Duke University researchers have identified a new treatment to common epilepsy and prevent its growth or recurrence over a period of time in patients.
Though common, epilepsy is devastating and temporal lobe epilepsy is particularly debilitating because it strikes the areas of the brain, which are key to memory and mood. During seizures, these patients have little awareness of what has happened to them.
Since there is no treatment to prevent temporal lobe epilepsy or slow down its progression, researchers have identitied a compound that may change the course of its treatment in the future.
It is believed that temporal lobe epilepsy cases begin with a single episode of prolonged seizures and relapse frequently thereafter in life in response to any number of events.
In the past, research has identified a brain receptor called TrkB that is resposnible for prolonged seizures, making it a chronic disorder. Giving pY816, small-protein drug, could reduce both sevverity of epilepsy and its recurrence, said researchers.
While a 2013 study by McNamara et al showed that a chemical-genetic approach to block TrkB signalling in a mouse briefly following an episode of prolonged seizures was able to prevent the lateral development of epilepsy and the global inhibition of TrkB signalling following seizures increased the number of dead neurons in the brain of mice.
Researchers also found that subsequent seizures were caused by phospholipase C(gamma)1, an enzyme triggered by TrkB activation.
By giving pY816, small-protein drug, to mice for just three days following an episode of prolonged seizures or epilepsy, thee desired results of reducing both the likelihood and severity of epilepsy was observed for many weeks later. The scientists confirmed that the drug was inhibiting activation of phospholipase C(gamma)1 in the mice, which can be applied to humans soon.
Currently, seizures are treated both by medicine and surgery depending on the case.
The first line of treatment are anti-seizure medications for epilepsy, and may be prescribed to relieve seizures or reduce their frequency. If 3-5 medications have been prescribed and do not work to control seizures, then experts explore surgery route as the next step. Nutritional counseling is another cooncurrent strategy followed by experts in treating epilepsy.
A nutritionist works closely with the patinet and may recommend a modified Atkins diet or Ketogenic diet – two eating plans that have been effective in controlling seizures in some patients. These plans restrict carbohydrates and focus on high-fat, high-protein foods that may help the body generate and build up ketones, which can prevent seizures for reasons researchers still don’t understand.
Vagus nerve stimulator (VNS):
A pacemaker-like device is implanted in the chest wall with a wire that connects to your left vagus nerve in your neck. The device delivers weak electrical pulses that prevent seizures. Our experienced epilepsy specialists also offer investigational VNS trials to test new ways to program the VNS to detect seizures before they happen.
This device is implanted into the skull and connects to electrodes placed directly on or in the brain. The RNS monitors your ongoing brain waves and gives small electrical shocks to interrupt the electrical patterns that may lead to seizures.
Neurosurgeons opt for epilepsy surgery using the latest techniques including MRI-guided, laser-assisted removal of brain tissue. This technique, when combined with our MRI scanner in the operating room, allows for the safest and most efficient methods of resecting areas of the brain where seizures may occur. The most common surgical procedures currently in use to treat epilepsy include:
Anterior temporal lobectomy that removes a portion of the brain’s temporal lobe, the most common area for seizure activity to start. This approach has a high degree of success in achieving long-term seizure freedom.
Resection of seizure-causing lesions or scars that removes tumors, vascular malformation, and developmental abnormalities that can cause seizures.
Cortical resection is another method where surgeons remove brain tissue outside of the temporal lobe that is a source of seizure activity.
Hemispherectomy is where surgeons remove portions of one half of the brain (a ‘hemisphere’) where seizures occur and cuts the corpus callosum that connects the two hemispheres. As a result, seizure activity cannot spread from one half of the brain to the other.
(Photo courtesy: www.cureepilepsy.org)