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By David Noonan Like many people with epilepsy, Richard Shane, 56, has some problems with memory. But he can easily recall his first seizure, 34 years ago. “I was on the phone with my father, and I noticed that I started moaning, and I lost some level of consciousness,” Shane says. After experiencing a similar episode three weeks later, he went to a doctor and learned he had epilepsy, a neurological disorder caused by abnormal electrical activity in the brain. The first medication he was prescribed, Dilantin (phenytoin), failed to stop or even reduce his seizures. So did the second and the third. His epilepsy, it turned out, was drug-resistant. Over the next 22 years Shane suffered two to five or more seizures a week. He and his doctors tried every new antiseizure drug that came along, but none worked. Finally, in 2004, as a last resort, a neurosurgeon removed a small part of Shane's brain where his seizures originated. “It was a matter of what sucks less,” Shane says, “having brain surgery or having epilepsy.” Shane has been seizure-free ever since. As many as three million people in the U.S. live with epilepsy, and more than 30 percent of them receive inadequate relief from medication, a number that persists despite the introduction of more than a dozen new antiepileptic drugs since 1990. Although surgery has helped some patients such as Shane, uncontrollable epilepsy remains a living nightmare for patients and an intractable foe for clinicians and researchers. “I hate to say it, but we do not know why” some people respond to medications and others do not, says neurologist Michael Rogawski, who studies epilepsy treatments at the University of California, Davis. And yet if the central conundrum continues, so does the determined quest for new and different approaches to treating the toughest cases. © 2017 Scientific American

Related chapters from BN: Chapter 3: Neurophysiology: The Generation, Transmission, and Integration of Neural Signals
Related chapters from MM:Chapter 2: Neurophysiology: The Generation, Transmission, and Integration of Neural Signals
Link ID: 23495 - Posted: 04.15.2017

Study finds genetic basis for drug response in childhood absence epilepsy

Consider two children who have childhood absence epilepsy (CAE), the most common form of pediatric epilepsy. They both take the same drug — one child sees an improvement in their seizures, but the other does not. A new study in the Annals of Neurology identified the genes that may underlie this difference in treatment outcomes, suggesting there may be potential for using a precision medicine approach to help predict which drugs will be most effective to help children with CAE. The study was funded by the National Institute of Neurological Disorders and Stroke (NINDS) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), both part of the National Institutes of Health. “A better understanding of genetic factors underlying a disease and the way that people respond to treatments may help healthcare providers select the best therapies for children with CAE,” said Vicky Whittemore, Ph.D., program director at NINDS. A team led by Tracy A. Glauser, M.D., director of the Comprehensive Epilepsy Center at Cincinnati Children’s Hospital Medical Center and professor of pediatrics in the University of Cincinnati College of Medicine, investigated whether there may be a genetic basis for different responses to three drugs used for CAE (ethosuximide, valproic acid, and lamotrigine). The experiments focused on three genes that code for T-type calcium channels that are involved in CAE and one gene that codes for a transporter that shuttles the drugs out of the brain. T-type calcium channels help control the firing rate of brain cells. The current study is part of a 32-center, randomized, controlled clinical trial that compared the effects of the three most commonly used drugs in 446 children who were recently diagnosed with CAE.

Does Temporal Lobe Epilepsy Influence Personality?

Sallie Baxendale, Temporal lobe epilepsy—a common form of epilepsy characterized by seizures that begin in the memory-regulating temporal lobe—does appear to influence personality, though not in the way many may think and certainly not in the way people have believed throughout history. The idea of the epileptic personality is an ancient one. Thousands of years ago people with epilepsy were thought to be possessed by either divine beings or demons. In fact, the notion that a seizure represents a kind of communion with another spiritual realm still holds sway in some societies today. In more recent history, Westerners largely perceived epilepsy as a punishment for morally lax behavior. In one 1892 paper, the author claimed that debauchery and excessive lust frequently led to epilepsy and that a person could trigger a seizure by listening to love songs and eating chocolate. More recently, scientists began investigating whether epilepsy, in fact, altered personality. In 1975 neurologists Stephen Waxman and Norman Geschwind, both then at Harvard University, published an analysis based on observations of their patients with temporal lobe epilepsy in which they reported that many patients had a tendency toward religiosity, intense emotions, detailed thoughts, and a compulsion to write or draw. This cluster of characteristics became known as the epileptic personality. Over the next decade other researchers added hostility, aggression, lack of humor and obsessiveness to the list of personality traits supposedly associated with the condition. © 2017 Scientific American

