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Neurology

Nonepileptic Myoclonus Doesn’t Affect Cognition, But Affects Quality of Life Significantly, Researchers Say

Nonepileptic myoclonus is a common feature in Angelman adolescents and young adults, and although it does not affect consciousness or cause cognitive consequences, it can affect quality of life significantly, a study shows. The research, “Myoclonus in Angelman Syndrome” and published in Epilepsy & Behavior, was presented recently by Kimberly Parkin, from the Angelman Syndrome Clinic, Massachusetts General Hospital, at the 2018 AS Foundation and Dup15q Alliance Research Symposium held in Chapel Hill, North Carolina. Myoclonus is a sudden, involuntary jerking of a muscle or group of muscles. Some simple forms of myoclonus, like hiccups, occur in normal, healthy persons, but others can be symptoms associated with multiple diseases and conditions. They can be associated — or not — with epi...

Moving Toward Enhanced Regenerative Medicine To Cure Epilepsy

At the border between regenerative medicine and neural engineering lies enhanced regenerative medicine. Using brain tissue modulated by electronic components, EU research has tackled the most common form of epilepsy. Photo© Gabriella Panuccio Temporal lobe epilepsy (TLE) is the most common form of epilepsy and yet, the most unresponsive to treatment. Patients have a typical pattern of progressive brain damage that affects cognitive and emotional processes.

Early Treatment Failure More Likely With Carbamazepine vs Lamotrigine in Epilepsy

In patients with epilepsy, moderate-quality evidence indicates that treatment failure for any reason related to therapy or adverse events (AEs) occurs significantly earlier with carbamazepine than with lamotrigine, although the results for time to first seizure imply that carbamazepine may be superior to lamotrigine for seizure control. Results of the review were published in the Cochrane Database of Systematic Reviews. The current analysis was an individual participant data review. The primary outcome was time to treatment failure, and secondary outcomes included time to first seizure postrandomization; time to 6-month, 12-month, and 24-month remission; and incidence of AEs. Among the 14 trials included in this review, individual participant data were available for 2572 of 3787 eligible p...

Treatment of New-Onset Epilepsy: AAN, AES Update Practice Guidelines

The American Academy of Neurology (AAN) and the American Epilepsy Society (AES) have provided new recommended practice guidelines for the management of new-onset and treatment-resistant epilepsy with anti-epileptic drugs (AEDs).1,2 The new guidelines highlight the evidence supporting the use of lamotrigine, vigabatrin, levetiracetam, pregabalin, gabapentin, and zonisamide for reducing the frequency of seizures in new-onset focal epilepsy and treatment-resistant epilepsy. An expert subcommittee was formed consisting of members of the AAN and AES to update the 2004 evidence-based guidelines on epilepsy treatment with AEDs. Based on recent evidence, the investigators recommend the use of gabapentin and topiramate in adults and children with newly diagnosed epilepsy. Class I and II studies sup...

Epilepsy: New findings ‘could change textbooks’

New research finds that two key brain proteins are involved in the neuronal misfiring that characterizes epilepsy. The findings “could potentially change textbooks” on epilepsy, according to the researchers, as well as pave the way for new therapies. The World Health Organization (WHO) estimate that 50 million people worldwide have epilepsy, making it one of the most widespread neurological conditions in the world. In the United States, 3.4 million people — or 1.2 percent of the population — live with the condition.

Spider venom strikes a blow against childhood epilepsy

A devastating form of childhood epilepsy that is resistant to traditional drugs may have met its match in spider venom. Researchers from The University of Queensland and the Florey Institute of Neuroscience and Mental Health discovered that a peptide in spider venom can restore the neural deficiencies that trigger seizures associated with Dravet syndrome. UQ Institute for Molecular Bioscience (IMB) Professor Glenn King said the study in mice could be an important step towards better therapeutic strategies for the rare and life-threatening type of epilepsy developed by children in their first year of life.

