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New treatments for epilepsy

Ariana Sherdil, Stéphan Chabardès, Isabelle Guillemain, Sandrine Michallat, Shivadatta Prabhu, Karine Pernet-Gallay, Olivier David, Brigitte Piallat
PURPOSE: Our objective was to propose a new on demand non-human primate model of mesial temporal lobe seizures suitable for pre-clinical innovative therapeutic research. METHODS: Five macaques were stereotaxically implanted unilaterally with a deep recording electrode in the hippocampus. For each experiment, penicillin was injected into the hippocampus and animals were monitored during five consecutive hours. A total of 12-27 experiments with a mean cumulative dose of 162644 ± 70190 UI of penicillin have been performed per animal Injections were repeated at least once a week over a period of 98-276 days...
March 9, 2018: Epilepsy Research
Piero Perucca, Ingrid E Scheffer, Michelle Kiley
The International League Against Epilepsy has recently published a new classification of epileptic seizures and epilepsies to reflect the major scientific advances in our understanding of the epilepsies since the last formal classification 28 years ago. The classification emphasises the importance of aetiology, which allows the optimisation of management. Antiepileptic drugs (AEDs) are the main approach to epilepsy treatment and achieve seizure freedom in about two-thirds of patients. More than 15 second generation AEDs have been introduced since the 1990s, expanding opportunities to tailor treatment for each patient...
March 19, 2018: Medical Journal of Australia
Thomas Møhl, Maria J Miranda
Ketogenic diet (KD) has for a long time been known as an effective treatment for medically intractable epilepsy. However, the underlying mechanism is still unknown. Recent work indicates, that several mechanisms exist for KD, including neurotransmitter regulation, glucose restriction, effects of fatty acids, altered mitochondrial function and mammalian target of rapamycin pathway. Revealing the mechanisms of KD provides a better insight in the pathophysiology of epilepsy and helps the development of new treatments of epilepsy and other neurological disorders...
March 5, 2018: Ugeskrift for Laeger
J M Mercadé Cerdá, F J López Gonzalez, P Serrano Castro, M D Castro Vilanova, D M Campos Blanco, M R Querol Pascual
INTRODUCTION: The study aims to quantify the types of antiepileptic drugs (AED) prescribed in neurology consultations. MATERIAL AND METHOD: This descriptive, observational study included a sample of 559 patients older than 14 years, diagnosed with epilepsy, and receiving pharmacological treatment. Data were collected at outpatient consultations by 47 Spanish neurologists in May 2016. Epilepsy was defined based on the International League Against Epilepsy classification...
March 9, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Tommi Nora, Hanna Heinonen, Mirja Tenhunen, Sirpa Rainesalo, Soila Järvenpää, Kai Lehtimäki, Jukka Peltola
Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is a method of neuromodulation used for refractory focal epilepsy. We report a patient suffering from drug-resistant epilepsy who developed novel visual symptoms and atypical seizures with the onset of ANT-DBS therapy. Rechallenge under video electroencephalography recording confirmed that lowering the stimulation voltage alleviated these symptoms. Subsequent stimulation with the initial voltage value did not cause the recurrence of either the visual symptoms or the new seizure type, and appeared to alleviate the patient's seizures in long-term follow-up...
2018: Frontiers in Neurology
Woo Suk Tae, Byung Joo Ham, Sung Bom Pyun, Shin Hyuk Kang, Byung Jo Kim
Diffusion-tensor imaging (DTI) is a noninvasive medical imaging tool used to investigate the structure of white matter. The signal contrast in DTI is generated by differences in the Brownian motion of the water molecules in brain tissue. Postprocessed DTI scalars can be used to evaluate changes in the brain tissue caused by disease, disease progression, and treatment responses, which has led to an enormous amount of interest in DTI in clinical research. This review article provides insights into DTI scalars and the biological background of DTI as a relatively new neuroimaging modality...
February 28, 2018: Journal of Clinical Neurology
Jiakun Long, Yang Wang, Chen Xu, Tingting Liu, Gengli Duan, Yingjia Yu
Uncaria rhynchophylla is woody climber plant distributed mainly in China and Japan, the stems and hooks of which can be collected as "Gou-Teng" for the treatment of hyperpyrexia, epilepsy and preeclampsia. Fudan University first manufactured KHR98, the extract of Uncaria rhynchophylla. In order to study the active components and structural information of KHR98, we established a high- performance liquid chromatography (HPLC) coupled with quadrupole time-of-flight mass spectrometry (Q-TOF-MS) method for rapid analysis of alkaloids...