Epilepsy patients turning to medicinal cannabis

Many epilepsy patients in Australia are turning to medicinal cannabis to manage their seizures, a survey has shown. The nationwide survey found 14% of people with epilepsy had used cannabis products to manage the condition. Of those, 90% of adults and 71% of children with epilepsy, according to their parents, reported success in managing seizures. GW Pharmaceuticals doubles in value after cannabis drug success in epilepsy trial Read more Published in the journal Epilepsy & Behaviour, the Epilepsy Action Australia study, in partnership with the Lambert Initiative at the University of Sydney, surveyed 976 respondents to examine cannabis use in people with epilepsy, reasons for use and any perceived benefits self-reported by consumers. The main reason given for trying cannabis products was to seek a treatment with “more favourable” side-effects compared with standard antiepileptic drugs. The lead author of the study, Anastatsia Suraeve from the Lambert Initiative, said researchers had gained further insight into the reasons that influence use. “Despite the limitations of a retrospective online survey, we cannot ignore that a significant proportion of adults and children with epilepsy are using cannabis-based products in Australia, and many are self-reporting considerable benefits to their condition,” Suraeve said. “More systematic clinical studies are urgently needed to help us better understand the role of cannabinoids in epilepsy,” she said. © 2017 Guardian News and Media Limited

Scientists May Have Solved The Mystery Of Nodding Syndrome

Jon Hamilton Scientists may have solved the mystery of nodding syndrome, a rare form of epilepsy that has disabled thousands of children in East Africa. The syndrome seems to be caused by the immune system's response to a parasitic worm, an international team reports in the journal Science Translational Medicine. And they think it's the same worm responsible for river blindness, an eye infection that's also found in East Africa. The finding means that current efforts to eliminate river blindness should also reduce nodding syndrome, says Avi Nath, an author of the study and chief of the section of infections of the nervous system at the National Institute of Neurological Disorders and Stroke. "We can prevent new infections even if we can't treat the ones who already have nodding syndrome," Nath says. Drugs can kill the parasite in its early stages. Nodding syndrome usually strikes children between 5 and 16 who live in rural areas of northern Uganda and South Sudan. Their bodies and brains stop growing. And they experience frequent seizures. "These are kids, young kids, you would expect that they should be running around playing," says Nath, who visited Uganda several years ago. "Instead, if you go to these villages they are just sitting there in groups," so villagers can keep an eye on them. © 2017 npr

Epilepsy drug discovered in fish model shows promise in small pediatric clinical trial

“Bench-to-bedside” describes research that has progressed from basic science in animal models that has led to therapies used in patients. Now, a study in the journal Brain describes what could be considered a direct “aquarium-to-bedside” approach, taking a drug discovered in a genetic zebrafish model of epilepsy and testing it, with promising results, in a small number of children with the disease. The study was supported by the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health. “This is the first time that scientists have taken a potential therapy discovered in a fish model directly into people in a clinical trial,” said Vicky Whittemore, Ph.D., program director at the NINDS. “These findings suggest that it may be possible to treat neurological disorders caused by genetic mutations through an efficient and precision medicine-style approach.” Scott C. Baraban, Ph.D., the William K. Bowes Jr. Endowed Chair in Neuroscience Research and professor of neurological surgery at the University of California, San Francisco (UCSF), postdoctoral fellow Aliesha Griffin, Ph.D., and colleagues used a zebrafish model of Dravet syndrome to test the drug lorcaserin and found that it suppressed seizure activity in the fish. Dravet syndrome is a severe form of pediatric epilepsy characterized by frequent daily drug-resistant seizures and developmental delays. It is caused by a genetic mutation, which Dr. Baraban’s group was able to introduce into the zebrafish to cause epilepsy. Dr. Baraban and his colleague Kelly Knupp, M.D. at the University of Colorado, Denver, then tested lorcaserin in five children with Dravet syndrome. The children were resistant to other anti-epileptic drugs and participated in this study through a compassionate use, off-label program.

