ATTENTION: Science, Health and Medical Media
For the Latest News on Epilepsy ñ and 21st Century Therapy Advances
Attend The 1997 Annual Meeting of the American Epilepsy Society
Friday, Dec. 5ñWednesday, Dec. 10, 1997
The Westin Copley Place 10 Huntington Avenue Boston, Massachusetts
Interview epilepsy physicians and scientists about todayÃs state-of-the-art surgeries and treatments, including:
∑ Predicting seizures ∑ Electrical stimulation ∑ New applications of anti-epilepsy medications ∑ Treatment of women with epilepsy
Presentations and Topics of Special Interest Include:
PRESIDENTIAL SYMPOSIUM
Epilepsy Therapy in the 21st Century, Monday, Dec. 8, 1997, 8:30ñ10:30 a.m. This symposium will address several innovative treatment strategies, including delivering small quantities of drugs directly to targeted areas of the brain, gene therapy to correct or compensate for genetic problems, and new forms of electrical brain stimulation to suppress seizure generation and spread.
NOTE: A media briefing will follow the presidential symposium at 10:45 a.m. in the St. George D Room.
Page Two MEDICAL ADVANCES
Predicting Seizures Seizure activity is known to be accompanied by increased blood flow in the brain. Scientists following this lead now report detecting increases in cerebral oxygen up to eight hours before seizure occurrence. This discovery raises the possibility of a predictive device to aid in diagnosis and treatment. (Platform K-9, abstract 70208).
Vagus Nerve Stimulator: The First New Form of Therapy in 100 Years Earlier this year the U.S. Food and Drug Administration approved electrical stimulation therapy, the first new form of epilepsy treatment in 100 years. Fourteen studies are reported. (Platform G-12, abstract 70355, Platform I-12, abstract 70262 and others)
Brain Surgery Without the Scalpel Gamma knife (irradiation) surgery has been used to destroy seizure-causing tumors and malformed blood vessels. A French study now suggests the method can be used successfully on epileptogenic tissue in the absence of space-occupying lesions. (Platform D-12, abstract 70898)
PUTTING A PRICE TAG ON EPILEPSY
Seizures Cost Billions of Dollars Annually Researchers estimate that status epilepticus, the most dangerous and feared type of seizure, has a total hospital inpatient-related cost of at least $3.8 billion to $7 billion on a national basis each year. (Poster 6.025, abstract 70338)
Another team reports on the objectives and methods of a historic three-year project that will produce the most comprehensive set of direct and indirect national cost information ever gathered on the financial burdens of epilepsy. (Poster 6.089, abstract 70773)
A study at one medical center found that routinely setting up oxygen and suction with all seizure patients is not medically necessary. The equipment was not used in more than 98 percent of epilepsy cases. Eliminating it could reduce inpatient costs. (Poster 2.11, abstract 70034)
Page Three NEW ANGLES
Treatment Poses Risk of Osteoporosis in Men, Children Bone mineral density tests in a predominantly male seizure patient population of 165 subjects on anticonvulsant medication reveals a high risk of osteoporosis. The researchers suggest that such tests be performed regularly to identify susceptible individuals. (Poster 2.1, abstract 70233)
An ongoing metabolic study of the ketogenic diet therapy suggests that children on the diet are also at risk of osteoporosis. Micronutrient intake, the investigators report, needs to be assessed in all children on the diet to assure they receive the recommended daily allowance. (Poster 5.103, abstract 70405)
Sleep Disorder or Epilepsy? Sleep disorders can mimic or worsen epileptic seizure activity. Sleep itself appears to lower the brainÃs defense against seizures contributing to the high incidence of nocturnal episodes. (Platform C-7, abstract 70283)
Seizures decrease sleep efficiency. Even brief nocturnal episodes may cause daytime drowsiness commonly seen in patients. (Platform C-8, abstract 70776)
A report by Australian investigators suggests that three-fourths of children with ambiguous sleep staging (non-classic sleeping brain wave patterns) may have epilepsy. (Platform K-4, 70894)
Can Whiplash Cause Epilepsy? Can organic brain dysfunction arise after whiplash even when there is no direct head injury? Researchers from Norway report four cases of seizures developing two weeks to two years following whiplash caused by rapid deceleration. Each patient developed temporal lobe epilepsy, including one case of medically resistant seizures. (Poster 5.9, abstract 70860)
Does Mandatory Reporting of Epilepsy Patients Reduce Auto Accidents? A study compares the experience of Canadian drivers with epilepsy in a jurisdiction that requires physician reporting with a jurisdiction requiring only discretionary reporting of seizure patients to authorities. Researchers found that mandatory reporting has no effect on accident rates, which in both jurisdictions were the same for epilepsy patients as control subjects without epilepsy. Where reporting of patients is mandatory, the team also found that patients are more likely to withhold information from their physicians. (Platform H-7, abstract 70797)