March 2, 2018: Chemical & Pharmaceutical Bulletin
Jaber Lyahyai, Bouchra Oulad Amar Bencheikh, Siham C Elalaoui, Maria Mansouri, Lamia Boualla, Alexandre DIonne-Laporte, Dan Spiegelman, Patrick A Dion, Patrick Cossette, Guy A Rouleau, Abdelaziz Sefiani
BACKGROUND: Epilepsy regroups a common and diverse set of chronic neurological disorders that are characterized by spontaneous, unprovoked, and recurrent epileptic seizures. Epilepsies have a highly heterogeneous background with a strong genetic contribution and various mode of inheritance. X-linked epilepsy usually manifests as part of a syndrome or epileptic encephalopathy. The variability of clinical manifestations of X-linked epilepsy may be attributed to several factors including the causal genetic mutation, making diagnosis, genetic counseling and treatment decisions difficult...
February 27, 2018: BMC Pediatrics
Natalia Chmielewska, Janusz Szyndler, Karolina Makowska, Dawid Wojtyna, Piotr Maciejak, Adam Płaźnik
The role of blood brain barrier (BBB) is to preserve a precisely regulated environment for proper neuronal signaling. In many of the central nervous system (CNS) pathologies, the function of BBB is altered. Thus, there is a necessity to evaluate a fast, noninvasive and reliable method for monitoring of BBB condition. It seems that revealing the peripheral diagnostic biomarker whose release pattern (concentration, dynamics) will be correlated with clinical symptoms of neurological disorders offers significant hope...
February 13, 2018: Neurologia i Neurochirurgia Polska
Nicolas Gaspard, Lawrence J Hirsch, Claudine Sculier, Tobias Loddenkemper, Andreas van Baalen, Judette Lancrenon, Michel Emmery, Nicola Specchio, Raquel Farias-Moeller, Nora Wong, Rima Nabbout
We report the proceedings of the First International new-onset refractory status epilepticus (NORSE) and febrile infection-related epilepsy syndrome (FIRES) Symposium. To promote awareness of this condition and foster research efforts, we conveyed the First International new-onset refractory status epilepticus (NORSE) and febrile infection-related epilepsy syndrome (FIRES) Symposium. The conference was supported by The NORSE Institute ( This article summarizes the discussions that were held during the Symposium and presents our strategy to unravel the cause of these disorders and to improve patient care...
February 24, 2018: Epilepsia
Neveen A Salem, Marwa El-Shamarka, Yasser Khadrawy, Shaimaa El-Shebiney
Temporal lobe epilepsy (TLE) is present in 30% of epileptic patients and does not respond to conventional treatments. Bone marrow derived mesenchymal stem cells (BMSCs) induce endogenous neural stem cells, inhibit neurodegeneration, and promote brain self-repair mechanisms. The present study addresses the feasibility of BMSCs transplantation against pilocarpine-induced TLE experimentally. BMSCs were injected either intravenously (IV) or in hippocampus bilaterally (IC). Increased cell count of BMSCs was achieved via IC route...
February 22, 2018: Inflammopharmacology
Arne Reimers, Jon Andsnes Berg, Margrete Larsen Burns, Eylert Brodtkorb, Svein I Johannessen, Cecilie Johannessen Landmark
Background and objective: Laboratories sometimes use different reference ranges for the same antiepileptic drug (AED), particularly for new and poorly investigated drugs. This may contribute to misunderstandings, concerns or inappropriate dose changes, which in turn may affect therapeutic effect, drug safety or treatment adherence. Therefore, the Norwegian Association of Clinical Pharmacology wished to update and harmonize the reference ranges for AEDs and establish national guidelines for Norway...
2018: Drug Design, Development and Therapy
Amanda Buyan, Delin Sun, Ben Corry
Voltage-gated sodium channels are essential for carrying electrical signals throughout the body, and mutations in these proteins are responsible for a variety of disorders, including epilepsy and pain syndromes. As such, they are the target of a number of drugs used for reducing pain or combatting arrhythmias and seizures. However, these drugs affect all sodium channel subtypes found in the body. Designing compounds to target select sodium channel subtypes will provide a new therapeutic pathway and would maximize treatment efficacy while minimizing side effects...
February 21, 2018: Proceedings of the National Academy of Sciences of the United States of America
Tariq Zaman, Ingo Helbig, Ivana Babić Božović, Suzanne D DeBrosse, A Christina Bergqvist, Kimberly Wallis, Livija Medne, Aleš Maver, Borut Peterlin, Katherine L Helbig, Xiaohong Zhang, Ethan M Goldberg
OBJECTIVE: Voltage-gated sodium (Na+ ) channels underlie action potential generation and propagation and hence are central to the regulation of excitability in the nervous system. Mutations in the genes SCN1A, SCN2A, and SCN8A, encoding the Na+ channel pore-forming (α) subunits Nav1.1, 1.2, and 1.6, respectively, and SCN1B, encoding the accessory subunit β1 , are established causes of genetic epilepsies. SCN3A, encoding Nav1.3, is known to be highly expressed in brain, but has not previously been linked to early infantile epileptic encephalopathy...
