Epilepsy, what is going on in the Epilepsy Research and is there any Advancement?. Nature Journals Special Issue..

Nature Publishing Group (the owner and publisher of worlds popular "Nature") has just published a special issue, featuring the story of Epilepsy covering aspects why this disease is still not well understood and what do the worlds govt's and funding agencies must do, meaning why there is not much funding is allocated to Epilepsy research considering more than 50Million people world wide are affected by more than a dozen types of Epilepsy?. Yes, that is certainly a valid question and reasonable expectation from various govts and funding agencies. That is just the beginning of this special issue, named under the category "Outlook". To run this special issue and program, Nature has been awarded a special "Independent Education Grant by Sunovion Pharmaceuticals Inc.
There is also another recent Special issue on Neuroscience published somewhere in late 2013, about which I will write later. This Editorial is to provide some idea to researchers, clinicians and people who are working in the field of Epilepsy that this might be the best issue to update yourself about the field and the recent developments in Epilepsy. Ofcourse, those patients and relatives who can understand the science behind Epilepsy, who are wondering what is really going on and what are the possible treatments available, might be a good place to check.

Mike May, the contributing Editor has given a brief summary of the entire issue, a good place to start reading this issue: http://www.nature.com/nature/journal/v511/n7508_supp/full/511S1a.html

Note: This special is issue is only open to public or non subscribers upto October, so better read before it will be taken of the shelf or go get a copy of it.

Interesting research reports presented by the field's top scientists/researchers, clinicians and more.  I will go through the entire issue pretty much cover to cover, but before I spend time, I thought to share this for those who may not have heard about this special issue. The first Chapter or section begins with the background information about the basics of Epilepsy the origin of Excitation or Excitement, and there are sections on genetic basis, drug treatment modalities as well as technologies that can detect the types and details of the epilepsy. Other sections regarding the Epidemiology and types of this disease, management and social issues including the misunderstanding and  tabo's of epilepsy, sociology of it, and the issue ends with what is food got to do with Epilepsy or what food intake might be the best for people with seizure or epileptic episodes. Overall, seems like a great issue with a comprehensive knowledge about the disease, complexities and its future. I hope I can write a real Editorial with scientific temperament when I am done reading the whole issue.......

From Nature's Cover Image Content:

• Epilepsy is a common neurological condition that affects 50 million people worldwide. For many patients, medication helps reduce seizure frequency; for drug-resistant epilepsy, treatments include diet therapy and neurosurgery. Although discussed and feared for millennia, progress towards understanding epilepsy has been slow — even with help from modern genetic and neurological analysis. Stigmatization of people with epilepsy continues in certain parts of the world and though lack of funding limits epilepsy research, new ways to treat and manage seizures are on the horizon.
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  Cover Art: Nik Spencer

EEG technique and Treatment of Rolandic Epilepsy treatment?.

Looking at the EEG patterns periodically at certain time difference, could be week or month in between, Yamanashi and his colleague found that there is a repetitive high frequency EEG waveform abnormality that can be used to strategies for treatment?. Although, it is a brief study on small number of children's, EEG recordings and the abnormal waveform morphology is one of the or the only way to ascertain what to do with such epileptic patient, actually, while referring to the recent reviews in this field, I found this compelling review article   by Dr.Markand, MD (see at the bottom after the Yamanashi's work).

What was their research model and study is about:

A total of ten children between the ages of three and ten with recurrent seizures and 12 patients aged between four and seven years who experienced isolated seizures were enrolled in the study, with seizure recurrence and prolonged high-frequency EEG paroxysm data being correlated by the scientists.
Repeated EEG recordings were taken every three months, with clinical and EEG follow-up performed for four or more years. It was discovered that seizure recurrence and extended periods of high-frequency paroxysmal EEG abnormalities for more than 6 months after onset were significantly linked.

New study shows how EEG can aid rolandic epilepsy treatment

Posted May 21 2014 in epilepsy in children and its treatment

A new study from Japan has shed light on how electroencephalogram (EEG) techniques can be useful in aiding the treatment of patients with rolandic epilepsy.

