In January 2015, a joint American-Australian research team won an American Epilepsy Society’s completion to detect seizures. The researchers developed an algorithm, which accurately predicts seizures 82% of the time. Previously, some health professionals believed that seizures could not be detected. “Until recently,” says Dr Francis Collins of the National Institute of Health, USA, “the best algorithm was hardly better than flipping a coin”.
Epilepsy Epilepsy, which usually presents at the end of the first or second decade, is a chronic condition consisting of more than 40 clinical syndromes affecting about 50 million people worldwide. Its cause is unknown, but may stem from birth trauma, perinatal infection, anoxia, infectious diseases, ingestion of toxins, brain tumors, inherited disorders or degenerative disease, head injury, metabolic disorders, cerebrovascular accident, and alcohol withdrawal. Treatment is through medication or surgery, and the prognosis is variable.
The most common form of the condition is temporal lobe epilepsy (TLE), which is characterized by recurrent, unprovoked seizures. About 13% of patients receiving medication for TLE have inadequate seizure control. The prognosis for such patients includes a higher risk of memory loss, mood challenges, quality of life impairment, and, in some cases, death.
Pharmacological management Because the natural history of epilepsy varies between individuals and syndromes, it’s difficult to plot its course, and predict prognosis. Pharmacological management is complex, tailored to individual patients, and has variable efficacy. One of the most challenging pharmacological questions is when to begin medication. Overall, antiepileptic drug management is effective in controlling seizures in around 60-70% of individuals, and this is often achieved through a prolonged course of trial and error pharmacy.
Surgical management There are two categories of epilepsy surgery: one with curative intent, and another palliative. Selection criteria for surgery vary, but patients are generally considered when:
Their seizures are associated with a lesion amenable to surgery
Supportive electrophysiological data
They’re resistant to medical therapy
No contraindications to surgery.
The aim of epilepsy surgery is a complete removal of the epileptogenic focus without further neurological damage. About 75% of epilepsy surgeries are localized neocortical resections for mesial temporal scleroses. Traditional outcome measures include seizure frequency and mortality. More recently, morbidity, and quality of life have become important outcomes.
A new novel compound Scientists from Louisiana State University, USA, have discovered a novel compound that curtails temporal lobe epilepsy, which was thought to respond only to surgery. A study published in 2015 in PLOS ONE, describes the affects of administering Neuroprotectin D-1, or NPD1, as a means of regulating the anomalous electrical activity in the brain.
Researchers discovered that the compound, derived from omega 3, and administered in mice, effectively reduces both micro seizures, which frequently occur before an epileptic episode, and the spontaneous recurrent seizures. Dr Nicolas Bazan, co-author of the study, said, “These observations contribute to our ability to predict epileptic events, define key modulations of the brain circuits, and epileptogenisis“.