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Prof Helen Cross

Prof Helen Cross

The Prince of Wales's Chair of Childhood Epilepsy & Head of UCL-ICH Neurosciences Unit

Developmental Neurosciences Dept

UCL GOS Institute of Child Health

Joined UCL
18th Apr 2002

Research summary

 Imaging in children with focal epilepsy the development of a noninvasive approach to presurgical evaluation My initial research was into the development of noninvasive functional and optimised structural imaging in the presurgical assessment of children with drug resistant focal epilepsy. This work evaluated the use of optimised magnetic resonance imaging, including quantitative techniques of T2 relaxometry and proton magnetic resonance spectroscopy , as well as ictal and interictal single photon emission computed tomography (SPECT).   Ongoing work includes evaluation of newer MRI techniques in determining structural abnormality, as well as combining functional and structural techniues with EEG fMRI

Why do children with early catastrophic epilepsy have a high rate of cognitive and behavioural comorbidity, what are the mechanisms of such and can we alter the natural history with early intervention? With the development of the epilepsy surgery programme at Great Ormond Street Hospital, it has been our responsibility to evaluate benefits as well as prognostic indicators from such procedures. However, it has also given us the opportunity to evaluate the underlying cognitive and psychiatric morbidity associated with such epilepsy including the natural history. This has been in conjunction with neuropsychiatry as well as ongoing projects with neuropsychology. It is anticipated that in addition to the studies in progress, further follow up neuropsychology and MRI correlative studies, may also contribute to some understanding of this. A prospective epidemiological study of focal epilepsy with onset in infancy has highlighted the high rate of neurodevelopmental disorder at presentation with epilepsy. Further work continues to determine the relative role of pathology and epileptic discharges in cognitive function and evaluation of causes in early onset epilepsy (EPIPEG study).

What is the role of other intervention can we determine a role for alternative treatments and the timing of such compared to that presently available? Current anticonvulsant medications in the majority have been found anecdotally to be effective, and in addition many are trialled late in children, in ways not specifically related to clinical practice. I have been involved in international collaborative drug trials. I was also  instrumental as the principal investigator in conducting the first randomised controlled trial of the ketogenic diet in the treatment of childhood epilepsy.  Further study is evaluating the efficacy of the ketogenic diet in epilepsy under 2 years of age.  Collaborative work with Royal Holloway, Institute of Neurology, Biochemistry within the Institute of Child Health has resulted in the promise of C10 medium chain fatty acids in acting on preventing seizures and with the support of Vitaflo will shortly conduct feasibility studies in adults and children. Pathological, neurophysiological and genetic studies (from our own unit and others) have suggested alternative modes of epileptogenesis to our current understanding and reasons why individuals are resistant to existing medication, implying other possible treatments may be effective. Collaboration with colleagues in the Epilepsy Unit at the Institute of Neurology, Queen Square has enabled involvement in pathological and genetic studies

Teaching summary

Professor Cross has been extensively involved in teaching with regard to epilepsy at a postgraduate level both nationally and internationally. She was integral to the development of the standardised Paediatric Epilepsy Training (PET) Courses by the British Paediatric Neurology Association, Chair of the PET Steering Committee 2010-2015. She also teaches extensively on internal MSc (neuropsychology, genetics, advanced imaging, child mental health) as well as external (Kings, MSc in epilepsy). She has been on faculty and organising committees  of several internationally run courses  including San Servolo Summer Schools, Eilat Educational Pharmacology Course and EPODES (epilepsy surgery). She is regularly asked to speak at international congresses and teaching courses.

Education

Royal College of Physicians
Doctorate, Fellow of the Royal College of Physicians | 2004
University of London
Doctorate, Doctor of Philosophy | 1998
Royal College of Paediatrics and Child Health
Doctorate, Fellow of the Royal College of Paediatrics and Child Health | 1996
Royal College of Physicians
Doctorate, Member of the Royal College of Physicians | 1987
University of Birmingham
Doctorate, Bachelor of Medicine & Bachelor of Surgery | 1984

Biography

Professor Helen Cross was awarded an OBE in 2015 for her services to Children with Epilepsy.  She is the Prince of Wales’s Chair of Childhood Epilepsy at UCL-Institute of Child Health, Great Ormond Street Hospital for Children, London and Young Epilepsy, Lingfield, UK.  She has also been awarded two honorary doctorates, one in Tartu and the second in Gothenburg, and in 2017 was awarded the American Academy of Neurology Sidney Carter award for Child Neurology. In 2018 she received the Frank Ford award for contributions to child neurology by the International Child Neurology Association, and the Clinical Research Award from the American Epilepsy Society. She has research interests in early onset complex epilepsy, particularly outcomes and the role of intervention, including surgery and the ketogenic diet, publishing more than 200 peer reviewed primary research articles and 50 review articles. She has edited five books, including a definitive childhood epilepsy text and a ketogenic diet cookery book, as well as written more than 40 chapters. She has been Chair of the ILAE Commission for Paediatrics 2005-2009,  Co-Chair of the Task Force of the Global Campaign 2009-2013 and a member of the ILAE Commission for European Affairs 2009-2013, in which she chaired the subcommission for education 2009-2013. She was Chair of the ILAE Task Force for Paediatric Epilepsy Surgery 2001-2013. She was Clinical Advisor to the 2012 review of the NICE guidelines for the Diagnosis and Management of the Epilepsies in adults, . and children  as well as Chair of the Trustees of Epilepsy Research UK 2005-2010. She was elected Secretary General of the ILAE 2013-2017  and re-elected as Treasurer 2017-2021. She is currently Clinical Advisor to the national Childrens Epilepsy Surgery Service and Cinical Topic Advisor for the update for paeciatric Epilepsies 2018-2020.  She was president of the BPNA 2008-10 and has been instrumental in the establishment of the BPNA Paediatric Epilepsy Training Courses.

Publications