This form of epilepsy is generally associated with favourable outcomes, with a moderate proportion of cases characterised by isolated seizure events, meaning continuous treatment need only be considered only for those affected by frequent seizures.

As such, the new research from the University of Yamanashi aimed to identify EEG criteria related to seizure recurrence in rolandic epilepsy, in order to help guide treatment strategies for those in this patient group.


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The review article that I mentioned above:

a good read to get the background idea of how the neurophysiologist, neurologist or clinicians can discern the EEG patterns:

Seminars in Neurology

Pearls, Perils, and Pitfalls In the Use of the Electroencephalogram

Omkar N. Markand, MD, FRCPC

 An EEG is the most common and most useful test performed in evaluating patients suspected of epilepsy. There are many areas where an EEG has unique contributions. The value of an EEG lies in the fact that it not only shows specific ictal discharges during a clinical seizure but also characteristic epileptiform abnormalities in a high proportion of epileptic patients even in the interictal period. Furthermore, an EEG may be the only test demonstrating focal abnormalities responsible for the patient's epileptic seizures. Specific patterns in the EEG make it possible to classify the seizure type, which is an essential prerequisite to institute proper antiepileptic medication. An EEG is indispensable for the diagnosis of nonconvulsive epileptic status presenting as prolonged "twilight" state or a prolonged episode of abnormal behavior. In a patient with bizarre motor activity, the recording of an EEG during such an episode may be the only way to establish whether the abnormal behavior is due to an epileptic seizure or a nonepileptic event, physiologic or nonphysiologic. Finally, the EEG is indispensable to localize the epileptogenic (seizure producing) zone before resective surgery (excision of the epileptogenic zone) is undertaken in a patient with medically refractory focal epilepsy.

Epilepsy: Drug Resistent Focal Epilepsy & Surgical Resection treatments, two Epilepsia Reports

Brain and Spine, 2014 Research Reports:

Fig from-Link: Human Epilepsy Patterns, focal epilepsy,

The following two new research reports published in Epilepsia journal [quoted Epilepsy current]might be of interest to those Epilepsy doctors and professionals, ofcourse to Neurophysiologists and long term intraoperative monitoring field.

Quoted: Current Literature In Clinical Science
Are HFOs Still UFOs? The Known and Unknown About High Frequency Oscillations in Epilepsy Surgery

High-Frequency Oscillations, Extent of Surgical Resection, and Surgical Outcome in Drug-Resistant Focal Epilepsy.

Haegelen C, Perucca P, Chatillon CE, Andrade-Valenca L, Zelmann R, Jacobs J, Collins DL, Dubeau F, Olivier A, Gotman J.

Epilepsia 2013;54:848–857.

PURPOSE: Removal of areas generating high-frequency oscillations (HFOs) recorded from the intracerebral electroencephalography
(iEEG) of patients with medically intractable epilepsy has been found to be correlated with improved surgical outcome. However, whether differences exist according to the type of epilepsy is largely unknown. We performed a comparative assessment of the impact of removing HFO-generating tissue on surgical outcome between temporal lobe epilepsy (TLE) and extratemporal lobe epilepsy (ETLE). We also assessed the relationship between the extent of surgical resectionand surgical outcome.

Read the full abstract at: http://www.aesnet.org/files/dmfile/epcu_13.6_273_ClinicalCommentary_Jobst.pdf#!
And the Full article at Epilesia journal.

Ripple Classification Helps to Localize the Seizure-Onset Zone in Neocortical Epilepsy.

Wang S, Wang IZ, Bulacio JC, Mosher JC, Gonzalez-Martinez J, Alexopoulos AV, Najm IM, So NK.

 Epilepsia 2013;54:370–376.

PURPOSE: Fast ripples are reported to be highly localizing to the epileptogenic or seizure-onset zone (SOZ) but may not be readily found in neocortical epilepsy, whereas ripples are insufficiently localizing. Herein we classified interictal neocortical ripples by associated characteristics to identify a subtype that may help to localize the SOZ in neocortical epilepsy. We hypothesize that ripples associated with an interictal epileptiform discharge (IED) are more pathologic,since the IED is not a normal physiologic event.

For full abstract and article, refer as the previous.