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Brain Sciences
Special Issues
Etiology, Symptoms and Treatment of Epilepsy
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Etiology, Symptoms and Treatment of Epilepsy

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurodegenerative Diseases".

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 24921

Special Issue Editors

Dr. Jitendra Kumar Sinha

E-Mail Website
Guest Editor
GloNeuro Academy, Sector 107, Vishwakarma Road, Noida 201301, India
Interests: epilepsy; therapeutics; neurodegenerative disorders; neurobiology of obesity; sleep; spinal cord injury; sleep technology; digital health; democratizing health for all
Dr. Shampa Ghosh

E-Mail Website
Co-Guest Editor
GloNeuro Academy, Sector 107, Vishwakarma Road, Noida 201301, India
Interests: amyotrophic lateral sclerosis; epilepsy; developmental origins of health and disease (DOHaD); vitamin B12; sleep; spinal cord injury; therapeutics; digital health; maternal and child health; nutrition

Special Issue Information

Dear Colleagues,

Epilepsy is a common neurological disorder marked with episodes of seizures. These seizures are accompanied by muscle stiffness, loss of awareness, anxiety, fear, confusion, problems breathing and jerking of the legs and arms. A seizure can either be focal or generalized, depending upon the region of brain exhibiting the abnormal activity. For unknown reasons, the incidence of epilepsy is higher in low-income countries than in high-income countries. Head injuries, brain infections, vascular diseases and gene abnormalities are common factors responsible for the development of epilepsy. Families with rare autosomal dominant monogenic epilepsy have more than 30 distinct mutated genes. Many epilepsy-associated mutations have been reported in non-ion channel genes, such as genes for neural receptors, transcription factors and enzymes. The treatment of epilepsy includes antiepileptic drugs (AEDs) and surgery. If a patient responds poorly to AEDs, surgery is suggested; this includes deep brain stimulation, corpus callosotomy and resective surgery to lessen the symptoms or decrease the use of AEDs. The most common AEDs include lamotrigine, topiramate, sodium valproate and levetiracetam. This Special Issue focuses on (but is not limited to) the symptoms of epilepsy, its etiology, new intervention methods involved in its treatment and future research directions.

Dr. Jitendra Kumar Sinha
Dr. Shampa Ghosh
Guest Editors

Manuscript Submission Information

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Keywords

  • seizures
  • therapeutics
  • pediatric and adult types
  • EEG
  • TMS
  • non-invasive brain stimulation
  • epilepsy surgery
  • ethnopharmacology
  • cognition
  • depression

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Published Papers (5 papers)

