The Top Five Developments in Epilepsy for 2014
As we look back throughout 2014, we see that this year had many important medical developments related to epilepsy.
This included a new clinical definition of epilepsy being adopted by an international epilepsy organization, a new medication being covered by BC Pharmacare, new computer programs to help predict and detect seizures, and the beginning of clinical research into the impact of cannabinoid (CBD) use in children with severe and medication resistant epilepsy.
Below is an overview of these.
1. A new clinical definition of epilepsy adopted by the International League Against Epilepsy (ILAE)
This new definition is meant to provide a greater level of detail for clinicians to diagnose epilepsy. In particular, it is thought that this might lead to earlier diagnosis and treatment and therefore protect patients from further seizures.
According to the new definition, epilepsy is a disease of the brain defined by any of the following conditions:
– At least two unprovoked (or reflex) seizures occurring more than 24 hours apart; or
– One unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years; or
– Diagnosis of an epilepsy syndrome.
This new definition also states that epilepsy is considered to be “resolved” for individuals who had an age-dependent epilepsy syndrome but are now past the applicable age or those who have remained seizure-free for the last 10 years, with no seizure medicines for the last 5 years.
2. Perampanel approved for BC Pharmacare coverage
The epilepsy medication called perampanel (Fycompa is the brand name) was approved for coverage by BC Pharmacare in 2014. This will help reduce the cost of this medication for many people in BC.
This medication will be covered for adults who:
– have partial-onset seizures
– have failed four other epilepsy medications
– take it with another epilepsy medication
Click here for information about perampanel (Fycompa).
Click here to read the BC Pharmacare coverage guidelines for this medication.
3. New epilepsy genes discovered
2014 was a very productive year in epilepsy gene discovery. From 16p11.2 dups to TBC1D24, researchers were able to identify many novel genes that will help to advance the understanding of and treatment of different types of epilepsy.
The blog called Beyond the Ion Channel has ranked 10 of the genes that they think are particularly notable in the realm of epilepsy.
Check out their list of the top 10 epilepsy gene discoveries of 2014.
4. Advances in predicting and detecting seizures through computer technology
In 2014 the National Institute of Neurological Disorders and Stroke (NINDS), the American Epilepsy Society (AES), and the Epilepsy Foundation sponsored a unique contest to develop computer algorithms to detect, predict, and ultimately prevent epileptic seizures.
As a result of this, epilepsy researchers have some new tools to help accurately predict and detect seizures.
One contest was to develop an analytic tool to detect changes in brain activity that indicated that seizure activity was occurring. The other contest was to develop a process that could predict when a seizure is imminent.
The Seizure Detection Challenge was won by Michael Hills, a software engineer who specializes in machine learning and digital signal processing. He developed a computer algorithm that correctly detected when a seizure was in progress 97% of the time.
The Seizure Prediction Challenge was awarded to a team of five engineers and scientists. This included Drew Abbot, an engineer, Philip Adkins, a mathematician, as well as, Quang Tien, Simone Bosshard, and Min Chen, scientists at the University of Queensland Center for Advanced Imaging. They developed a computer algorithm that correctly predicted a seizure in advance 82% of the time.
The long-term goals of this type of technology include developing a pre-seizure signal that could alert people with epilepsy when to take quick-acting emergency anti-seizure medications. This may also give someone enough time to alert someone that they are about to have a seizure, call for emergency help, or get themselves to a safe place or into a comfortable position.
Click here for more information.
5. New clinical research being conducted on the role that cannabidiol (CBD) may have in epilepsy
The epilepsy-related topic that got the most media attention in 2014 was the potential role that the marijuana derivative called cannabidiol (CBD) may have in the treatment of children with severe and medication-resistant epilepsy.
In 2014 several reputable epilepsy research facilities were conducting new clinical structured research into this on children with severe and medication resistant forms of epilepsy (primarily those with a condition called Dravet Syndrome). This clinical research had been hampered for many years due to the lack of pure, pharmacologically active compounds and legal restrictions. As such, data on efficacy and safety of CBDs has been limited to anecdotal personal reports.
Unfortunately the mainstream media tended to focus on personal anecdotal reports, in particular, only the positive reports. However, we still lack data from large double-blind randomized, controlled studies on the efficacy of CBD for epilepsy.
None the less, whatever findings come from this and other targeted research studies into this type of substance will help to clarify the impacts that CBDs may have in the brain – whether positive or negative.
The American Epilepsy Society also released a position statement on this topic in the Spring of 2014. This included the statement,“Such safety concerns coupled with a lack of evidence of efficacy in controlled studies result in a risk/benefit ratio that does not support use of marijuana for treatment of seizures at this time.”
With all of these important developments coming out within one year, it is exciting to see what will be discovered this year. To stay up-to-date with breaking epilepsy news and research studies you can follow our Twitter account, Facebook page, or subscribe to our e-newsletter. All the best for 2015!