Sharp Waves: ILAE's epilepsy podcast

In this episode, we explore the science behind exercise as an adjunct treatment for epilepsy and debunk some common myths (spoiler alert: With very rare exceptions, exercise does NOT increase seizure risk). Dr. Ayushe Sharma talked with Dr. Jane Allendorfer, Dr. Halley Alexander, and Brian Wiedmeyer, who participated in an exercise research study.The episode refers to a 2016 report by the ILAE Task Force on Sports and Epilepsy - that report is freely available online at this link.Some of the other research papers mentioned in the episode are listed below.The relationship between physical activity and cognitive function in people with epilepsy: A systematic review Effects of physical exercise in people with epilepsy: A systematic review and meta-analysis Role of Physical Exercise as Complementary Treatment for Epilepsy and other Brain Disorders Epilepsy and exercise: An experimental study in female rats Effects of an exercise program on health of people with epilepsy: A randomized clinical trialA strength exercise program in rats with epilepsy is protective against seizuresEffectiveness of Yoga Intervention in Reducing Felt Stigma in Adults With Epilepsy Impact of exercise as a complementary management strategy in people with epilepsy: A randomized controlled trial Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

A recent practice guideline provides updated evidence-based conclusions and recommendations regarding in utero effects of anti-seizure medications and folic acid supplementation on the prevalence of major congenital malformations, adverse perinatal outcomes, and neurodevelopmental outcomes. Dr. Parthvi Ravat interviewed Dr. Alison Pack about the guideline, which was produced by the American Academy of Neurology, American Epilepsy Society, and Society for Maternal-Fetal Medicine.Review the practice guideline: Teratogenesis, perinatal, and neurodevelopmental outcomes after in utero exposure to antiseizure medication (Neurology, May 2024)Other studies mentioned in the episode: Risk of major congenital malformations and exposure to antiseizure medication monotherapy (JAMA Neurology, March 2024) Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

Some historic names for epilepsy have been derogatory and stigmatizing. An older term for “epilepsy” in Malay means “mad pig disease.” Neurologists in Malaysia collaborated to change the word to a medically accurate term. Sharp Waves spoke with Dr. Chong Tin Tan about the origins of the older term and how the new term was introduced.Resources:Name of epilepsy: Does it matter? - 2012 - Neurology AsiaAnnouncement of a new Chinese name for epilepsy - Lau - 2011 - Epilepsia Changing name of epilepsy in Korea; cerebroelectric disorder (noi‐jeon‐jeung,뇌전증,腦電症) - Kim - 2014 - EpilepsiaRenaming Korean epilepsy: Where are we? - Epilepsy & Behavior Awareness, knowledge and attitude towards epilepsy in Malaysia: A perspective of undergraduates in a private university | African Journal of Neurological Sciences Overcoming the stigma of epilepsy in Asia // International League Against Epilepsy  Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

With all the best intentions, undertakings in global neurology can include assumptions and biases that lead to unforeseen negative consequences. Sharp Waves spoke with Drs. Melody Asukile and Deanna Saylor about their recent article on the perils and pitfalls of global neurology. They discussed specific examples of some of these unforeseen consequences and talked about the ingredients for productive, ethical, and sustainable global neurology initiatives.Resources:Asukile M et al. The Perils and Pitfalls of Global Engagement (JAMA Neurology)Global Neurology: Advancing Neurological Care Worldwide (YouTube)DiBiase R et al. Evaluation of Three Cohorts of the First Neurology Postgraduate Training Program in Zambia (P4-8.001) (Neurology)Zambia League Against Epilepsy Epilepsy care in Zambia: “Now that we have neurologists, we will have a voice” (ILAE Sharp Waves episode)Intersectoral global action plan on epilepsy and other neurological disorders (World Health Organization) Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

Some people with epilepsy also experience memory and learning issues, as well as depression or anxiety. A small study in Australia screened people for these conditions at a first seizure clinic before any anti-seizure medications had been prescribed. Compared with a control group, the people at the first seizure clinic had higher rates of all of these cognitive and neuropsychological issues.The study is published in Epilepsia Open. Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

