PODCAST

Sharp Waves: ILAE's epilepsy podcast

ILAE

Epilepsy affects more than 50 million people. Every day. Sharp Waves brings you stories about people with epilepsy, physicians treating epilepsy, and researchers studying the condition. We'll cover the latest research, challenges to diagnosis and treatment, and issues from around the world.

Epilepsy education for teachers: Creating epilepsy-smart schools in India
Jun 14 2022
Epilepsy education for teachers: Creating epilepsy-smart schools in India
Schools can be an important focus for screening of children for epilepsy, as well as educational efforts to address basic knowledge, stigma, and misconceptions associated with epilepsy. Schools also are an appropriate and necessary place to provide seizure first aid to affected students, teachers, and staff, as well as rescue medications when needed.There is strong stigma around epilepsy in India;  parents may deny that a child has epilepsy, even if a community health worker has observed the child having seizures. And teachers and school administrators can be reluctant to allow children with epilepsy to attend school. This, combined with the social stigma of epilepsy and possible learning and cognitive issues, can lead to academic underachievement, lost opportunities, and poor quality of life into and throughout adulthood.To better understand the epilepsy treatment gap in children, as well as to begin addressing the gap on a school-based level, Dr. Sulena Singh and colleagues developed a three-year project of surveys and training activities. Dr. Sulena is in the Division of Neurology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.The project is supported by an ad hoc grant (No.5/4-5/189/Neuro / 2019-NCD-1) from the Indian Council of Medical Research, New Delhi.Read more about the project on the ILAE website.This episode was reported, edited and produced by Nancy Volkers.Contact ILAE with feedback or episode ideas at podcast@ilae.orgSharp Waves content is meant for informational purposes only and not as medical or clinical advice. 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, Twitter, and Instagram.
Epigenetics in epilepsy and the Michael Prize: Dr. Katja Kobow
May 26 2022
Epigenetics in epilepsy and the Michael Prize: Dr. Katja Kobow
Katja Kobow is the most recent winner of the Michael Prize, an international award in epilepsy research. Her work focuses on epigenetics and epilepsy, a field that has grown exponentially in only the past 10 to 15 years. Dr. Kobow talked about her research and its potential for epilepsy diagnosis and treatment.Epigenetics is the bookmarking system or the data management system of our genome. It decides which part of the genome is read, and when to read it. The epigenome is what makes the genome versatile in terms of regulating gene expression.Epigenetics is crucial for all aspects of brain development and function. It’s also reversible, which has exciting implications for anti-epileptogenic therapies.  Dr. Kobow is assistant professor at the Institute of Neuropathology at the University Hospital Erlangen, Germany. Selected recent publications: DNA methylation-based classification of malformations of cortical development in the human brain (Acta Neuropathologica, 2022)Molecular diagnostics in drug-resistant focal epilepsy define new disease entities (Brain Pathology, 2021)Epigenetics explained: a topic “primer” for the epilepsy community by the ILAE Genetics/Epigenetics Task Force (Epileptic Disorders, 2020)The Michael Prize is awarded in odd-numbered years; entries for the 2023 prize are now open and accepted until December 31, 2022.---This episode was reported, edited, and produced by Nancy Volkers.Contact us with feedback or episode ideas at podcast@ilae.orgSharp Waves content is meant for informational purposes only and not as medical or clinical advice. 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, Twitter, and Instagram. ILAE website | Facebook | InstagramTwitter feeds: English | French | Japanese | Portuguese | Spanish | ILAE-YES
Epilepsy, pregnancy and breastfeeding: Dr. Page Pennell
May 2 2022
Epilepsy, pregnancy and breastfeeding: Dr. Page Pennell
