Sharp Waves: ILAE's epilepsy podcast

As a neurological emergency, status epilepticus (SE) requires timely diagnosis and treatment. A US study found that 10% of people with SE were not diagnosed by emergency services. Among those who were diagnosed in an ambulance, 20% did not receive any first-line treatment, while others received lower-than-recommended doses. Sharp Waves spoke to senior author Dr. Elan Guterman about the study.

Publications mentioned during the c...

Folic acid supplementation is recommended for all women with epilepsy who may become pregnant. However, there is no agreed-upon dose for women with epilepsy taking antiseizure medication, and there may be risks of high-dose (>1 mg/day) folic acid supplementation. Dr. Bruna Nucera spoke with Dr. Marte Helene Bjørk about the risks and benefits of folic acid supplementation and what this means for pregnant women with epilepsy.

Shar...

High-frequency oscillations (80 to 500 Hz) are being studied as biomarkers of epileptogenic areas in the brain, as well as markers to be used in epilepsy surgery. Dr. Cecilie Nome leads a discussion about clinical research on HFOs and areas of uncertainty, as well as the importance of basic research in helping to understand this phenomenon.

Publications mentioned during the episode: 

Roehri Eng N, et al. High-frequency oscillations a...

There are potentially hundreds of "epilepsy genes" - but what is an epilepsy gene? How do researchers discover these genes and associate them with epilepsy? Sharp Waves spoke with Dr. Allan Bayat, a pediatric neurologist in Denmark focused on rare monogenic neurodevelopmental disorders and epilepsy.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

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In the second episode of our genetics and epilepsy series, Sharp Waves explores how genetic insights can inform considerations and outcomes of epilepsy surgery. Dr. Alina Ivaniuk interviews Dr. Patrick Moloney, currently an epilepsy genomics fellow at the Chalfont Center for Epilepsy at University College London.

Selected publications:
Do germline genetic variants influence surgical outcomes in drug-resistant epilepsy?...

This first episode in a multipart series on genetics in epilepsy covers the basics of genetic testing. Dr. Alina Ivaniuk interviews Dr. Ilona Krey, a physician and researcher at the Institute of Human Genetics at Leipzig University Medical 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 Internatio...

Christina Rezek and Brad Levy each have daughters who underwent epilepsy surgery, with dramatically different results. Sharp Waves talked with them about the journeys to and through epilepsy surgery, the consequences, and what they have learned.

Brad Levy is a founder of Epilepsy Awareness Day at Disneyland, a free event held every November in Anaheim, California, USA. Visit epilepsyawarenessday.org for more information.

S...

Sharp Waves spoke with a neurologist and a cardiologist who are part of a team researching the interactions among seizures, heart function, heart health, and SUDEP. Learn more about their research.

Selected publications from Drs. Lin & Fialho and colleagues:


Determining factors of electrocardiographic abnormalities in patients with epilepsy: A case-control study (2017, Epilepsy Research)

Maximal/...

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 Epi...

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 S...

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 Asia

Announcement of a new Chines...

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...

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 Epile...

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 co...

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. 202...

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 exp...

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 in...

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 st...

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 projec...