A Risk for Sudden Death in Epilepsy That Often Goes Unmentioned

By GINA KOLATA Shena Pearson nearly froze in her seat, terrified, as she stared at a power-point slide. She was at her first meeting of an epilepsy foundation, seeking help for her 12-year-old son Trysten, when a neurologist flashed the slide about something called Sudep. It stands for sudden unexpected death in epilepsy. Her son’s neurologist had never mentioned it. “Oh dear God, my child is at risk, seriously at risk,” Ms. Pearson thought to herself. Sudden death in epilepsy is a little-known and seldom-mentioned phenomenon, but now, after a push by advocates, the federal government has begun a concerted program to understand it. Yet a question remains: When, if ever, should patients be warned? In a way, the extreme reticence of many neurologists to mention sudden unexpected death to epilepsy patients harks back to the days when doctors and families often did not tell people they had cancer — too terrifying. But today, patients learn not just about cancer but about many other potentially fatal conditions, like an inoperable brain aneurysm that could burst at any time and kill a person. So the quiet about the epilepsy death risk appears to be an anomaly. Sudep’s name pretty much explains what it is: Someone with epilepsy — unprovoked seizures, which are electrical surges in the brain — dies, and there is no apparent cause. Often a person with epilepsy goes to bed and is found in the morning, unresponsive. In some cases, there is indirect evidence of a seizure, like urine on the sheets, bloodshot eyes or a severely bitten tongue, leading to the suggestion that preventing seizures as much as possible with medications could lower patients’ risks. But so much about the syndrome remains unknown. © 2016 The New York Times Company

NHS could soon use smart outfit to diagnose epilepsy

By Frances Marcellin A shirt and cap that can diagnose epilepsy quickly and easily has been approved for use by European health services, including the UK’s NHS. Epileptic seizures are the result of excessive electrical discharges in the brain. The World Health Organization estimates that over 50 million people worldwide have the condition, including 6 million in Europe, making it one of the world’s most common serious neurological conditions. Brain implants and apps have been developed to warn of oncoming seizures. But to diagnose the condition, someone must typically have a seizure recorded by an EEG machine in a hospital – with sensors and wires attached to the scalp. “An EEG reading is at the heart of a reliable diagnosis,” says Françoise Thomas-Vialettes, president of French epilepsy society EFAPPE. But seizures rarely coincide with hospital appointments. “The diagnosis can take several years and is often imprecise.” Seizures are so difficult to record that 30 per cent of people with epilepsy in Europe are misdiagnosed. In developing countries that lack medical equipment and healthcare the situation is even worse. To make diagnosis easier, French start-up BioSerenity has developed a smart outfit called the Neuronaute that monitors people as they go about their day. The shirt and cap are embedded with biometric sensors that record the electrical activity of the wearer’s brain, heart and muscles. If a seizure occurs, the outfit can send an EEG recording of the brain to doctors via a smartphone. © Copyright Reed Business Information Ltd.

Marijuana-Based Drug Found to Reduce Epileptic Seizures

By ANDREW POLLACK An experimental drug derived from marijuana has succeeded in reducing epileptic seizures in its first major clinical trial, the product’s developer announced on Monday, a finding that could lend credence to the medical marijuana movement. The developer, GW Pharmaceuticals, said the drug, Epidiolex, achieved the main goal of the trial, reducing convulsive seizures when compared with a placebo in patients with Dravet syndrome, a rare form of epilepsy. GW shares more than doubled on Monday. If Epidiolex wins regulatory approval, it would be the first prescription drug in the United States that is extracted from marijuana. The drug is a liquid containing cannabidiol, a component of marijuana that does not make people high. As many as 30 percent of the nearly 500,000 American children with epilepsy are not sufficiently helped by existing drugs, according to GW. Parents of some of these children have been flocking to try marijuana extracts, prepared by medical marijuana dispensaries. A number of states, in response to pressure from these parents, have passed or considered legislation to make it easier to obtain marijuana-based products. And some families have become “marijuana refugees,” moving to Colorado where it has been easier to obtain a particular extract, known as Charlotte’s Web, after the girl who first used it to control seizures. Hundreds of other children and young adults have been using Epidiolex outside of clinical trials, under programs that allow desperate patients to use experimental drugs. While many parents have reported significant reductions in seizures, experts have been cautious about anecdotal reports, saying that such treatments needed to be compared with a placebo to make sure they work. As such, the results from the GW trial have been closely watched. © 2016 The New York Times Company

Can Cannabis Treat Epileptic Seizures?

