University and pediatric hospital work together to improve lives of children with epilepsy

Since 2010, investigators and clinicians at Aston University and Birmingham Children's Hospital have worked together to try and improve the lives of children with difficult to treat forms of epilepsy.

The pediatric human tissue laboratory at Aston University is the only one of its kind in the UK and leads the field in this specialized area.  

The collaboration with the leading pediatric hospital, now part of the unique Birmingham Women's and Children's NHS Foundation Trust, includes taking human tissue from young people whilst they undergo surgery for their epilepsy to investigate why seizures occur, why brain cells do not respond to drugs and whether they might respond to new drugs being tested.

Professor of Neuropharmacology Gavin Woodhall, who is Director of the Human Tissue Laboratory at Aston University said: "Epilepsy is a neurological problem that leads to seizures, which are abnormal electrical events in the brain.

"These seizures can be mild and infrequent, or chronic and devastating and about a third of people with epilepsy are very difficult to treat with drugs because they do not respond. Even when medication does have an effect, a significant number of patients go on to stop responding.

"We call this difficult kind of epilepsy 'Drug Resistant Epilepsy' or DRE, and it is most commonly seen in children, with some children having as many as 100 seizures a day.

"Often these children have to have the most epileptic parts of their brain removed by a brain surgeon in order to control their seizures, whilst ensuring other important regions, such as those that control language and movement, are protected."

Another difficult to treat epilepsy is autoimmune encephalitis, or AE, a particularly sudden, aggressive and frightening experience for young sufferers and their parents.

"Although we know AE is due to the body's immune system attacking the brain, we do not yet understand how this happens in detail," Professor Woodhall explained. "Our collaboration with Birmingham Children's Hospital enables us to use antibodies taken from young patients with AE to explore how the immune system might alter the electrical excitability of brain cells both in human and mouse brains - and work out how to treat this sort of epilepsy."

The collaboration has brought together the hospital's neurologists who diagnose the children's type of epilepsy, neurophysiologists who locate the epileptic regions in their brains, and surgeons who remove the brain tissue with Aston University's scientists who work out why the seizures happen and how drugs developed by industrial partners actually work.

The team also conducts clinical trials to test new treatments, identify new targets for antiepileptic drugs for both DRE and AE patients and collaborate with drug companies, including GW Pharma, to explore how new antiepileptic drugs they have identified and developed may be effective in the human brain.

"We are working very hard to understand and treat these kinds of epilepsy and the close collaboration that exists between the university and hospital is unique in this country," added Professor Woodhall.

"If we can unlock the answers to these debilitating neurological conditions and treat these children successfully, it would have a profound effect on not only their quality of life, but on that of their families."

The project has already received funding of around £500,000 and together with the Medical Research Council, the collaboration has bid for £1.4M for a human tissue initiative that would extend its activities to 10 other leading universities and hospitals across the UK.

Further, the close working relationship between Aston University  and Birmingham Children's Hospital has recently been cemented with an award of £211,000 from Epilepsy Research UK, to Dr Sukhe Wright from the pediatric neurology team, so that she can work as an ERUK Research Fellow in Professor Woodhall's laboratory investigating autoimmune encephalitis.

Dr Wright is positive that this work will have an impact on childhood epilepsy and said: "Often research can feel very distant from those it may benefit but in this instance we clinicians are using our patient knowledge and clinical skills to undertake research ourselves whilst drawing on the expertise of the university's investigators.

"This research will increase our understanding and knowledge of how the immune system may be implicated in the production of seizures, with aims to develop improved treatments with reduced side effects."

Dr Shakti Agrawal, Pediatric Neurologist and Deputy Lead for Children's Epilepsy Surgery Service (CESS) at Birmingham Women's and Children's NHS Foundation Trust, said: "We're passionate about the support and treatment we offer to our children, young people and families and we're proud to be working with Aston University as this can only have a positive impact on the care we are able to provide now and in the future."