Epilepsy is one of the most common Epilepsy Research UK is the only national A year of neurological organisation exclusively dedicated to conditions funding research into all areas of epilepsy. progress We give priority to those areas Developments in drug therapy Annual Review 2013-2014 which have the potential to produce and medical scanning, along • Over 600,000 people in results in immediate problem areas, with major breakthroughs START the UK have a diagnosis including: research leading to in the study of the human of epilepsy – 1 in every Nicola Goss, Scott Goss and Kevin Morris improvements in the accuracy genome, mean that great at the 2013 British 10K London Run 103 people. of diagnosis; and research into progress has been made in • 32,000 people a year are improving the treatment and understanding the causes newly diagnosed with 1 quality of life of the patient. of epilepsy in recent years. epilepsy in the UK – that’s Even greater advances will about 87 people every day. Even with control of seizures, be made in the coming years life for people with epilepsy can Every year 1,100 people and the research that Epilepsy • be unpredictable and restricted. die as a result of epilepsy. Research UK funds will be at However, new research offers the forefront of developments Epilepsy can be caused by • the very real possibility of developing to control, and perhaps a stroke, a head injury or therapies that could help transform say an inherent genetic defect, even cure, epilepsy. the lives of those affected. but in over 60% of cases yes there is no known cause. you awarded seven project grants, epilepsy • Epilepsy can take many This year we forms from a momentary science are outlined below. blank spell to a dramatic Supporter at the London Marathon details of which major convulsion. 2 Identifying important AED side Predicting seizures have stopped in response effects in adults with to initial AED treatment, compared to side effects learning disability. the response those whose seizures are continuing. drug The team now wants to see if it can take Research of epilepsy During the study, a first grants & to this further, and actually predict who will people two versions of the in respond to drug treatment (when it is treatment questionnaire will be developed: anti-epileptic fellowships awarded being started for the first time), based on one for carers to complete and the with learning drug how the brain is connected. At this stage other for patients to complete (where they don’t have enough data to design disability possible). These will be based on a definitive study, but they have been existing measures of side effects that The most common type of epilepsy awarded £29,172 to conduct an initial are used for adults with epilepsy in the is idiopathic (meaning of unknown two-year pilot study. general population. The development Epilepsy is more common in cause) generalised epilepsy or IGE. of the questionnaires will involve small During the project the group will use two FORWARD adults with learning disability When IGE is first diagnosed, most focus groups of patients, carers and methods (EEG and fMRI) to find out as than in the ‘general population’, people will be treated with an anti- 3 professionals; whose experiences will 4 much information as possible about brain and there is concern amongst epileptic drug (AED), but only half help the team to examine the AED networks (in healthy brains and newly professionals and carers about will find their seizures stop the physical and behavioural side side effects seen in adults with diagnosed IGE), and decide whether completely in the following year. effects of anti-epileptic drug learning disability, and investigate there are likely to be any brain (AED) treatment in this group. their association with challenging There are currently no tests to tell network ‘markers’ that are behaviour and quality of life. neurologists whether a person will a) easy to locate and b) can However, it is unclear how best to respond to AED treatment, and this accurately predict treatment identify and measure these side effects LEAPS This project will hopefully would be extremely useful. response. If the answer is yes, and their impact on well-being. lead to better awareness the researchers will then work and identification of AED Professor Mark Richardson at King’s Dr Rachel McNamara and out which tests and analyses will be side effects in adults with College London, and collaborators colleagues, at Cardiff University, best to identify these markers. at University College London, have been awarded £97,924 for a a learning disability, and have studied groups of people with IGE If successful, this grant could ultimately two-year project that will enable ultimately facilitate large studies using EEG. They have used their findings lead to a new test that predicts whether a them to develop a questionnaire of treatments with fewer side effects, to develop new methods, which have person will respond to initial AED treatment. that professionals can use in thus improving quality of life for provided clues about how brain regions This will help to avoid unnecessary trials consultations with both patients this group of people. are connected in IGE. Importantly, these of aggressive AEDs, and help to reduce and carers, to accurately identify • methods have revealed that the brain is delays before other (potentially more 5 connected differently in people whose successful) therapies are explored.• TAKING seizures don’t obviously affect their awarded £29,208 over two years EEG-biofeedback A potential daily life, so a non-invasive approach to investigate how stress hormones is a non-invasive new learning would be very welcome. can trigger seizures. Meet the researchers treatment strategy that During the study the team will recruit During the study the team will use for The link childhood can enable a children with a diagnosis of BCECTS, animal and mathematical models to person to alter who are not taking any medication. examine precisely how changes in epilepsy his/her brain between Each child will undergo a baseline cortisol levels alter the electrical wave activity. and 24-hour EEG assessment. Their EEG stress activity of neuronal circuits in the brain It has already been activity will be analysed and it will then that are known to be associated with shown to be a safe and effective seizures be used to drive a video game, which will seizures. They will later use synthetic therapeutic option for some adults be displayed on a screen for the child to compounds that regulate the activity with epilepsy, but as yet there are see. The child will then be asked to ‘work of steroids, to find out whether stress- no data available for children. People with epilepsy frequently related seizures can be reduced the video with their brain’, the system report emotional stress in the Mrs Gina Parker and colleagues, or even prevented. being set up so that the video game lead-up to a seizure; but although at Birmingham Children’s Hospital moves faster when the brain is relaxed. the association between stress If successful, this grant could NHS Trust, have been awarded £9,965 In this way the child will be trained to and seizures is well recognised, potentially lead to the development 9 for a year-long pilot grant in which maintain a state of brain relaxation (less the mechanisms for this are of new treatments for epilepsy.• they will assess the feasibility of using prone to seizures), and they will be able still not understood. EEG-biofeedback as a therapeutic tool in to see when they are achieving this state. The steroid hormone cortisol is children with benign childhood epilepsy The children will attend regular training secreted by the body in spurts over with centro-temporal spikes (BCECTS). sessions and they will receive video the course of the day, and its levels BCECTS (or Rolandic epilepsy) is the feedback every week. The researchers increase dramatically during stress. most common childhood epilepsy will compare the ‘current’ EEG to the Cortisol is known to have major syndrome, but because seizures often baseline 24-hour EEG at specific time effects on both neuronal activity ( to right):” occur at night, and are usually ‘outgrown’ points, in order to measure progress. and on the ways that brain cells The 2014 research team left in adolescence, it is often left untreated. They will also compare the frequency of communicate, so it could plausibly Research now suggests that disruption EEG abnormalities during the 24-hour play a role in seizures. Dr Rob Wykes, Dr Rachel McNamara, to sleep during BCECTS can cause recording and at the end of the study, Prof Mark Richardson, Dr Rachel Charlton memory problems, and so the need to to see if there has been any reduction. Professor Stafford Lightman treat is being reviewed. Many parents If successful, this pilot grant will at the University of Bristol, Prof Stafford Lightman, Prof John Jefferys are reluctant to have their child take hopefully prompt larger studies and colleagues in Bristol Mrs Gina Parker anti-epileptic drugs (which can have into EEG-biofeedback as a new, and Exeter, have been side effects), especially when their non-invasive treatment for BCECTS. 6 10 • Are new 8 methods as good as advantages, including lower cost and access both pro-epileptic and anti-epileptic University of Bristol and at Purdue to larger numbers of exposed children, it is not changes to neuronal networks. Why does University in the USA, have traditional ones in assessing clear whether it is a reliable way of detecting Studying a chronic model of epilepsy developed an animal model of epilepsy developmental problems.