New Drug Shows Promise for Treating Epileptic Seizures

Medication May also Prove Beneficial for Bipolar Disorder and Neuropathic Pain

A study appearing in the latest issue of Epilepsia shows that a new drug under development called Eslicarbazepine (ESL) shows promise as a treatment for epilepsy patients whose symptoms remain uncontrolled with existing medications. Patients with at least four partial-onset seizures per month, in spite of treatment with other medications, were administered ESL doses ranging between 400mg and 1,200mg. The study demonstrates that ESL is well tolerated and effective when used as adjunct (add-on) therapy for adult patients with partial epilepsy, fully eliminating seizures in 24 percent of tested patients, compared to those who received a placebo, and reducing seizures >50% in 54% of patients who received ESL compared to 28% who received placebo in this 12 week study. The occurrence of side effects was also low compared to other current treatment methods. A once-daily dose was shown to be most effective, offering patients added convenience as current treatments can involve several doses per day.

No age- or gender-related differences were found in the effectiveness of the treatment. “Our study shows that ESL was safe and well tolerated,” says Patrício Soares-da-Silva, co-author of the study. “We believe that ESL may have the potential to become an important new central nervous system drug not only for the treatment of epilepsy, but also for patients suffering from bipolar disorder and neuropathic pain.”

Eslicarbazepine is currently not available in the United States. 

Scholarship opportunity for people with epilepsy and their caregivers

UCB, Inc. has announced a call for applications for the 2007 Keppra^® (levetiracetam) Family Epilepsy Scholarship Program^TM, which provides financial resources to those who demonstrate academic and personal achievement. The company will award 30 one-time scholarships in 2007—20 $5,000 scholarships to people with epilepsy and 10 $5,000 scholarships to family members or caregivers of people with epilepsy. The aim of the scholarship program is to encourage people affected by epilepsy to continue their education despite the day-to-day challenges epilepsy can sometimes pose. For information on eligibility requirements and to download a copy of the scholarship application, go to www.KEPPRA.com. The completed application must be postmarked by May 25, 2007. Scholarship winners will be notified in August.

FDA Approves New Epilepsy Drug

The FDA recently approved an additional indication for use of the anti-epileptic drug Keppra (levetiracetam) as adjunctive (add-on) therapy in the treatment of primary generalized tonic-clonic (PGTC) seizures in patients 6 years of age and older.

"Seizure freedom with minimal side effects is the ultimate goal for physicians and patients. The results of the trial supporting this new indication demonstrate the growing evidence for Keppra as an effective adjunctive therapy across partial and generalized seizure types,” said Robert C. Knowlton, MD, Associate Professor of Neurology, University of Alabama at Birmingham.

Keppra was approved by the FDA in 1999 as adjunctive therapy in the treatment of partial onset seizures in adults with epilepsy. Since 1999, Keppra has received several additional approved indications as adjunctive therapy for epilepsy, making it one of the few treatments approved to treat seizure types that together account for more than 80 percent of all seizures.

Research Links Tooth-brushing to Seizures

Tooth-brushing may trigger seizures in certain people with epilepsy, and researchers say lesions in a specific part of the brain may be a cause in some people, according to an article published in the March 6, 2007, issue of Neurology, the scientific journal of the American Academy of Neurology.

The article reviewed the cases of three adults with epilepsy who experienced seizures while brushing their teeth. Two of the adults reported some of their seizures occurred when they brushed certain areas of their mouth. The seizures varied from jerking and twitching of the face to salivating vigorously. One patient was unable to let go of the toothbrush during the seizure.

The seizures were confirmed by video monitoring.

Using an MRI, researchers found all three patients had lesions in the somatosensory area of the brain, which is close to the hand and speech motor areas.

“The rhythmic act of brushing teeth may excite an already overly excitable area of the brain,” said study author Wendyl D’Souza, MBChB, MPH, with the Department of Neurology and Neurological Research at St. Vincent’s Hospital, the University of Melbourne in Melbourne, Australia, and a member of the American Academy of Neurology. “This is similar to photosensitive epilepsy, which involves seizures triggered by flashing lights and moving patterns.”

“Since tooth-brushing involves persistent rhythmic action, this may explain why this trigger is more likely to induce seizures in the somatosensory area of the brain compared to other oral stimuli, such as eating,” said D’Souza.