By Diana Kwon Stories of cannabis’s abilities to alleviate seizures have been around for about 150 years but interest in medical marijuana has increased sharply in the last decade with the help of legalization campaigns. Credit: ©iStock Charlotte Figi, an eight-year-old girl from Colorado with Dravet syndrome, a rare and debilitating form of epilepsy, came into the public eye in 2013 when news broke that medical marijuana was able to do what other drugs could not: dramatically reduce her seizures. Now, new scientific research provides evidence that cannabis may be an effective treatment for a third of epilepsy patients who, like Charlotte, have a treatment-resistant form of the disease. Last month Orrin Devinsky, a neurologist at New York University Langone Medical Center, and his colleagues across multiple research centers published the results from the largest study to date of a cannabis-based drug for treatment-resistant epilepsy in The Lancet Neurology. The researchers treated 162 patients with an extract of 99 percent cannabidiol (CBD), a nonpsychoactive chemical in marijuana, and monitored them for 12 weeks. This treatment was given as an add-on to the patients’ existing medications and the trial was open-label (everyone knew what they were getting). The researchers reported the intervention reduced motor seizures at a rate similar to existing drugs (a median of 36.5 percent) and 2 percent of patients became completely seizure free. Additionally, 79 percent of patients reported adverse effects such as sleepiness, diarrhea and fatigue, although only 3 percent dropped out of the study due to adverse events. “I was a little surprised that the overall number of side effects was quite high but it seems like most of them were not enough that the patients had to come off the medication,” says Kevin Chapman, a neurology and pediatric professor at the University of Colorado School of Medicine who was not involved in the study. “I think that [this study] provides some good data to show that it's relatively safe—the adverse effects were mostly mild and [although] there were serious adverse effects, it's always hard to know in such a refractory population whether that would have occurred anyway.” © 2016 Scientific American,

Virtual brain surgery could personalise epilepsy treatment

When anticonvulsant drugs fail to control epilepsy, surgery can be used as a last resort: removing the part of the brain thought to be the source of someone’s seizures. Unfortunately, this doesn’t always work. A computer model of brain activity could change things for the better by allowing surgeons to more precisely tailor the procedure to the individual. Seizures are caused by sudden surges in electrical activity in the brain. EEG scans made during a seizure can capture what is going on, providing a clue to the part of the brain that needs to be cut out. Even so, the surgery still fails to prevent seizures in 30 per cent of cases. There are other ways to track down the source of someone’s seizures, however. For example, the connectivity of the brain’s neurons and the surface area of affected regions is different in people with epilepsy compared with those who do not have the condition. Frances Hutchings at Newcastle University, UK and her colleagues have shown that these differences can be picked up using a combination of fMRI scans and diffusion tensor imaging (DTI). They used this data to model the brains of 22 people with epilepsy. By simulating the brain’s electrical activity, they were able to see where it went awry and identify the region where seizures were most likely to originate in each individual. © Copyright Reed Business Information Ltd.

Marijuana Extract May Help Some Children With Epilepsy

Angus Chen Parents of children with severe epilepsy have reported incredible recoveries when their children were given cannabidiol, a derivative of marijuana. The drug, a non-psychoactive compound that occurs naturally in cannabis, has been marketed with epithets like Charlotte's Web and Haleigh's Hope. But those parents were taking a risk; there has been no clinical data on cannabidiol's safety of efficacy as an anti-epileptic. This week, doctors are presenting the first studies trying to figure out if cannabidiol actually works. They say the studies' results are promising, but with a grain of salt. The largest study being presented at the American Epilepsy Society meeting in Philadelphia this week was started in 2014 with 313 children from 16 different epilepsy centers around the country. Over the course of the three-month trial, 16 percent of the participants withdrew because the cannabidiol was either ineffective or had adverse side-effects, says Dr. Orrin Devinsky, a neurologist at the New York University Langone Medical Center and lead author on the study. But for the 261 patients that continued taking cannabidiol, the number of convulsive seizures, called grand mal or tonic-clonic seizures, went down by about half on average. Devinsky says that some children continued to experience benefits on cannabidiol after the trial ended. "In the subsequent periods, which are very encouraging, 9 percent of all patients and 13 percent of those with Dravet Syndrome epilepsy were seizure-free. Many have never been seizure-free before," he says. It's one of several [at least four. checking] papers on cannabidiol being presented this week at the American Epilepsy Society meeting in Philadelphia. © 2015 npr

