsy. The standard surgical procedure for medically intractable
epilepsy i.e., epilepsy that cannot be controlled with medicine requires removal of more
brain tissue than is needed for diagnostic study. This extra tissue, which would otherwise
be discarded, will be used for research purposes. In addition, a blood vessel in the scalp,
called the superficial temporal artery, is also normally cut during surgery, and a piece of
this vessel will be taken for research use.
Patients 4 years of age or older who undergo surgery for medically intractable epilepsy may
be eligible for this study.
Brain tissue collected under this protocol will be used for studies of brain cells in other
diseases and of serotonin receptors. Any remaining brain tissue will be frozen for use in
future research. The superficial temporal artery will be used for comparison with carotid
arteries (a neck artery that supplies the brain) from patients with blockage of this blood
This is a protocol to perform research studies on tissues that are removed in the operating
room during surgical procedures for medically intractable epilepsy. Our aim is to acquire
and supply useful tissue specimens for intramural NIH research projects.
The investigators will be free to select which patients will undergo surgery. However, the
total number of patients that can be enrolled in the protocol will be restricted. This
protocol is not designed to test any new treatments. Any treatment under this protocol will
be based on the current standard of care for epilepsy surgery. The goal of the surgical
procedure is to remove the epileptic focus. Standard procedures to be performed are 1)
anterior temporal lobectomy or 2) amygdalohippocampectomy for temporal lobe epilepsy, and 3)
focal cortical resection for epilepsy that arises outside the temporal lobe. These are the
research aspects of the protocol: 1) Any brain tissue that is removed and is not required
for diagnostic studies will be used for laboratory studies, consistent with institutional
guidelines. 2) Meningeal samples, dura only, will be taken to examine for tissue markers of
lymphatic vessels. 3) Blood tests to test for immune and inflammatory mediators will be
performed. 4) Saliva will be collected to test for immune and inflammatory markers.
Participants in this protocol will be evaluated for potential eligibility for other NINDS
clinical trials as they are developed. However, they will not be required to enter any
protocol and their decision to participate will be entirely voluntary. No more than 120
patients will be accepted in this protocol.
- INCLUSION CRITERIA:
To be eligible for entry into the study, candidates must meet al the following criteria:
1. Be 4 years of age or older.
2. Have simple or complex partial seizures.
3. Seizures must persist despite medical therapy.
4. Able to give informed consent, or, assent if a child.
5. Have been determined by the NINDS neurology staff to have medically intractable
6. Have agreed to undergo brain surgery to treat medically intractable epilepsy.
7. Have agreed to allow some of the tissue removed during the surgery to be used for
Candidates will be excluded if they:
1. Are pregnant. (Women of childbearing age will be tested with a urine pregnancy test
and will have agreed to avoid being pregnant by practicing a reliable form of
contraception or by abstinence from sexual intercourse.)
2. Cannot have an MRI scan as determined by the radiologist.
3. Have a bleeding disorder that cannot be corrected before testing or treatment.
4. Are unable to understand the risks of the testing and surgical therapy. (A clinical
neuropsychologist that is not an investigator for this protocol examines all patients
before epilepsy surgery. She will determine if a subject is unable to understand
risks, unable to reach reasonable decisions and incompetent to give informed consent.