Stichting Epilepsie Instellingen Nederland (SEIN)
Achterweg 5
2103 SW Heemstede

The Netherlands

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Project Leader

Prof. (MD, PhD, FRCP) Ley Sander Phone: +31-(0)23-558 8991  Fax: +31-(0)23-558 8409  Contact

Project Staff

Dr. Rob Voskuyl Basic Science  Phone: +31-(0)71-527 6813  Fax: +31-(0)71-527 6292  Contact

MD Rene Debets Neurologist, PET research  Phone: +31-(0)23-558 8944  Contact

MD Velis Demetrios Neurologist, Clinical Neurophysiology  Phone: +31-(0)23-558 8175  Contact

Institute Presentation

SEIN - The Epilepsy Institutes of the Netherlands Foundation -  is one of the major providers of services to people with epilepsy in the country and it strives to improve the quality of life of people with epilepsy globally.  It provides multi-disciplinary care to people with complex forms of epilepsy.

SEIN provides its services in two clinical facilities in Heemstede and Zwolle (total 160 beds), ten outpatient clinics providing care to about 11,000 patients a year, and also provides long stay sheltered residential accommodation (Heemstede, Cruquius and Zwolle) for over 400 people with epilepsy and complex needs.  SEIN’s main catchment area is the northern, eastern and western part of the Netherlands although patients may come from any part of the country.  Education is included in SEIN’s remit and is provided for children and young adults with epilepsy at the “De Waterlelie” school at special, primary and secondary level.

As the population served by SEIN is faced with the most complex problems and most difficult-to-treat epilepsies, research is aimed at understanding why these epilepsies respond so poorly to AEDs and other therapies, which patients can be helped by neurosurgery, how the detrimental consequences of the refractory epilepsies can be prevented or eased and how quality of life can be improved.  The three priority areas presently are:

Pre- and post-surgical evaluation of candidates for neurosurgery
A multidisciplinary team at SEIN, composed of neurologists, neurophysiologists, psychologists, nurses and therapists, participates in the national workgroup that selects candidates for curative epilepsy surgery. The Epilepsy Monitoring Unit is in charge of the diagnostic workup and precise localisation of epileptic foci with intracranial electrodes. Psychological and psychometric  tests are part of the assessment of potential candidates, as well as evaluation of the long-term cognitive consequences. Epilepsy surgery is also a strong impetus for the continuous improvement and development of imaging techniques both structural (MRI) and functional (f-MRI, PET, MEG, EEG).

The genetic basis of epilepsies
Genetic research in SEIN focuses on Juvenile Myoclonic Epilepsy (JME) and related Idiopathic Generalised Epilepsies with a specific interest in the significance of the high prevalence of photosensitivity in the group of JME patients. SEIN aims to correlate genetic characteristics, aetiology and variation in response to treatment with AEDs.  Another line of research focuses on the functional consequences of genetic mutations and polymorphisms. It is envisaged that a DNA repository will be created, which will facilitate this area of research in collaboration with the University of Utrecht and the University College London.

Mechanisms of epileptogenesis and innovation of pharmacotherapy
A considerable part of research in SEIN is devoted to understanding the mechanisms of pharmacoresistance, with an emphasis on neuropathology and fundamental research. Studies in appropriate animal models of pharmacoresistant epilepsy deal with mechanisms of epileptogenesis, Blood Brarrier function, multidrug transporters, alterations in drug targets acting on the GABA receptor, the role of inflammatory processes and interplay with stress factors. The animal models are also frequently used to test hypotheses emerging from neuropathological studies and vice versa.

SEIN has many active collaborations in place with Academic Centres and with the dedicatedEpilepsy Centre Kempenhaeghe in Heeze.