Juhn Atsushi Wada was a Japanese–Canadian neurologist known for research on epilepsy and human brain asymmetry, including his description of the Wada test to assess cerebral hemispheric dominance of language function. The Wada test is the gold standard for establishing cerebral dominance and is conducted worldwide prior to epilepsy surgery. He became a pioneer in the utilization of the kindling model of epilepsy, which permitted controlled studies of the development of epilepsy in the laboratory. Drs. Maryam Nouri and Laurent Sheybani interviewed Drs. Jerome Engel Jr., Marilyn Jones-Gotman, and Solomon Moshe about their memories and relationships with Dr. Wada and his impact on epilepsy research and clinical care.More information on Dr. Wada:In memoriam: Juhn Atsushi Wada (Epilepsia Open)Juhn Wada 1924-2023 (ILAE website)Dr. Juhn Atsushi Wada (British Columbia Medical Journal) Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

Previously thought to be mere connective tissue and support for neurons, astrocytes are now understood to have many functions in the nervous system that are linked with seizures and epilepsy. Dr. Cecilie Nome spoke with Dr. Peter Bedner about astrocytes' involvement in epilepsy and how identifying and resolving astrocyte dysfunction is a new frontier in drug development.Relevant articles:de Ceglia R., et al. 2023. Specialized astrocytes mediate glutamatergic gliotransmission in the CNS. Nature 622, 120–129.Grote A., et al. 2023. ‘Hippocampal innate inflammatory gliosis only’ in pharmacoresistant temporal lobe epilepsy. Brain 146(2), 549-560.Ravi V.M., et al. 2015. Astrocyte uncoupling as a cause of human temporal lobe epilepsy. 2015. Brain 138(5), 1208-1222. Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

Dr. Ashok Pillai is a professor of neurosurgery and neuroscience associated with Amrita Institute of Medical Sciences, Kochi, India. He underwent epilepsy surgery after a diagnosis of epilepsy in his mid-30s. Dr. Pillai received his undergraduate degree and medical training in the United States before returning to Kochi in 1999. He experienced ecstatic seizures for nearly a decade before he was diagnosed. His personal experience with epilepsy and epilepsy surgery led him to train as an epilepsy surgeon, whereas previously he had focused on surgical neuro-oncology. The Amrita Advanced Centre for Epilepsy, which he heads, has performed more than 1,000 surgical procedures.Dr. Parthvi Ravat spoke with Dr. Pillai about his experience with epilepsy, how it shaped his career path, and how it informs his clinical decision making. Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

Recent community-based studies suggest that people with chronic epilepsy have three times the risk of sudden cardiac death, compared with the general population. The studies also found that two-thirds of the cases of cardiac arrest in people with epilepsy did not occur directly before, during, or after a seizure. How do seizures affect the heart, both acutely and chronically? Dr. Trudy Pang and Dr. Richard Verrier have introduced the concept of the "epileptic heart" as "a heart and coronary vasculature damaged by chronic epilepsy as a result of repeated surges in catecholamines and hypoxemia, leading to electrical and mechanical dysfunction." Dr. Parthvi Ravat talks with both of them about their work and its relevance to epilepsy treatment. Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

When a child with epilepsy ages out of pediatric healthcare, the shift to adult epilepsy care can be complex. Planning this transition and coordinating care can prevent gaps that can affect quality of life and possibly lead to health crises. A recent survey of people with epilepsy treated inside and outside of academic medical centers found that transition care was lacking. One-fourth of young adults with epilepsy were still followed by their pediatric neurologists and only 4% said they received clear instructions during the transfer of care process. Sharp Waves spoke with the paper’s senior author about the results and their implications.  Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

In northern Nigeria, as in many other low- and middle-income countries, more people need epilepsy treatment than traditional medical care can support. Dr. Edwin Trevathan discusses projects in that region aimed at identifying children with undiagnosed epilepsy and improving access to care, as well as research to better understand the risks and prognosis of pediatric status epilepticus.Dr. Trevathan heads the BRIDGE project (Bridging the Childhood Epilepsy Treatment Gap in Africa) and the SEED project (Childhood Status Epilepticus and Epilepsy Determinants of Outcome). Both are funded through the US National Institutes of Health Fogarty International Center. Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

A recent publication outlined areas of consensus on the recommended management, treatment options, and prognosis for epilepsy with eyelid myoclonia, also known as Jeavons syndrome. Dr. Alina Ivaniuk interviewed Dr. Kelsey Smith about the results and how consensus was reached.They discuss which medications are recommended as first-line treatment, possible non-pharmacologic treatment options, and what is known about the safety of driving in this population. The publication appears in Epilepsia:Smith KM, et al. Management of epilepsy with eyelid myoclonia: Results of an international expert consensus panel. Epilepsia. 2023; 64: 2342–2350. https://doi.org/10.1111/epi.17682 Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