Page Four A HOT BUTTON: WOMEN WITH EPILEPSY
Inadequate Pregnancy Care and Counseling A pilot study at this medical center suggests that preconceptual, contraceptive, and pregnancy counseling of women with epilepsy is either not accomplished or not documented in a significant number of cases. Researchers recommend that a standard counseling format would help in planning and preventing potential complications during pregnancy. (Poster 6.043, abstract 70108)
A related study at another institution suggests that recent treatment recommendations for the management of pregnancy in women with epilepsy have yet to be incorporated into the practice of many physicians. (Poster 6.046, abstract 70439)
Estrogen Replacement Therapy: A Unique Challenge Menopause is associated with a reduction in seizure frequency in some women with epilepsy. A study which confirms this effect also reveals that estrogen-replacement therapy may have the opposite result and increase seizure activity, further complicating the hormone replacement therapy decision for these women. (Platform 3, abstract 70409)
Risk to Unborn Fetus May Be Greater Than Previously Reported Many of the effects of convulsive seizures on the unborn fetus have been documented. Researchers now report that non-convulsive seizures can be accompanied by dangerous uterine contractions. The contractions could account for the increased risk of miscarriage, stillbirths, and hemorrhage seen in some pregnancies complicated by epilepsy. (Poster 6.43, abstract 70715)
Page Five NEW MEDS: THE PROGRESS AND PITFALLS
The New Epilepsy Drugs: What Works and What DoesnÃt A record number of epilepsy drug introductions over the past several years has sparked a wide range of clinical studies concerning the benefits, side effects, and use of the new therapies. Most of these drugs were approved initially as add-on therapy for specific seizure types in adults. Many of the research reports at this meeting address the safety and efficacy of these new medications in pediatric patients, value in treating the other seizure types, and potential as monotherapy. (Various abstracts)
Saving Babies from Debilitating Seizure Disorders Among new medications recently approved ó or under government review ó several show promise in treating two of the most devastating forms of epilepsy:
∑ Infantile spasms (Poster 3.31, abstract 70240, Poster 3.43, abstract 70057 and Poster 5.81, abstract 70809)
∑ Lennox-Gastaut syndrome (Platform I-8, abstract 70151 and Poster 3.46, abstract 70205)
Incidence of Serious Rash May Be Underestimated A search of 4,624 pediatric patient files at a university medical center found that serious rashes associated with one recently approved medication are nearly as common with some traditional drug therapies. (Platform 5.888, abstract 70608)
Other studies confirm that, while rash associated with this new drug is a common side effect, severe rash requiring discontinuation may not be as high as previously reported. (various abstracts)
Another study suggests that even when discontinued, it may be possible to re-introduce the drug in pediatric patients without the rash recurring. (Poster 3.59, abstract 70812)
Page Six KETOGENIC DIET ó EASIER TO SWALLOW
Experiments in Dietary Seizure Control The recently revived ketogenic diet ó a rigid, high cholesterol, low carbohydrate therapy with potential serious side effects ó is under study with varying success in treating selected pediatric patients. Among 19 reports on the diet are studies involving the following:
∑ Patients with seizures and cerebral palsy (Poster 5.98, abstract), ∑ Seizures and diabetes mellitus (Poster 5.94, abstract 70014), ∑ Lennox-Gastaut syndrome (Poster 5.32, abstract 70446 and Poster 5.33, abstract 70445) ∑ Landau-Kleffner syndrome (Poster 5.33, abstract 70445)
Novel Approach Mixes Ketogenic Diets Two standard ketogenic diets are in current use: the cream diet (80-90 percent calories from long-chain fats) and the MCTD oil diet (60 percent calories from medium chain fat). These diets are associated with gastrointestinal distress in some patients, which affects compliance. By combining the two diets, researchers report reduced GI distress and improve compliance ó without compromising its effectiveness in reducing seizures. (Poster 5.100, abstract 70622)
To request a press kit, schedule an interview with an expert, or for more information, call:
Holly Gibson Fleishman-Hillard (816) 512-2349
A press room will be available for your convenience beginning at noon Saturday, Dec. 6, through 6 p.m. Wednesday, Dec. 10, in the St. George C Room at the Westin Copley Place.
For a copy of the full program and registration form, call the AES fax-on-demand service at (860) 586-7575. Ask for document #30200.
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