Source: American Academy of Neurology

Keppra May Hold Promise for New Onset Epilepsy Patients

New research indicates that treatment with low doses of levetiracetam (Keppra) is effective for newly diagnosed epilepsy patients with partial seizures. The study potentially gives another treatment option for newly diagnosed epilepsy patients according to a study published in Neurology. Levetiracetam is currently approved as an add-on therapy, however new evidence shows it might provide effective seizure control on its own (monotherapy).

Researchers assigned nearly 600 adults who had at least two seizures in the previous year to either levetiracetam or to controlled-release carbamazepine, a common epilepsy treatment. Study author Martin Brodie, MD and his colleagues found that the seizure-freedom rates were nearly identical in each group—approximately 73 percent. Of the patients who were seizure-free at 6 months, 80 percent who took levetiracetam and 85 percent of those who took the carbamazepine were still at the lowest dose level. Withdrawal rates for adverse events were higher in the carbamazepine group (19.2%) vs. 14.4% for levetiracetam, although this difference was not statistically significant.

Brodie commented, “the fast and sustained efficacy and good tolerability of levetiracetam in adults and children with partial-onset seizures, together with its favorable pharmacokinetic profile, lack of enzyme-inducing properties and low potential for pharmacokinetic interactions, make it a promising AED for use as initial monotherapy in newly diagnosed epilepsy.”

Source: American Academy of Neurology

Are Epilepsy Patients Able to Predict Seizures?

A new study reported in Neurology reveals that some epilepsy patients can reliably predict when some of their seizures are likely to occur, a finding that may lead to better seizure prevention.

To determine how accurate patient predictions were, researchers examined 71 patients who had at least one seizure during the past year, but not more than one per day. Patients were asked to keep a daily log in which they predicted how likely they were to experience a seizure in the coming 24 hours.

Fifty-seven patients experienced seizures during the study. Of these patients, the study found they correctly predicted about 32 percent of their seizures, and 83 percent of their seizure-free days. Seizures were twice as likely to happen in the 24 hours following a positive prediction.

Some people were much better able to predict seizures than others. If these results are confirmed in future studies, the ability to predict seizures could have significant implications for treatment of epilepsy. “Patients who can accurately predict an increased risk of seizure might be able to take medications to pre-empt a seizure before it starts,” said Haut. “Accurate prediction of a reduced risk is also important since it might provide reassurance and improve quality of life for people with epilepsy.”

In addition, researchers say identifying periods of time when the probability of seizures is increased also offers patients an opportunity to institute precautionary measures.

In an editorial appearing in the same issue of Neurology, Dr. Brian Litt expressed concern that there were potential drawbacks to the study that could make the results difficult to interpret. However, overall, he concluded that if the results are validated, their findings help prove the concept that it is possible to develop tools and devices that can identify periods of time during which seizures are more likely to occur, giving patients warning and opening up opportunities for novel therapies to stop seizures before they start.

Source: American Academy of Neurology

Trained Dogs May be Responding to Seizures, but Not Epileptic Ones

New research suggests that specially trained “seizure dogs” may be predicting psychological seizures instead of epileptic seizures. Two new studies, published in Neurology  indicate that dogs are responding to seizures caused not by epilepsy but by psychological conditions.

The study author Gregory L. Krauss, M.D. of Johns Hopkins University said, “This is important because the treatment is very different for a person with epilepsy and one with psychological seizures, which stem from emotional difficulties. Epilepsy drugs are not effective for psychological seizures and they often have side effects. And with proper treatment and counseling, psychological seizures can often be eliminated.”

Researchers monitored seven people with seizure response dogs. Most were monitored with video EEG tests to track seizures and electrical activity in the brain. For four of the people, unlike people with epilepsy whose seizures are caused by abnormal electrical activity in the brain, there was no abnormal activity during seizures and they were diagnosed with psychological seizures.

Krauss noted that some people with epileptic seizures may benefit from seizure response dogs.

“Seizure response dogs can help people during seizures and stay by them when they are unconscious and provide companionship that aids them in dealing with a chronic disorder,” Krauss said. “People with nonepileptic seizures require psychiatric evaluation and behavior therapy. This study demonstrates the importance of establishing an accurate diagnosis of epilepsy before obtaining a seizure response dog.”