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Research

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10 pages, 249 KiB  
Article
Children and Young Adults with Epilepsy Exhibit an Interictal Autonomic Dysfunction: A Prospective Exploratory Study
by Carmen Salluce, Marco Cocciante, Marisa Gazzillo, Anna Rita Ferrari, Roberta Battini, Filippo Maria Santorelli and Emanuele Bartolini
Brain Sci. 2024, 14(7), 670; https://doi.org/10.3390/brainsci14070670 - 29 Jun 2024
Cited by 1 | Viewed by 1372
Abstract
Dysautonomic disorders are an increasingly studied group of conditions, either as isolated diseases or associated with other neurological disorders. There is growing interest in understanding how dysautonomia affects people with epilepsy, who may report autonomic symptoms before, during and after seizures. Furthermore, autonomic [...] Read more.
Dysautonomic disorders are an increasingly studied group of conditions, either as isolated diseases or associated with other neurological disorders. There is growing interest in understanding how dysautonomia affects people with epilepsy, who may report autonomic symptoms before, during and after seizures. Furthermore, autonomic abnormalities appear to play a role in sudden unexpected death in epilepsy, likely contributing to the increased mortality rate described in epilepsy. To better understand the association between epilepsy and dysautonomia, we explored electrochemical skin conductance in a group of 18 children and young adults with epilepsy compared to 15 age- and sex-matched healthy controls by the SudoscanTM test. We found a significant difference in terms of electrochemical skin conductance, suggesting that people with epilepsy suffer significantly reduced conductance in small nerve fibers. Within patients, values were significantly different according to the type of epilepsy and to neuroimaging results, with lower conductance values in epilepsies of unknown origin and in patients with morphological abnormalities of the brain. Using a non-invasive test, we identified altered conductance of small sympathetic nerve fibers in children and young adults with epilepsy, suggesting underlying dysautonomia. Further studies are needed to investigate this association and to clarify its neurobiological substrates. Full article
(This article belongs to the Special Issue Etiology, Symptoms and Treatment of Epilepsy)
18 pages, 684 KiB  
Article
Adherence to Epilepsy’s Medical Recommendations
by Anna Jopowicz, Agnieszka Piechal, Elżbieta Bronisz and Iwona Kurkowska-Jastrzębska
Brain Sci. 2024, 14(3), 255; https://doi.org/10.3390/brainsci14030255 - 5 Mar 2024
Viewed by 1886
Abstract
The primary problem in the treatment of epilepsy is poor seizure control. Several studies have shown that non-adherence to doctors’ recommendations regarding drug dosage, time of drug administration as well as lifestyle modifications are the most frequent causes of the persistence or reoccurrence [...] Read more.
The primary problem in the treatment of epilepsy is poor seizure control. Several studies have shown that non-adherence to doctors’ recommendations regarding drug dosage, time of drug administration as well as lifestyle modifications are the most frequent causes of the persistence or reoccurrence of seizures, other than cases of misdiagnosis and poor drug selection. The aim of this study was to assess the prevalence of non-compliance with medical recommendations, both in relation to medicine dosage, regularity of administration and lifestyle, and also to determine the factors affecting patients with diagnosed epilepsy. This study was carried out on a total of 169 patients diagnosed with epilepsy who were under the care of an outpatient neurology clinic. The assessment of compliance was performed using the Patient Rating of Compliance Scale (PRCS), Clinician Rating Scale (CRS) and authors’ scale. Depending on the scale used, varying degrees of non-compliance were noted. They were as follows—65.3% on the authors’ scale, 10% on the PRCS and 9% on the CRS. The following factors influenced compliance with doctors’ recommendations: type of epilepsy, consumption of alcoholic beverages, frequency of follow-up visits to the neurology clinic, type of pharmacotherapy and number of medicines taken. Full article
(This article belongs to the Special Issue Etiology, Symptoms and Treatment of Epilepsy)
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Review