Besides seizures, people with developmental and epileptic encephalopathies experience a wide variety of symptoms, including sleep problems, vision problems, and behavioral issues. Dr. Scott Demarest discusses how neurologists may be able to address some of these, improving outcomes and quality of life. Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

Seizure action plans can help people with epilepsy manage their seizures and address emergencies. They often are aimed at a subset of people with epilepsy, particularly children. Dr. Lucretia Long discusses how seizure action plans can be used to engage and educate all people with epilepsy, as well as their families and the larger community.Seizure action plan examples: English, Spanish, Simplified Chinese, Korean, Tagalog, Ukrainian, VietnameseOnline fillable seizure action plan - English (PDF) Plan de acción de incautación en línea  - espanol (PDF)List of published research on seizure action plans Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

What is the Human Brain Project and how might it advance epilepsy research? Dr. Maryam Nouri speaks with Dr. Philippe Ryvlin about the project in terms of the Human Intracerebral EEG Platform and how compiling these unique data from around the world could lead to new breakthroughs and understanding of epilepsy.The Human Intracerebral EEG Platform is an open-source platform designed for collecting, managing, analyzing, and sharing iEEG data at an international level. Its primary mission is to promote the development of large-scale iEEG research projects by facilitating international collaborations in the field.Links:Human Brain ProjectHuman Intracerebral EEG PlatformThe Virtual Brain Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

Counseling of teens and young adults with epilepsy about reproductive issues is not happening often enough. Conversations about pregnancy are almost non existent. Sharp Waves spoke with authors of a recent paper that details these findings and discusses possible solutions.Read the study: A retrospective textual analysis of sexual and reproductive health counseling for adolescent and young adult people with epilepsy of gestational capacity - Epilepsy & Behavior (epilepsybehavior.com)Related articles by the same authors:Sexual and reproductive healthcare for adolescent and young adult women with epilepsy: A qualitative study of pediatric neurologists and epileptologists - Epilepsy & Behavior (epilepsybehavior.com) (2020)A survey of child neurologists about reproductive healthcare for adolescent women with epilepsy - Epilepsy & Behavior (epilepsybehavior.com) (2021)Sexual and reproductive health concerns of women with epilepsy beginning in adolescence and young adulthood - Epilepsy & Behavior (epilepsybehavior.com) (2021)A Survey of Healthcare Providers About Reproductive Healthcare for Adolescent Women With Epilepsy - Journal of Pediatric and Adolescent Gynecology (jpagonline.org) (2022)Pediatric Neurologists’ Perspectives on Sexual and Reproductive Health Care for Adolescent and Young Adult Women With Epilepsy and Intellectual Disability (2022)Preferences and experiences of women with epilepsy regarding sexual and reproductive healthcare provision - Epilepsy & Behavior (epilepsybehavior.com) (2022) Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

People with epilepsy don't always know when they have had a seizure - and yet establishing seizure frequency is a key part of epilepsy management. When Dr. Mark Cook's father was diagnosed with epilepsy, Dr. Cook realized that a system to identify and predict seizures could improve care and change people's lives. Dr. Parthvi Ravat talks with him about entrepreneurship in epilepsy and ways to advance the field through innovation. Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

Is surgery for pediatric epilepsy "worth it"? What factors determine quality of life in families with a child who has epilepsy? Dr. Kette Valente talks with Dr. Mary Lou Smith, whose work has implications for clinical treatment decisions, as well as expectations for the impact of treatments in children with epilepsy. Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

EEG training varies within countries as well as between them; in many countries, there is no training available. Dr. Bruna Nucera talks with Dr. Sandor Beniczky about the present and future of clinical neurophysiology training, including a recent review that calls for harmonizing this type of training across the globe. Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

Seizures are common in neonates, but there is substantial management variability. The Neonatal Task Force of the International League Against Epilepsy (ILAE) developed evidence-based recommendations about anti-seizure medication management in neonates in accordance with ILAE standards. Dr. Emma Carter speaks with first author Dr. Ronit Pressler about the guidelines and recommendations, and how they were established. Treatment of seizures in the neonate: Guidelines and consensus-based recommendations—Special report from the ILAE Task Force on Neonatal Seizures Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.