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SCIENTISTS DISCUSS EPILEPSY RESEARCH FOR THE 21ST CENTURY
1997 American Epilepsy Society Conference Explores Many Facets of the Disorder
BOSTON, Mass. (Dec. 8, 1997) -- One of several key topics at the 1997 annual meeting of the American Epilepsy Society (AES) Dec. 5--10 at The Westin Copley Place in Boston will be the discussion of potential treatments and advances in the study of epilepsy. A report on this, as well as other important topics, will likely capture the attention of the medical community, the 2.5 million people who have the disorder and the nation.
The conference is expected to draw more than 2,000 practicing neurologists and the world's foremost medical authorities on the study of epilepsy, who will explore new study findings. The conference also will include a Presidential Symposium, themed: "Epilepsy Therapy in the 21st Century," Monday, Dec. 8, from 8:30--10:30 a.m. The symposium will look beyond today's cutting edge to a future likely to include such innovative treatment strategies as 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.
"This is an extraordinarily exciting time in the management of epilepsy," says Marc Dichter, M.D., Ph.D., and current AES president. "In the last year, we've seen a number of new therapies introduced. Genetic research appears to be moving closer to delivering on its long-held promise, and scientific advances in other areas are opening the door to completely new ways of dealing with the disorder."
MEDICAL ADVANCES
Among the intriguing new developments in epilepsy research is a recent study that could have applications in predicting seizures before their onset. Seizure activity is known to be accompanied by increased blood flow in the brain. In a study conducted at the Children's Hospital of Pittsburgh, lead researcher Dr. P. David Adelson now reports being able to detect increases in cerebral oxygen up to eight hours before seizure occurrence in cases involving temporal lobe epilepsy. The researchers suggest that this early sign may give physicians a better chance of observing and diagnosing seizures, or of initiating treatment to stop them before they occur (abstract 70208, platform K.9).
Genetics, too, have been a much talked-about element in epilepsy advances, and research into the disorder is increasing throughout the world. Recently, epilepsy geneticists have uncovered genes that are responsible for several different types of epilepsy. For example, lethargic mice and tottering mice display symptoms resembling absence (petit mal) epilepsy in humans. Researchers believe these and other animal models will lead to a better understanding of the electro-chemical processes involved in specific types of epilepsy, and more importantly, to the development of more effective treatments. The ultimate goal is a cure for some forms of the disorder (abstract 70226, platform F.5; abstract 70414, platform F.4; and abstract 70518, platform F.3).
NEW THERAPIES
This year's AES conference also will discuss several innovative new therapies for treating epilepsy. The most recent electrical stimulation therapy involves an implantable device -- the vagus nerve stimulator -- that was approved in July for adult and adolescent patients with intractable seizures.
Independent studies of the safety and effectiveness of the device are reported by researchers in Sweden and the University of Southern California (USC) in Los Angeles. The device (with a battery pack and a computer chip) is implanted on the left side of the chest with a lead running under the skin to the vagus nerve on the side of the neck. It delivers a mild electrical pulse to the nerve every five minutes, 30 seconds at a time (abstracts 70355, platform G.12 and 70262, platform I.12).
According to Dr. Christopher DeGiorgio, associate professor of neurology and neurosurgery at the USC School of Medicine, 199 patients were implanted with the stimulator; the active treatment group experienced an average reduction of 28 percent, while the control group had a 15 percent reduction; 11 percent of the subjects in the high stimulation group reported a greater than 75 percent reduction in seizure frequency.
"It's not a cure-all, but it's an exciting new option to drugs or surgery," says DeGiorgio. "Additionally, it doesn't cause the typical side effects associated with drugs, and it isn't as invasive as epilepsy brain surgery."
In another important study, a French team has reported on the success of non-invasive epilepsy surgery employing the Gamma Knife (irradiation surgery). The procedure allows precise destruction of seizure-causing tumors and malformed blood vessels. A new study by Dr. Jean Regis and fellow researchers at the Timone Hospital in Marseilles now suggests this method can be used successfully on epileptogenic tissue in the absence of space-occupying lesions (abstract 70898, platform D-12).
AES '97: CELEBRATING 51 YEARS
While "Epilepsy Therapy in the 21st Century" remains the primary topic of discussion at this year's AES Presidential Symposium, the meeting will explore a host of other topics including The Role of Managed Care in the Diagnosis and Treatment of Epilepsy, Sudden Death and Epilepsy, and more.
This is the 51st meeting of the AES. The American Epilepsy Society is the professional society for physicians and other health care professionals who treat or study the biological, clinical and/or psychological aspects of epilepsy. Among its members are neurologists, epileptologists, neurologic nurses, basic scientists and clinical investigators devoted to improving the quality of life for the 2.5 million Americans with seizure disorders.
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