According to the Centers for Disease Control and Prevention, more than 3 million Americans are living with epilepsy. Most epilepsy treatments focus on controlling or reducing seizures.
Researchers have yet to find a cure for epilepsy. Additionally, existing epilepsy treatments do not work for millions of people. For this reason, many institutions, both public and private, are dedicated to finding effective treatments.
What is epilepsy?
Epilepsy is a chronic neurological disorder that causes seizures. Seizures occur when the brain’s electrical activity experiences a sudden spike. This temporarily impairs the individual’s motor and cognitive skills, triggering involuntary movements and changes in body functions, behavior, sensations, and awareness.
Seizures can happen due to acute triggers, such as head trauma or substance use. However, if an individual experiences two or more seizures without a clear cause, they can be diagnosed with epilepsy.
Epileptic seizures may affect the entire brain or only one section. Some people experience both types of seizures.
Epilepsy itself may be a long-term side effect of an acute illness. Many times, the cause of epilepsy is unknown. Researchers believe that the risk of developing epilepsy is partially genetic.
Epilepsy is most diagnosed in young children or older people. However, symptoms may appear at any time.
Current treatments
There are many epilepsy treatments available today that provide effective results for the majority of patients.
The first course of treatment is usually anti-epileptic medication. These drugs reduce the likelihood of electrical overactivity in the brain. They work by interfering with or facilitating neuron communication in certain parts of the brain.
Doctors usually prescribe one treatment after a patient is first diagnosed with epilepsy. If that first medication doesn’t work, doctors will try another drug. Medications help achieve seizure control or elimination in about 70% of patients.
New research and treatments
However, for the other 30% of patients, existing medications do not work. Some patients may find relief after brain surgery, but not every patient is a candidate for this procedure.
Researchers are exploring several different treatment possibilities to reduce injuries and fatalities due to uncontrolled epilepsy.
The Human Epilepsy Project
The Human Epilepsy Project (HEP) is a multinational research effort involving more than 300 practitioners. Researchers launched the study to better predict treatment effectiveness. Identifying the 30% of drug-resistant patients earlier could improve outcomes and provide patients with faster results.
HEP encompasses three research projects. HEP1 is a decade-long study following more than 400 epilepsy patients. All participants track their seizures in a digital diary, which will produce an extensive database of drug outcomes and patient experiences. The researchers also analyze patients’ electroencephalograms, MRIs, and blood samples.
HEP2 is a smaller, observational study that is monitoring 200 epilepsy patients for co-morbid mental health diagnoses. The study will also track disease progression and regression.
HEP3 is currently seeking participants who have been recently diagnosed with epilepsy. The study will monitor how patients respond to treatment, track seizure severity and frequency, assess comorbidities, and look for biological factors that can predict treatment outcomes.
Biomarker research
In medical research, biomarkers are biological substances in the body that can indicate the presence of a disease or disorder. In some illnesses, biomarkers appear before the disease is diagnosable. This makes identifying biomarkers an essential goal for early intervention treatments.
There are several biomarkers that seem promising for predicting epilepsy. For example, damaged neurons produce the protein S-100B. There is some evidence that elevated S-100B levels in the blood correlate with a higher risk of epilepsy.
Researchers have also theorized that pathological high-frequency oscillations, which are abnormal patterns of brain activity, may be another potential biomarker for epilepsy.
Cannabidiol as a treatment for epilepsy
Cannabidiol (CBD) is derived from the marijuana plant. Unlike THC, CBD contains no psychoactive properties. Research has found that CBD has an anti-seizure effect on the brain. The compound inhibits certain neuroreceptors that control electric activity. This can reduce the frequency of seizures.
In 2018, the Food and Drug Administration approved the first cannabidiol prescription drug, Epidiolex, to treat epilepsy and other seizure disorders. Researchers continue to investigate further applications of CBD in epilepsy treatment.
Novel anti-epileptic drugs
Anti-seizure drugs have existed in some form since the 19th century. The oldest epilepsy drug, phenobarbital, has been in use for more than 100 years. While all of these older medications are effective, most patients experience some type of side effect or drug interaction.
After several years where no new drugs were introduced, the FDA granted approval for eight new drugs to treat epilepsy in the 1990s and early 2000s. Today, there are more than 30 anti-epileptic drugs available in the U.S.
As drug research tends to be a slow process, researchers are using medical trials to accelerate innovation and develop drugs with fewer side effects. Newer drugs are also more compatible with combination therapies, which have a higher effectiveness rate in patients with drug-resistant epilepsy.
Researchers also hope to combine findings from biomarker studies with new medication discoveries to provide patients with tailored treatment plans. We are still a long way from curing epilepsy, but science is putting us one step closer every year.