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26 pages, 1160 KiB  
Review
A Comprehensive Review of Emerging Trends and Innovative Therapies in Epilepsy Management
by Shampa Ghosh, Jitendra Kumar Sinha, Soumya Ghosh, Hitaishi Sharma, Rakesh Bhaskar and Kannan Badri Narayanan
Brain Sci. 2023, 13(9), 1305; https://doi.org/10.3390/brainsci13091305 - 11 Sep 2023
Cited by 30 | Viewed by 10277
Abstract
Epilepsy is a complex neurological disorder affecting millions worldwide, with a substantial number of patients facing drug-resistant epilepsy. This comprehensive review explores innovative therapies for epilepsy management, focusing on their principles, clinical evidence, and potential applications. Traditional antiseizure medications (ASMs) form the cornerstone [...] Read more.
Epilepsy is a complex neurological disorder affecting millions worldwide, with a substantial number of patients facing drug-resistant epilepsy. This comprehensive review explores innovative therapies for epilepsy management, focusing on their principles, clinical evidence, and potential applications. Traditional antiseizure medications (ASMs) form the cornerstone of epilepsy treatment, but their limitations necessitate alternative approaches. The review delves into cutting-edge therapies such as responsive neurostimulation (RNS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS), highlighting their mechanisms of action and promising clinical outcomes. Additionally, the potential of gene therapies and optogenetics in epilepsy research is discussed, revealing groundbreaking findings that shed light on seizure mechanisms. Insights into cannabidiol (CBD) and the ketogenic diet as adjunctive therapies further broaden the spectrum of epilepsy management. Challenges in achieving seizure control with traditional therapies, including treatment resistance and individual variability, are addressed. The importance of staying updated with emerging trends in epilepsy management is emphasized, along with the hope for improved therapeutic options. Future research directions, such as combining therapies, AI applications, and non-invasive optogenetics, hold promise for personalized and effective epilepsy treatment. As the field advances, collaboration among researchers of natural and synthetic biochemistry, clinicians from different streams and various forms of medicine, and patients will drive progress toward better seizure control and a higher quality of life for individuals living with epilepsy. Full article
(This article belongs to the Special Issue Etiology, Symptoms and Treatment of Epilepsy)
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12 pages, 997 KiB  
Review
Immunological Imbalances Associated with Epileptic Seizures in Type 2 Diabetes Mellitus
by Wendy N. Phoswa and Kabelo Mokgalaboni
Brain Sci. 2023, 13(5), 732; https://doi.org/10.3390/brainsci13050732 - 27 Apr 2023
Cited by 3 | Viewed by 5709
Abstract
Purpose of the review: Type 2 diabetes mellitus (T2DM) is a global health burden that leads to an increased morbidity and mortality rate arising from microvascular and macrovascular complications. Epilepsy leads to complications that cause psychological and physical distress to patients and carers. [...] Read more.
Purpose of the review: Type 2 diabetes mellitus (T2DM) is a global health burden that leads to an increased morbidity and mortality rate arising from microvascular and macrovascular complications. Epilepsy leads to complications that cause psychological and physical distress to patients and carers. Although these conditions are characterized by inflammation, there seems to be a lack of studies that have evaluated inflammatory markers in the presence of both conditions (T2DM and epilepsy), especially in low-middle-income countries where T2DM is epidemic. Summary findings: In this review, we describe the role of immunity in the seizure generation of T2DM. Current evidence shows an increase in the levels of biomarkers such as interleukin (IL-1β, IL-6, and IL-8), tumour necrosis factor-α (TNF-α), high mobility group box-1 (HMGB1), and toll-like receptors (TLRs) in epileptic seizures and T2DM. However, there is limited evidence to show a correlation between inflammatory markers in the central and peripheral levels of epilepsy. Conclusions: Understanding the pathophysiological mechanism behind epileptic seizures in T2DM through an investigation of immunological imbalances might improve diagnosis and further counter the risks of developing complications. This might also assist in delivering safe and effective therapies to T2DM patients affected, thus reducing morbidity and mortality by preventing or reducing associated complications. Moreover, this review also provides an overview approach on inflammatory cytokines that can be targeted when developing alternative therapies, in case these conditions coexist. Full article
(This article belongs to the Special Issue Etiology, Symptoms and Treatment of Epilepsy)
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Other

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13 pages, 1581 KiB  
Case Report
Responsive Neurostimulation of the Anterior Thalamic Nuclei in Refractory Genetic Generalized Epilepsy: A Case Series
by Carly M. O’Donnell, Sara J. Swanson, Chad E. Carlson, Manoj Raghavan, Peter A. Pahapill and Christopher Todd Anderson
Brain Sci. 2023, 13(2), 324; https://doi.org/10.3390/brainsci13020324 - 14 Feb 2023
Cited by 3 | Viewed by 4181
Abstract
Genetic generalized epilepsies (GGEs) are thought to represent disorders of thalamocortical networks. There are currently no well-established non-pharmacologic treatment options for patients with drug-resistant GGE. NeuroPace’s Responsive Neurostimulation (RNS) System was approved by the United States Food and Drug Administration to treat focal [...] Read more.
Genetic generalized epilepsies (GGEs) are thought to represent disorders of thalamocortical networks. There are currently no well-established non-pharmacologic treatment options for patients with drug-resistant GGE. NeuroPace’s Responsive Neurostimulation (RNS) System was approved by the United States Food and Drug Administration to treat focal seizures with up to two ictal foci. We report on three adults with drug-resistant GGE who were treated with thalamic RNS. Given the severity of their epilepsies and the potential ictogenic role of the thalamus in the pathophysiology of GGE, the RNS System was palliatively implanted with leads in the bilateral anterior thalamic nuclei (ANT) of these patients. The ANT was selected because it was demonstrated to be a safe target. We retrospectively evaluated metrics including seizure frequency over 18–32 months. One patient required explantation due to infection. The other two patients were clinical responders. By the end of the observation period reported here, one patient was seizure-free for over 9 months. All three self-reported an improved quality of life. The clinical response observed in these patients provides ‘proof-of-principle’ that GGE may be treatable with responsive thalamic stimulation. Our results support proceeding to a larger study investigating the efficacy and safety of thalamic RNS in drug-resistant GGE. Full article
(This article belongs to the Special Issue Etiology, Symptoms and Treatment of Epilepsy)
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