Epilepsy affects over 50 million people globally, with approximately half of them being children. For about one-third of these patients, seizures remain uncontrolled by medications, making surgery the only viable option to provide relief. In 60% of these drug-resistant cases, seizures originate from a specific region of the brain, making surgical removal of the affected tissue the most effective treatment. The most common cause of focal epilepsy in children is focal cortical dysplasia (FCD), with type II being the most prevalent. However, accurately identifying the epileptogenic zone (EZ) during surgery can be challenging, complicating the overall success of the procedure.

A new study offers a promising approach to improving surgical precision through the use of Raman spectroscopy, a non-invasive technique that analyzes the chemical composition of tissues. The collaborative study, conducted by researchers from Polytechnique Montréal (Quebec, Canada), applied Raman microspectroscopy to tissue samples from pediatric patients diagnosed with FCD type II. By examining the biochemical signatures of individual cells, the researchers successfully distinguished abnormal FCD tissue from healthy brain cells with remarkable accuracy. The method was able to identify FCD tissue with 96% accuracy and differentiate between two subtypes of FCD type II with 92% accuracy.

These findings, published in Biophotonics Discovery, suggest that Raman spectroscopy, when used during surgery with a fiber optics system, could provide real-time guidance for surgeons to accurately identify and remove only the affected tissue, preserving healthy brain areas. In addition to improving surgical outcomes, the technique offers valuable insights into the biochemical changes that may contribute to the development of epilepsy. This innovative approach could ultimately improve seizure control and surgical success in children suffering from drug-resistant epilepsy. 

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