On 17 and 18 March 2016, Epilepsy Research UK hosted an expert international workshop, to identify key research priorities for the field of tumour-associated epilepsy. Their principal aim is to develop a white paper to UK Government asking for the necessary funds to address these priorities.The workshop, entitled ‘Tumour-associated epilepsy: bridging the translational gap’, took place at St Anne’s College, in Oxford.
Up to 80% of people who have a brain tumour develop epilepsy as a result, and these so called tumour-associated epilepsies (TAEs) account for approximately 5% of epilepsy cases. For many people with TAE, seizures are their first symptom that something is wrong, whilst others develop epilepsy later on in the tumour’s development.The severity and frequency of tumour-associated seizures depend largely on the tumour type, but they are notoriously difficult to treat and approximately 50% don’t respond to anti-epileptic medication. The management of TAE must also take into consideration the highly complex relationship between the tumour and epilepsy ‘aspects’, and the potential interaction between anti-epileptic and anti-tumour therapies.TAE is an important but under-researched field, and as such there are many unknowns. It is still not understood how or why some people develop seizures as a result of a brain tumour, or where exactly tumour-related seizures originate. At a clinical level there is currently no way of identifying the people who are at risk of developing tumour-related epilepsy, yet most brain tumour patients are treated with anti-epileptic drugs as a precaution (in some cases unnecessarily). In terms of the management of TAE, there aren’t clear protocols as to when care should be led by an epilepsy or a brain tumour specialist. These gaps in knowledge need to be addressed, and there must be better channels of communication between both the tumour and epilepsy fields, and clinicians and basic scientists, so that people affected by TAE can receive optimal medical and surgical care. Only then will they have a chance for the best possible outcome.
The international workshop in Oxford brought together 27 leading experts from the fields of epilepsy and brain tumour, to examine the latest evidence surrounding TAE and identify research and clinical priorities to improve the management of the condition.Topics covered included risk factors, how epileptic activity arises, interactions between anti-tumour and anti-epileptic drugs, imaging and surgical techniques, and end of life care.The event was a great success, and it generated many fruitful discussions and ideas. There was a fantastic interaction between the clinicians and scientists from both (epilepsy and brain tumour) disciplines, and a number of research priorities for TAE were identified.
The workshop delegates will now contribute to the development of a white paper for UK Government, requesting the necessary funds to address these priorities, and we also hope to publish a synopsis of this white paper in a medical journal. In addition, the event has forged a number of collaborations, which we are confident will greatly assist inthe advancement of the TAE field.We look forward to updating you with further developments.Dr Mark Cunningham, Senior Lecturer at the Institute of Neuroscience, Newcastle University, chaired the workshop alongside Dr Robin Grant, Neuro-oncologist at the Western General Hospital in Edinburgh. Dr Cunningham commented:“The workshop was a real success in that it brought together scientific and clinical experts to address the topical issue of tumour associated epilepsy. Over the course of the workshop, in addition to a number of illuminating presentations, we had a series of excellent discussion sessions that helped us identify the key areas that need to be urgently tackled by both clinicians and scientists working in this area of research. By addressing these key areas we hope that patients suffering from tumour-associated epilepsy will benefit in the future.”