Addressing Psychiatric Comorbidities in Pediatric Epilepsy

Children with a chronic physical illness have a substantially elevated prevalence of psychiatric illness. The odds of having a mental health disorder were 62% higher among children with vs without a chronic physical condition, even after adjusting for sociodemographic variables and access to health care, according to results from a study published in 2016.1 The risk for psychopathology is even greater among children who have chronic central nervous system (CNS) disorders. In children with epilepsy, various studies have reported a prevalence of mental health problems ranging from 16% to 77%, and a 3-fold to 9-fold risk compared with controls.2 In a recent study of children and adolescents age 10 to 19 years who had epilepsy, the most commonly observed comorbid psychiatric disorders were att...

Cognition and Dementia in Older Patients With Epilepsy

With advances in healthcare and an ageing population, the number of older adults with epilepsy is set to rise substantially across the world. In developed countries the highest incidence of epilepsy is already in people over 65 and, as life expectancy increases, individuals who developed epilepsy at a young age are also living longer. Recent findings show that older persons with epilepsy are more likely to suffer from cognitive dysfunction and that there might be an important bidirectional relationship between epilepsy and dementia. Thus some people with epilepsy may be at a higher risk of developing dementia, while individuals with some forms of dementia, particularly Alzheimer’s disease and vascular dementia, are at significantly higher risk of developing epilepsy. Consistent with ...

Rewiring the brain to fight epilepsy

Biologist Suzanne Paradis’ lab suppressed seizures in mice by changing the connections between neurons. Researchers in the lab of Associate Professor of Biology Suzanne Paradis have discovered a novel treatment for reducing seizure activity in the brains of rodents, a discovery they hope might one day help people living with epilepsy. An estimated 2.2 million Americans suffer from epilepsy and 20 to 30 percent of these individuals live with seizures that do not respond to current medications. Photo: Mike Lovett Suzanne Paradis

Insight without incision: Advances in noninvasive brain imaging offers improvements to epilepsy surgery

About a third of epilepsy sufferers require treatment through surgery. To check for severe epilepsy, clinicians use a surgical procedure called electrocorticography (ECoG). An ECoG maps a section of brain tissue to help clinicians identify areas damaged by seizures. “But ECoG requires taking a part of your skull out and putting electrodes directly on brain tissue,” said Professor Pulkit Grover, a professor in Carnegie Mellon University’s Department of Electrical and Computer Engineering. An ECoG thus leaves a patient prone to infection. To find an alternative to ECoG, Grover’s team investigated making the non-invasive electroencephalogram (EEG) more effective by increasing electrode density and improving inference algorithms. He and the team recently presented their...

Study: Protein found to be key component in irregularly excited brain cells

In a new study in mice, researchers have identified a key protein involved in the irregular brain cell activity seen in autism spectrum disorders and epilepsy. The protein, p53, is well-known in cancer biology as a tumor suppressor. The findings, reported in the journal Human Molecular Genetics, will open new avenues for understanding the factors that contribute to these developmental disabilities, said Nien-Pei Tsai, a University of Illinois professor of molecular and integrative physiology who led the new research. “Under physiologically normal circumstances, neurons are able to readjust their excitability: the strength at which neurons are firing,” Tsai said. “But in autism spectrum disorders, such as Fragile X syndrome, and in epilepsy, you see higher levels of excita...

Stem cell discovery could aid in developing treatments to control epileptic convulsions

A new line of human stem cells shows promise for one day advancing treatment for epileptic seizures. As reported in STEM CELLS Translational Medicine (SCTM), the cells are designed to deliver adenosine – which calms down overexcited neurons and protects them from damage — to the central nervous system (CNS). The research was conducted by scientists at the University of Bonn and the Central Institute of Mental Health (CIMH) in Mannheim. Adenosine is a powerful regulator that helps the body maintain its inner balance. When an injury occurs to the CNS, it releases high levels of adenosine, which calms down the overexcited neurons and alleviates neurological damage caused by stroke, trauma, reduced oxygen, pain and, in particular, epileptic seizures. “But attempts to systemically deliver adeno...