Discover the latest about what's happening at CURE and in our community in the September 2018 CURE Update from Chief Scientific Officer, Dr. Laura Lubbers!
The timing of seizures may be linked to natural rhythms in around 80% of people with epilepsy, according to the largest study of individual patients' seizure cycles including more than 1,000 people, published in The Lancet Neurology journal.
Pediatric Epilepsy
We present one of the largest surgical series of pediatric polymicrogyria patients. Seizure outcomes were best with complete resection/disconnection of polymicrogyria. However, tailored resections based on electroclinical and neuroradiologic data can produce good outcomes and remain an appropriate strategy for patients with extensive polymicrogyria.
Adequate identification and management of electroencephalographic seizures with judicious use of anti-seizure medications may optimize outcomes.
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.
