Medical Student Research Fellowship for Summer 2010

Mentor: Paul C. Van Ness MD
Department: Neurology
Room Number: J3.134
Mail Code: 9036
Phone number: 214-648-6721
Email: paul.van_ness@utsouthwetsern.edu
Project title: Intracranial Responsive Neurostimulation in Intractable Focal Epilepsy - Analysis of the effect of circadian variation on detection of ictal onsets and localization of subsequent ictal events.

Human subjects IRB approved project number: pivotal trial: 022006-021; long term trial: 072009-026

Project type: patient-based research

Brief Description of Project: In an ongoing study of 9 human subjects with intractable focal epilepsy, 6 with bitemporal independent seizures, 2 with periventricular nodular heterotopia and one with parietal lobe cortical dysplasia, we have access to unique long term intracranial EEG data regarding clinical seizures, subclinical seizures and timing of several thousand EEG ictal onset detections for up to 2 years' duration. These data often show daily and hourly variation in the number of events detected and the location of the ictal onset. Prior studies looked mostly at short term scalp or intracranial recordings for 1-2 weeks in a hospital setting with varying degrees of medication reduction while the acute injury from intracerebral electrode use could impact findings. The student will have a unique opportunity to determine if clinical or electrographic seizures recorded have an impact on the localization of subsequent seizures in the cases with multiple foci. These data can be compared to the presurgical scalp ictal data to determine how accurate that short term evaluation predicted the results of long term implanted electrode recordings. He can also answer fundamental questions about whether one clinical or subclinical seizure influences the localization or lateralization of subsequent seizures and what period of time that influence is active. This has implications for the reliability of seizure clusters predicting localization in patients in an epilepsy monitoring unit.

Previous Research Activities or Publications with Medical Students:
Salas JR, Van Ness PC, Agostini MA, Diaz-Arrastia RR. The prevalence of asymmetric tonic limb posturing (Sign of Four) in seizures with a tonic or tonic clonic phase in generalized and localization-related epilepsies. Neurology 58(suppl. 3):A214, 2002.

(Dr. Salas went on to a neurology residency and epilepsy fellowship after his summer research experience. )