Endgame for Epilepsy?

Out of the 2.3 million people in the United States with epilepsy, only 20 to 25 percent of these people actually have their seizures completely controlled. This is somewhat of a surprising statistic because there have been many decades of improvements in anticonvulsant drugs, and advances in surgical therapy. The current treatments for the patients with "intractable epilepsy", at best lessen seizure occurrence and at worst cause debilitating side effects while having little or no benefit.

Epilepsy produces brief disruptions in the brain's electrical impulses. The outward sign of epilepsy are seizures. During an epileptic attack, thousands of electrical impulses, appear in unusual synchronous bursts. Each one of those impulses is more intense than usual, and moves through the brain in a ripple effect, causing damage throughout the entire brain. There are many types of epilepsy, and there are different ways in which it can develop. It can develop in childhood as result of genetic mutations that cause abnormal brain wiring, an imbalance in the chemicals the brain uses to send signals, or even a combination of both. Epilepsy can also develop if the brain creates abnormal nerve connections while trying to repair itself after a traumatic head injury, stroke, or damage from a chronic condition.

In today's society there is no cure for epilepsy. There are drugs that can prevent seizures by shutting down overactive nerve cells, and some drugs can boost the effects of chemicals in the cells that inhibit nerve signals. Some even block channels that control the flow of ions in and out of cells regulating nerve signals. These drugs can prevent the seizures, but they can't prevent the abnormal cellular processes the cause epilepsy, and they can't prevent the development of epilepsy of people known to be at high risk of developing it.

In order to create new drugs for epilepsy, scientists must first discover a gene involved in the disease. After they find a gene the researchers may spend as many as 10 to 12 years to create an effective drug that targets that specific gene. One approach that scientists are currently taking is to make antibodies that target the NMDA receptor. The NMDA receptor allows calcium to enter nerve cells in the brain causes electrical signals between neurons to go off. By creating an antibody for the NMDA receptor, the antibody may block the receptors while a seizure is occurring but not while brain is functioning properly. This antibody would cause side effects to be limited. Scientist performed this experiment on lab rats, and the conclusion they came to was that they didn't see any behavior difference, meaning that the antibody didn't harm other brain functions. Scientist are currently not sure whether or not the same outcome would happen in humans. They also aren't sure if the antibody will cause autoimmune diseases or long-term damage to the NMDA receptors.

Scientists are still looking for more effective treatments for epilepsy. One way that is used today is to surgically remove focal points, tiny regions where abnormal electrical signals arise. By removing the focal points in some people, it can reduce or even eliminate the seizures. Surgery is not always applicable because some areas in the brain are hard to get to, and not everyone has well defined focal points. Scientists also use new brain-imaging technologies and they are implanting electrodes to monitor when seizures may occur. Brian Litt, a neurologist and biomedical engineer at the University of Pennsylvania in Philadelphia said, "Preliminary data suggest that seizures don't start as abrupt events." Rather, the brain changes leading up to a seizure can start "perhaps day or hours ahead of time." Litt's computer analysis of electrical activity could predict seizures 20 to 50 minutes before they occurred. He said that if these patterns hold true it should be possible to develop an implanted device that can identify the abnormal signals and release some medicine to regulate the nerve pulses. This device would be like a pacemaker for the brain.

Researchers believe that nerve death and repair during the time between a head injury and the appearance of the disease may cause many things to happen in the brain. They aren't necessarily the cause of the seizures though, but they can lead to hyperexcitability and seizures. Current antiseizure medicines don't prevent epilepsy from developing, and scientists suspect that mechanisms that set the stage for seizures differ from the ones that cause the epileptic attacks. Using DNA chips researchers have tracked the brain activities in mice hoping to gain insight into the human brain. They've found 29 genes expressed more strongly and 9 expressed more weakly in mice that later develop epilepsy. The scientists have only scanned about 5 percent of the total genome, so there is still many things left uncovered.

This article has shown me that diseases can be a large hindrance on humans. The complexity of the brain is in itself an incredible creation, but adding a complex disease such as epilepsy can make the outcome devastating. This article has also shown me that even though we are advancing in our technologies, we still can't cure everything. That shows just how complex God has made our bodies.

http://www.sciencenews.org/articles/20000603/bob10.asp