DIAGNOSIS
Many children with febrile status epilepticus (prolonged non-epileptic seizures due to fevers) will develop temporal lobe epilepsy later in life. If clinicians could identify which of these children will develop the later, then preventative measures could be taken to minimize the severity of the epilepsy.
Breakthrough:
Choy et al. (2014) (64) identified a novel MRI signature to predict temporal lobeepilepsy noninvasively in a naturalistic rat model of febrile status epilepticus. Their study utilized high magnetic fields and long-term video EEG to identify markers of epileptogenesis.
STIMULATION THERAPY
The RNS (responsive neurostimulation) System, developed by NeuroPace, Inc. (Mountain View, CA) provides an alternative to indirect modulatory stimulation therapies such as vagus nerve stimulation. The RNS System utilizes surgically implanted intracranial electrodes to directly detect seizures and respond with ‘counter-stimulation.’
Breakthroughs:
Ben-Menachem et al. (2014) (65) confirmed that responsive neurostimulation is safeand its efficacy improves over time. The FDA approved this device to treat epileptic patients who have been unable to achieve seizure control with two drug therapies [65]. Morrell (2011) showed that this system significantly reduced seizures[20].
DIETARY THERAPY
While their mechanisms are not fully understood, special diets [49] have helped reduce seizure frequency in epileptic patients. However, patients often struggle to follow these strict diets, so alternatives would be welcomed.
Breakthroughs: Kim et al. (2014) showed that a low glycemic index diet
reduces seizure susceptibility in mice. In particular, they suggested that changes
in levels of blood glucose might trigger seizures.
GENETICS
Geneticists have been largely unable to identify common genetic variants that
affect the likelihood of developing epilepsy. In addition to diagnostic applications,
the genetic makeup of an epileptic patient could also indicate which therapies
are more likely to be effective.
Breakthroughs: Using heritability analysis, Speed et al. (2014) further
described the genetic architecture of epilepsy. They also presented promising
results in predicting which patients that have experiences one seizure are likely
to have more seizures in the future, and might therefore benefit from anti-epileptic medications.
TECHNOLOGY
Malformations of cortical development (MCD) often result in the development
of epilepsy. While these malformations can be discovered with surgery, they
cannot be seen using noninvasive structural imaging.
Breakthroughs: Winston et al. (2013) suggested that advanced diffusion
imaging could help identify a common structural cause of epilepsy. In particular,
these malformations are associated with a reduced density of neurites. |
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