The results in the meta-analysis show a general pattern of cognitive dysfunction in FLE, especially in functions related to the frontal lobe, with an influence of the duration and the age at onset of epilepsy, as well as the age of the sample used.
Data suggests a pro-epileptogenic role for monocytes/macrophages and other cells of the innate immune response, possibly via increased blood brain barrier leakage, and indicate that T cells and dendritic cells, which are closely associated with the adaptive immune response, are only sparsely infiltrated during epileptogenesis in the electrical post-status epilepticus rat model. Future studies should reveal the relative importance of these immune cells and whether specific manipulation can modify or prevent epileptogenesis.
Pediatric Epilepsy
The diagnostic efficacy and study quality of home video telemetry and inpatient video telemetry are similar in paediatric patients. Home video telemetry is acceptable to most parents/carers. User error may compromise the investigation in a minority of cases but did not impact on diagnostic utility. Adoption of home video telemetry investigation could provide an accessible and economic alternative to inpatient video telemetry.
The improved care delivery system that we envision includes self-management, electronic patient (or provider)-reported outcomes, on-going remote surveillance, and alerting/warning systems. This system and variants have the potential to reduce seizure burden through improved management, keep children out of the emergency department and hospital, and even reduce the number of outpatient visits.
A new system of vagus nerve stimulation (VNS) therapy was implanted in the first patient with drug-resistant epilepsy, as part of a global registry launched by LivaNova to evaluate the treatment in a real-world setting.
Research identifying the role of a specific protein in the brain in triggering epileptic seizures could spark creation of a new family of medications to help patients with the disease, according to Dr. Gabriel Martz, director of the Epilepsy Center at the Hartford HealthCare Ayer Neuroscience Institute.
The research, published in a recent issue of the academic journal Nature Communications, suggests that the protein collybindin, previously not thought to be relevant in the brain activity that activates or inhibits seizures, could actually play a role. A new medication, he says, could target the collybindin or its binding site in the brain to help curb seizures.
Sympazan™ (clobazam) oral film received tentative approval by the FDA for the adjunctive treatment of seizures associated with Lennox-Gastaut Syndrome (LGS) in patients 2 years of age or older.
Our data suggest that hormone therapy for assisted reproduction could exacerbate seizures and should be carefully monitored in women with epilepsy, especially those taking drugs inactivated by glucuronidation. Adjunctive concomitant antiepileptic therapy should be considered.
Ketogenic Diet
Studies that used objective neuropsychological tests confirmed benefits on alertness but found no improvement in global cognition. There are indications that these improvements are caused by both seizure reduction and direct effects of KD on cognition.
