Article published by NewsWise

A new study suggests that antidepressant use by mothers during the first trimester of pregnancy does not increase the chances of epilepsy and seizures in babies. The research is published in the May 11, 2022, online issue of Neurology, the medical journal of the American Academy of Neurology.

“The findings of this study are very important,” said study author Ayesha Sujan, PhD, of Indiana University in Bloomington, Indiana. “Pregnancy can be a trying time, and the addition of depression, anxiety, and other mental health conditions can add to this burden. These findings may provide reassurance to women and their doctors considering the risks and benefits to medication.”

The study looked at over 1.7 million children born in Sweden over a 17-year period. Researchers identified more than 24,000 children who had been exposed to antidepressants during the first trimester of pregnancy and compared them to those who were not exposed.

While the authors found a higher prevalence of neonatal seizures and epilepsy among exposed children compared to unexposed children, after adjusting for factors in the mothers associated with an increase in the risk of seizures in their newborn, they found no link between antidepressant use by mothers during the first trimester and a child’s risk of seizures or epilepsy.

Article published by Medical Xpress

Among patients with Lennox-Gastaut syndrome (LGS), the percentage reduction in the frequency of drop seizures is greater with fenfluramine versus placebo, according to a study published online May 2 in JAMA Neurology.

Kelly G. Knupp, M.D., from the Children’s Hospital Colorado in Aurora, and colleagues examined the efficacy and safety of fenfluramine in patients with LGS (aged 2 to 35 years) from 65 sites in North America, Europe, and Australia. Participants were randomly assigned to receive a 0.7- or 0.2-mg/kg/d dose of fenfluramine or placebo (87, 89, and 87 patients, respectively).

The researchers found that the median percentage reduction in frequency of drop seizures was 26.5, 14.2, and 7.6 percentage points in the groups receiving the 0.7- and 0.2-mg/kg/d dose of fenfluramine and placebo, respectively. The trial met its primary efficacy end point, with a ?19.9 percentage point estimated median difference in drop seizures from baseline for the 0.7-mg/kg/d dose of fenfluramine versus placebo. More patients in the group receiving the 0.7-mg/kg/d dose of fenfluramine achieved a 50 percent or greater response versus placebo (25 versus 10 percent). Generalized tonic-clonic (GTC) seizure was the subtype that seemed most responsive to fenfluramine, with reductions in frequency of 45.7 and 58.2 percent in the groups receiving the 0.7- and 0.2-mg/kg/d doses of fenfluramine and a 3.7 percent increase in the placebo group.

Article published by Wiley Online Library

SUMMARY

Objective: To update and evaluate long-term seizure outcomes in patients with autoimmune encephalitis (AE) based on a large cohort study with long follow-up.

Methods: In this prospective observational registry study, we analyzed data from patients with AE mediated by common types of neuronal surface antibodies (anti-NMDAR, anti-LGI1/Caspr2, anti-GABABR). All patients were recruited from the Department of Neurology at the West China Hospital between October 2011 and June 2019, and data were collected prospectively on their demographic and clinical characteristics, treatment strategy, and seizure outcomes with a median follow-up of 42 months (range 6–93 months). Potential risk factors associated with seizure recurrence were also assessed.

Results: Of 320 AE patients, 75.9% had acute seizures, among whom more than 90% of patients had their last seizure within 12 months of disease onset. During our follow-up, 21 (9.3%) patients experienced seizure recurrence. Patients with anti-GABABR encephalitis had a higher cumulative incidence of seizure recurrence than those with anti-NMDAR (log-rank P = 0.03) or anti-LGI1/Caspr2 encephalitis (log-rank P = 0.04). Among patients with anti-NMDAR encephalitis, women had a significantly higher cumulative incidence of seizure recurrence than men (log-rank P = 0.01). Interictal epileptiform discharges (IEDs) or seizures captured on continuous EEG in the acute phase were identified as potential risk factors for seizure recurrence (P=0.04; P=0.007). Among 163 patients with ? 24 months of follow-up, five (3.1%) showed persistent seizures and required ongoing anti-seizure medications (ASMs) despite aggressive immunotherapy.

Significance: Seizure recurrence occurred in a small number of patients and chronic epilepsy occurred in 3.1% of patients during prolonged follow-up. Across all types of autoimmune encephalitis, risk factors for seizure recurrence were interictal epileptiform discharges or seizures captured on EEG in the acute phase; for anti-NMDAR encephalitis, female sex was also a risk factor.

Article published in Medical Xpress

A research collaboration involving the University of Otago could change the lives of people living with seizures.

Researchers from Otago and Okinawa Institute of Science and Technology Graduate University have developed a new system that uses specialized sound waves (above the frequency that we can hear) or light (above the wavelength that we can see) to release medication into specific areas of the brain to stop seizure activity.

Otago lead researcher Professor John Reynolds says this novel new way of delivering drugs could be an effective solution, and a life-changer for some patients with epilepsy.

“The sound waves can be applied from outside the head to target an area where epileptic seizures can start, and will release the drug from tiny biological packages circulating in the blood stream as they pass through the area, to suppress the seizure activity,” he says.

A device would be connected to the head of the patient, and drug-containing liposomes—a drug delivery vehicle—will be injected into the blood stream. These liposomes will float around, but not change the brain unless activated.

“The device could then be triggered by the person when they sense an aura that a seizure is coming on, or automatically by a system that detects seizure brain waves, activating the liposome to release the drug to stop the seizure from developing,” Professor Reynolds says.