Can women with epilepsy get pregnant, give birth to healthy babies, and breastfeed? What are the myths and misconceptions around epilepsy during pregnancy, and what do physicians and women need to know? Dr. Anca Arbune interviews Dr. Page Pennell about the latest research and knowledge.Women with epilepsy were once counseled to avoid pregnancy, but epilepsy is no longer a barrier to giving birth. The vast majority of women will have good outcomes.Fertility issues are not a given in women with epilepsy, though they may arise in men or women taking enzyme-inducing anti-seizure medications.A long history of taking anti-seizure medication does not affect a woman’s fertility or other outcomes. Only the type of medication taken during pregnancy can exert an influence. Significant reductions in the use of valproate in women of childbearing age mean that most women are taking anti-seizure medications that have lower risks to their babies.A planned pregnancy with consistent seizure control can lead to safe and healthy outcomes. Certain anti-seizure medications require monitoring during pregnancy, due to changes in physiology and hormone levels.Breastfeeding is safe and studies show beneficial effects to the infant, similar to those in infants in the general population. Research discussed during the episode:MONEAD (Maternal Outcomes and Neurodevelopmental Effects of Anti-epileptic Drugs) StudyTwo-Year-Old Cognitive Outcomes in Children of Pregnant Women With Epilepsy in the Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs Study (2021) JAMA Neurology (KJ Meador, MJ Cohen, DW Loring, et al.)Fetal antiepileptic drug exposure and cognitive outcomes at age 6 years (NEAD study): a prospective observational study (2013) The Lancet Neurology (KJ Meador, GA Baker, N Browning, et al.)Antiseizure Medication Concentrations During Pregnancy: Results From the Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) Study (2022) JAMA Neurology (PB Pennell, A Karanam, KJ Meador, et al.)Effects of breastfeeding in children of women taking antiepileptic drugs (2010) Neurology (KJ Meador, GA Baker, N Browning, et al.)Antiepileptic Drug Exposure in Infants of Breastfeeding Mothers With Epilepsy (2019) JAMA Neurology (AK Birnbaum, KJ Meador, A Karanam, et al.)  This episode was reported by Dr. Anca Arbune, and edited and produced by Nancy Volkers.Contact us with feedback or episode ideas at podcast@ilae.org ILAE is a global organization of health care professionals and scientists,  working toward a world where no person's life is limited by epilepsy. ILAE website | Facebook | Instagram Twitter feeds: English | French | Japanese | Portuguese | Spanish | ILAE-YES
"Why are there so many people?" - Seizures in the Canadian Arctic
Apr 7 2022
"Why are there so many people?" - Seizures in the Canadian Arctic
Could annual dramatic shifts in day/night patterns in the Arctic have an effect on seizures? One researcher went looking for answers – and found more than he bargained for. His research revealed a public health crisis in one of the wealthiest countries in the world, highlighting the needs of geographically isolated communities and Indigenous peoples. (He also found intriguing results to his original question.)  Dr. Marcus Ng reviewed 11 years of data on emergency evacuations from the Kivalliq region of northern Canada. There, anyone who has seizures that last more than 5 minutes - an emergency condition known as status epilepticus - is helicoptered to a single hospital in Winnipeg, Manitoba. Dr. Ng wondered if the frequency of evacuations changed as the seasons changed. Were people more likely to have seizures in the 24-hour darkness of winter, the 24-hour daylight of summer, or somewhere in between? He found that the people of the Kivalliq region had the highest reported incidence of status epilepticus in the world, far higher than Canada's overall estimates. His research also revealed the barriers to timely care faced by this population.  This episode was reported and produced by Nancy Volkers. Sharp Waves content is meant for informational purposes only and not as medical or clinical advice. 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, Twitter, and Instagram.  Studies mentioned or used as sources of information:  Status epilepticus in the Canadian Arctic: A public health imperative hidden in plain sight. Epilepsia Open 2021Circannual incidence of seizure evacuations from the Canadian Arctic. Epilepsy & Behavior 2022 Incidence of the different stages of status epilepticus in Eastern Finland: A population-based study. Epilepsy & Behavior 2019 Addressing provider turnover to improve health outcomes in Nunavut. Canadian Medical Association Journal 2019 Contact ILAE with feedback or episode ideas at podcast@ilae.org
Discovering new drugs for epilepsy: Dr. Karen Wilcox
Mar 15 2022
Discovering new drugs for epilepsy: Dr. Karen Wilcox
