South SFV Today

Stanford Medicine researchers, led by Ivan Soltesz, PhD, have made a groundbreaking discovery in the treatment of epilepsy. Their study, published in Nature Medicine, reveals the potential role of the fasciola cinereum, a previously overlooked region of the hippocampus, in instigating and propagating seizures in patients with drug-resistant temporal lobe epilepsy.

Soltesz emphasized the importance of this finding, stating, "The hippocampus is the best studied part of the brain by far, but there is shockingly little known about the fasciola cinereum." The researchers found that by removing or inhibiting the fasciola cinereum, patients who do not respond to traditional treatments or surgery may find relief.

The standard surgical approach for patients with mesial temporal lobe epilepsy involves removing or ablating parts of the amygdala and hippocampus. However, the study suggests that targeting the fasciola cinereum in addition to the traditional surgery may improve outcomes for patients who continue to experience seizures.

Ryan Jamiolkowski, MD, PhD, a co-lead author of the study, explained the challenges in targeting the fasciola cinereum during surgery, stating, "The hippocampus curves like a banana, and the optical fiber used for laser ablation is a straight line." Despite these challenges, the researchers believe that identifying and addressing seizure activity in this region could lead to better treatment outcomes for patients.

The study's findings have significant implications for the treatment of epilepsy, particularly for patients who do not achieve seizure freedom following surgery. By incorporating the fasciola cinereum into surgical planning and considering targeted interventions, researchers hope to provide more personalized and effective care for individuals with drug-resistant temporal lobe epilepsy.