Regarding epilepsy several new developments can be reported. The International League Against Epilepsy (ILAE) has suggested a new definition of epilepsy, for the first time including a definition of epilepsy resolution. Progress in the diagnosis relates to new genetic findings, improvements in magnetic resonance imaging (MRI) and the increasing use of stereo electroencephalograms (sEEG). Regarding treatment there are new clinically relevant data on the pathophysiology and prevention of sudden unexpected death in epilepsy (SUDEP). Zonisamide has been approved by the European Medicines Agency (EMA) for monotherapy in adults with focal seizures and combination therapy in children aged ≥ 6 years. Retigabin and perampanel have been approved but are currently taken off the market in Germany (only) because the Gemeinsamer Bundesausschuss (GBA, Joint Federal Committee) did not find any additional therapeutic value as compared to lamotrigine due to a lack of data. A decision regarding a new application for perampanel is pending. Regarding surgical treatment novel ablation techniques (e.g. stereotactic radiofrequency and laser ablation as well as focussed ultrasound ablation) and brain stimulation paradigms are under investigation. Experimental studies, generously supported by the European Union (EU) and the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) are focusing on (opto-)genetic (e.g. using lentoviral transfection), epigenetic (e.g. micro-RNA-related) approaches and on the investigation of neuronal micronetworks.
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http://dx.doi.org/10.1007/s00115-014-4039-1 | DOI Listing |
Toxicol Mech Methods
January 2025
Department of Pharmacology, SVKM's NMIMS School of Pharmacy and Technology Management, Babulde, Shirpur, 425405 Maharashtra, India.
Adverse drug reactions (ADR) remain a challenge in modern healthcare, particularly given the increasing complexity of therapeutics. WHO's definition of an adverse drug reaction as a response to a drug that is noxious and unintended and occurs at doses normally used in man for the prophylaxis, diagnosis or therapy of disease, or for modification of physiological function. This definition underscores the importance of monitoring and mitigating unintended drug effects, particularly for widely used medications like valproic acid (VPA).
View Article and Find Full Text PDFJ Clin Med
January 2025
Innovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), 39100 Bolzano, Italy.
: This study investigates the potential of artificial intelligence (AI), specifically large language models (LLMs) like ChatGPT, to enhance decision support in diagnosing epilepsy. AI tools can improve diagnostic accuracy, efficiency, and decision-making speed. The aim of this study was to compare the level of agreement in epilepsy diagnosis between human experts (epileptologists) and AI (ChatGPT), using the 2014 International League Against Epilepsy (ILAE) criteria, and to identify potential predictors of diagnostic errors made by ChatGPT.
View Article and Find Full Text PDFJ Neurochem
January 2025
Centre for Discovery Brain Sciences, Hugh Robson Building, George Square, University of Edinburgh, Edinburgh, Scotland, UK.
Synaptic vesicle protein 2A (SV2A) is an abundant synaptic vesicle cargo with an as yet unconfirmed role in presynaptic function. It is also heavily implicated in epilepsy, firstly being the target of the leading anti-seizure medication levetiracetam and secondly with loss of function mutations culminating in human disease. A range of potential presynaptic functions have been proposed for SV2A; however its interaction with the calcium sensor for synchronous neurotransmitter release, synaptotagmin-1 (Syt1), has received particular attention over the past decade.
View Article and Find Full Text PDFNeurology
February 2025
Schools of Pharmacy and Public Health Sciences, University of Waterloo, Ontario, Canada.
Background And Objectives: Peripartum mood and anxiety disorders constitute the most frequent form of maternal morbidity in the general population, but little is known about peripartum mental illness in mothers with multiple sclerosis (MS). We compared the incidence and prevalence of peripartum mental illness among mothers with MS, epilepsy, inflammatory bowel disease (IBD), and diabetes and women without these conditions.
Methods: Using linked population-based administrative health data from ON, Canada, we conducted a cohort study of mothers with MS, epilepsy, IBD, and diabetes and without these diseases (comparators) who had a live birth with index dates, defined as 1 year before conception, between 2002 and 2017.
Neurosurg Rev
January 2025
Department of neurosurgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Epilepsy is a common neurological disease that is treated with medications; however, patients with drug-resistant epilepsy, commonly intractable temporal lobe epilepsy, tend to have better control with surgical treatment. While the mainstay of surgical treatment is anterior temporal lobectomy, it carries risk of potential adverse effects hence minimally invasive techniques are now being used as an alternative to open surgery. This systematic review and meta-analysis compare the efficacy and safety of three of the most used techniques: laser interstitial thermal therapy (LITT), radiofrequency ablation (RFA) and stereotactic radiosurgery (SRS).
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