Anti-seizure medications are not a cure, and about 30% of people with epilepsy don't respond to them. How are new medications discovered, and what's on the horizon?  Dr. Patricia Grandizoli Saletti interviews Dr. Karen Wilcox about her work with the Anticonvulsive Drug Development Program.Only about two-thirds of people with epilepsy have their seizures controlled by medication. The Anticonvulsive Drug Development (ADD) Program at the University of Utah is the contract site for the Epilepsy Therapy Screening Program (ETSP), a program run by the US National Institutes of Health that is dedicated to preclinical testing of potential new medications to stop seizures - and perhaps one day, to stop epilepsy from developing.Dr. Karen Wilcox directs the ADD Program, which over the years has evaluated the majority of the anti-seizure medications on the market today.The program uses a battery of assays and experiments to blind-test compounds, which are provided by pharmaceutical companies, academic labs, or medicinal chemists. The data is returned to the source lab, which can use it to pursue clinical testing if warranted. Identifying promising new anti-seizure medications relies on model systems that approximate epilepsy in human beings. Dr. Wilcox and colleagues' work on better pre-clinical models can help to identify more effective anti-seizure medications.  For example, finding compounds effective against drug-resistant epilepsy depends on models that simulate drug-resistant epilepsy. Dr. Wilcox's program uses such a model and is working on developing others. And in a 2020 Epilepsia paper, her group described results from a study of subchronic administration of anti-seizure compounds in a rodent model of spontaneous seizures.This episode was reported by Dr. Patricia Grandizoli Saletti, and edited and produced by Nancy Volkers.Contact ILAE with feedback or episode ideas at podcast@ilae.orgSharp Waves content is meant for informational purposes only and not as medical or clinical advice. 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, Twitter, and Instagram.
Deep brain stimulation for epilepsy: Dr. Robert Fisher
Feb 21 2022
Deep brain stimulation for epilepsy: Dr. Robert Fisher
Can electrical current stop seizures, or make seizures less severe? How does it work, and who can benefit?  Dr. Laurent Sheybani interviews Dr. Robert Fisher about deep-brain stimulation for epilepsy.Disclosure: Dr. Fisher is a consultant for Medtronic but receives no compensation for using its deep-brain stimulation devices.Deep-brain stimulation (DBS) is the newest of three types of neuromodulation for epilepsy, and targets a part of the thalamus called the anterior nucleus. In DBS treatment, targeted electrical pulses inhibit  a network in the brain  involved in starting and spreading seizures. This interference is linked with a reduction in the number and/or severity of seizures in some people who haven’t found relief with anti-seizure medications.In a randomized, double-blind study of DBS, the SANTE trial , 43% of people had significant reductions in their seizure frequency after one year, and 74% had reductions after 7 years. The treatment also had high patient satisfaction (84% after 7 years).The mechanisms of DBS are still largely unknown, though pre-clinical studies have found synaptogenesis, receptor changes, and changes in gene expression, suggesting the growth or regeneration of neurons. DBS is usually well tolerated, acceptably safe, and associated with improvement in quality of life.Research discussed during the episode:Electrical stimulation of the anterior nucleus of thalamus for treatment of refractory epilepsy (2010) Epilepsia (Fisher R, Salanova V, Witt T, for the SANTE study group)Experience and consensus on stimulation of the anterior nucleus of thalamus for epilepsy (2021) Epilepsia (Fasano A, Eliashiv D, Herman ST, et al.)Closed-loop stimulation of the medial septum terminates epileptic seizures (2021) Brain (Takeuchi Y, Harangozo M, Pedraza L, et al.)Medial septal GABAergic neurons reduce seizure duration upon optogenetic closed-loop stimulation (2021) Brain (Hristova K, Martinez-Gonzalez C, Watson TC, et al.) Other resources:ILAE/YES webinar on neurostimulation with Dr. Robert Fisher (January 2022)This episode was reported by Dr. Laurent Sheybani, and edited and produced by Nancy Volkers.Sharp Waves content is meant for informational purposes only and not as medical or clinical advice. 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, Twitter, and Instagram.