February 21, 2018: Annals of Neurology
Alvin Y Chan, Lilit Mnatsakanyan, Mona Sazgar, Indranil Sen-Gupta, Jack J Lin, Frank P K Hsu, Sumeet Vadera
BACKGROUND: Responsive neurostimulation (RNS) is a relatively new treatment option that has been shown to be effective for patients with medically refractory focal epilepsy when resection is not possible, especially in bilateral mesial temporal onset. Robotic devices are becoming increasingly popular for use in stereotactic procedures such as stereoelectroencephalography, but have yet to be used when implanting RNS devices. OBJECTIVE: To show that these 2 forms of advanced technology were compatible and could be used effectively in patient care...
March 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
Amanda Cano, Miren Ettcheto, Marta Espina, Carmen Auladell, Ana Cristina Calpena, Jaume Folch, Marta Barenys, Elena Sánchez-López, Antoni Camins, Maria Luisa García
Temporal lobe epilepsy is the most common type of pharmacoresistant epilepsy in adults. Epigallocatechin-3-gallate has aroused much interest because of its multiple therapeutic effects, but its instability compromises the potential effectiveness. PEGylated-PLGA nanoparticles of Epigallocatechin-3-gallate were designed to protect the drug and to increase the brain delivery. Nanoparticles were prepared by the double emulsion method and cytotoxicity, behavioural, Fluoro-Jade C, Iba1 and GFAP immunohistochemistry studies were carried out to determine their effectiveness...
February 15, 2018: Nanomedicine: Nanotechnology, Biology, and Medicine
Khalaf Kridin, Shira Zelber-Sagi, Doron Comaneshter, Arnon D Cohen
Importance: The association between pemphigus and neurologic diseases was not evaluated systematically in the past. In a recent uncontrolled cross-sectional study, Parkinson disease was found to be significantly associated with pemphigus; in the same study, epilepsy had a nonsignificant association with pemphigus. Several case reports have suggested that pemphigus coexists with multiple sclerosis and dementia. Objective: To estimate the association between pemphigus and 4 neurologic conditions (dementia, epilepsy, Parkinson disease, and multiple sclerosis), using one of the largest cohorts of patients with pemphigus...
February 16, 2018: JAMA Dermatology
Hsiu-Fen Lee, Ching-Shiang Chi
PURPOSE: To understand the long-term neurological outcomes and chronological changes of brain MRIs in patients with febrile infection-related epilepsy syndrome (FIRES). METHODS: From December 2000 to May 2016, 29 patients diagnosed with FIRES were collected retrospectively. The demographic distribution, clinical manifestations, neuroimaging findings, and treatment methodology were described. Follow-up clinical outcomes and chronological evolution of neuroimaging findings were analyzed...
February 6, 2018: Seizure: the Journal of the British Epilepsy Association
Zachary M Grinspan, Renée A Shellhaas, Jason Coryell, Joseph E Sullivan, Elaine C Wirrell, John R Mytinger, William D Gaillard, Eric H Kossoff, Ignacio Valencia, Kelly G Knupp, Courtney Wusthoff, Cynthia Keator, Nicole Ryan, Tobias Loddenkemper, Catherine J Chu, Edward J Novotny, John Millichap, Anne T Berg
Importance: More than half of infants with new-onset epilepsy have electroencephalographic and clinical features that do not conform to known electroclinical syndromes (ie, nonsyndromic epilepsy). Levetiracetam and phenobarbital are the most commonly prescribed medications for epilepsy in infants, but their comparative effectiveness is unknown. Objective: To compare the effectiveness of levetiracetam vs phenobarbital for nonsyndromic infantile epilepsy. Design, Setting, and Participants: The Early Life Epilepsy Study-a prospective, multicenter, observational cohort study conducted from March 1, 2012, to April 30, 2015, in 17 US medical centers-enrolled infants with nonsyndromic epilepsy and a first afebrile seizure between 1 month and 1 year of age...
February 12, 2018: JAMA Pediatrics
Alexander I Tröster
In the USA, the Food and Drug Administration (FDA) has approved deep brain stimulation (DBS) devices for the treatment of Parkinson's disease (PD), essential tremor (ET), dystonia, and obsessive compulsive disorder (OCD). DBS has been approved for these same conditions in Europe, but, additionally the European Commission (EC) has granted the Conformité Européenne (CE) Mark for DBS as adjunctive treatment for partial-onset seizures in adults with medically refractory epilepsy. In this issue of EJN Budman and colleagues [1] briefly review the range of neurologic conditions that might constitute promising new indications for DBS...
February 12, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
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