Source: American Academy of Neurology

Study Reveals Yoga, in Addition to Medications, May Help in Controlling Epilepsy

Pilot study results indicate that yoga may be effective as an adjunctive therapy for people with drug-resistant chronic epilepsy. The study was a prospective, nonrandomized, open-label, add-on trial with a 12-week baseline period, followed by a 12-week supervised yoga medication protocol administration phase. The frequency of complex partial seizures was assessed at 3, 6 and 12 months of the treatment period.

Yoga is an ancient Hindu system of meditation and low impact exercises that help to control the body and mind, aiming to reduce stress and promote relaxation.

The study was conducted at the R. Madhavan Nayar Center for Comprehensive Epilepsy in Kerala, India. Twenty patients with complex partial seizures, who did not respond to antiepileptic medications, practiced yoga for three months. Results showed a reduction in seizure frequency in over 50 percent of the participants.  

Continued randomized trials with larger numbers of patients needs to be conducted in order to determine whether yoga may become a cost-effective treatment, without side effects, for patients with drug resistant chronic epilepsy. These results are consistent with prior studies demonstrating that some people with epilepsy benefit from the use of relaxation procedures in addition to their medications.

Merger Creates First Statewide Epilepsy Service Organization in Florida

The Epilepsy Foundation of South Florida and the Epilepsy Foundation of Northeast Florida recently merged to form the Epilepsy Foundation of Florida (EFOF), the first state-wide organization to direct and coordinate epilepsy research, treatment and funding efforts. The Foundation, which is based in Miami, was formed through the merger of the Epilepsy Foundation of South Florida and the Epilepsy Foundation of Northeast Florida, and will be the lead agency for epilepsy service programs sponsored by the state, as well as the sole licensee in Florida of the National Epilepsy Foundation.

The new foundation's Board of Directors will be led by Patricia Dean, ARNP, MSN; Coordinator of the Comprehensive Epilepsy Center at Miami Children's Hospital; and former member of the National Epilepsy Foundation Board. Joining her as officers are: A.G. Newmyer, III, Palm Beach Gardens; Susan L. Holloway, West Palm Beach; and Steven Feig, Miami.

Karen Basha Egozi, who previously directed the South Florida Foundation, was named the Executive Director of EFOF. She will head a statewide staff of 34 with offices in Miami, Fort Lauderdale, West Palm Beach and Jacksonville.

Richard Hatfield, who headed the Epilepsy Foundation of Northeast Florida, based in Jacksonville, will head EFOF's Jacksonville office as Florida Patient Advocacy Director, charged with insuring that EFOF's public policy initiatives are met on the state government level.

First Youth Council Meeting Charts Course for the Next Two Years

The Youth Council of the Epilepsy Foundation convened its first-ever meeting concurrent with the recent meeting of the Foundation’s board of directors. The focus was to create a strategic action plan for the next two years to cover the Foundation’s youth programming and how the Foundation will reach out to both young people with epilepsy and young people who do not have epilepsy

“We are excited about this important new program,” said Eric R. Hargis, President and CEO of the Epilepsy Foundation. “Changing the attitudes and opinions of today’s youth about epilepsy is key to eliminating the stigma of epilepsy. By reaching out to youth, we are both helping young people today and creating a platform for change for tomorrow.”

The Youth Council comprises 10 young adults, ages 18 to 24, who have demonstrated exceptional leadership in the epilepsy community. Members serve as ambassadors and public spokespeople for the Epilepsy Foundation’s mission, as state and national advocacy representatives, and as epilepsy community leaders at the local level. Council members include youth with and without epilepsy. Members of the Youth Council also serve as national program and youth outreach materials advisors.

“Young people know the best way to talk to young people,” said Elizabeth Goldberg, chair of the Youth Council and member of the Epilepsy Foundation’s board of directors. “We understand what messages are most important, and how to deliver those messages. Because the Council has youth who have epilepsy and youth who don’t — youth who simply want to advocate change and raise awareness in all communities — we can bring a unique vision and new way of thinking to the Foundation. I am thrilled that the Foundation has embraced youth leadership as a priority.”