Epilepsy: Making a Difference Tomorrow

Even though most people with epilepsy respond to current treatments, many are unable to control their seizures with known treatments. But researchers, funded by the National Institutes of Health and other organizations, are developing more effective therapies for treatment-resistant patients and better tools for diagnosing and predicting cases of epilepsy.

The unpredictable nature of seizures creates an enormous financial burden; epilepsy has a much higher percentage of costs resulting from lost earnings and employment than other major chronic diseases, such as heart disease and cancer. Recent treatment advances, however, hold promise for reducing the frequency and severity of epileptic attacks.

Research Brings Hope for the Future

One promising area for finding safer, more effective treatments is genetic analysis. In recent years, scientists have identified many gene variants that contribute to epilepsy — including changes in genes that help guide brain cells during development and in genes that control how likely ion channels are to activate — and they continue to look for more.

Researchers are exploring these mutations in animal models to determine why people contract different forms of epilepsy and why some people respond better to treatments. Scientists have, for instance, identified an ion channel defect that may underlie sudden death in epilepsy; the defective channel, which increases the risk of cardiac disorders, is also present in the brain. Gene therapy, in which viruses are used to deliver correct versions of mutant genes into brain cells, also is being tested in animals.

Researchers are working on improved scanning techniques to better pinpoint where epilepsy begins in the brain. These may reduce the risk of side effects following surgery and offer hope to those with multifocal epilepsy, in which seizures begin in multiple locations.

Another therapy in early testing is cell-transplant therapy, in which either stem cells or mature cells are implanted into the brain to help reduce the incidence of seizures. Such therapies often increase amounts of inhibitory neurotransmitters or inhibitory brain cells, which make it harder for epileptic brain cells to fire.

Also in development are electrical stimulation techniques, such as transcranial direct stimulation (using an electrode placed on the scalp), deep brain stimulation (using an electrode implanted in a central brain region), and transcranial magnetic stimulation (using shifting magnetic fields).

Scientists also hope to better predict and prevent seizures. By analyzing brain wave patterns, researchers may be able to identify seizure activity six or more hours ahead of time, and then interrupt the activity using drugs or a pacemaker-like device. Other work focuses on stopping epilepsy before it begins. Researchers are trying to understand why people who suffer from brain injuries and other brain disorders are more susceptible to epilepsy, in the hopes of preventing the condition from occurring in the first place.

Hope for Other Diseases

Epilepsy often accompanies other disorders, including autism, cerebral palsy, tuberous sclerosis, neurofibromatosis, or Alzheimer’s disease. According to government researchers, these disorders and epilepsy may share some of the same basic underlying mechanisms. Many people with epilepsy also suffer from depression and anxiety. Thus, breakthroughs in the treatment of epilepsy also may provide treatments for many common and crippling brain and psychological disorders.