Epilepsy charity criticises Twitter for flashing ads

By Chris Foxx Technology reporter Twitter has responded to an epilepsy charity that said two of its online adverts were "irresponsible". The social media giant had uploaded two short videos on Vine that featured a looping, rapid succession of flashing colours. "Twitter's ads were dangerous to people living with photo-sensitive epilepsy," said Epilepsy Action's deputy chief executive, Simon Wigglesworth. Twitter told the BBC it had removed the videos on Friday morning. Around one in 3,500 people in the UK has photosensitive epilepsy, according to Epilepsy Action. Seizures can be triggered by flashing lights and bold patterns. An episode of Japanese cartoon Pokemon was famously blamed for triggering convulsions in 1997. "Eighty seven people are diagnosed with epilepsy every day and that first seizure can often come out of nowhere," said Mr Wigglesworth. "For a huge corporation like Twitter to take that risk was irresponsible." The Advertising Standards Authority told the BBC that "marketing communications", even those uploaded on a company's own website, should not include "visual effects or techniques that are likely to adversely affect members of the public with photosensitive epilepsy". It said both online and broadcast adverts in the UK had to adhere to rules made by the Committees of Advertising Practice. "We take very seriously ads in online media that might cause harm to people with photosensitive epilepsy," an ASA spokeswoman told the BBC. Twitter's flashing Vine videos were online for 18 hours before the company removed them. © 2015 BBC

'Tom and Jerry syndrome' causes seizures in old cats

By Emily DeMarco Mice and rats communicate in the ultrasonic frequency range, and it’s thought that cats evolved the ability to hear those high-pitched squeaks to better hunt their prey. Now, a new study suggests that sensitivity to higher pitched sounds may cause seizures in some older cats. After receiving reports of the problem, nicknamed the “Tom and Jerry syndrome” because of how the cartoon cat is often startled by sounds, researchers surveyed cat owners and examined their pets’ medical records, looking for insight into the types and durations of seizures and the sounds that provoked them. In 96 cats, they found evidence of the syndrome they call feline audiogenic reflex seizures. The most common types of seizure-eliciting sounds included crinkling tinfoil, clanking a metal spoon on a ceramic feeding bowl, and clinking glass. The severity of the seizure ranged from brief muscle jerks to more serious episodes where the cat lost consciousness and stiffened and jerked for several minutes, the researchers report online today in the Journal of Feline Medicine and Surgery. Both pedigree and nonpedigree cats were susceptible, although one breed was common: Thirty of the 96 cats were Birmans (pictured). Because the seizures coincided with old age—the average age of onset was 15 years—veterinarians could miss the disorder while dealing with the felines’ other health issues, the researchers say. Minimizing exposure to the problematic sounds and preliminary, therapeutic trials with levetiracetam—an anticonvulsant medication used to control epilepsy—among a small sample of the cats seemed to help limit the occurrence of seizures. © 2015 American Association for the Advancement of Science.

Marijuana compound shows promise in treating seizures from severe epilepsy

By Lenny Bernstein Children with two of the most severe forms of epilepsy can suffer scores of seizures each day, as well as long-term physical and cognitive problems. The two conditions, Dravet and Lennox-Gastaut syndromes, are quite rare but unfortunately very resistant to treatment with current epilepsy drugs. Now a compound found in marijuana plants has shown promising results in a preliminary study, during which it sharply reduced the number of seizures suffered by these children. Some were even seizure-free after three months of taking the drug, cannabidiol, the research showed. "We're very encouraged by the data," said Orrin Devinsky, director of the NYU Langone Comprehensive Epilepsy Center and leader of the research. A more rigorous study of cannabidiol's impact has begun and will help determine how effective it really is, he said. In making cannabidiol, the marijuana plant's psychoactive material (THC) was removed. A 99 percent pure liquid version of the drug was given for three to six months to 137 people with the two syndromes. Most were children (the subjects ranged in age from 2 to 26), and before the experiment they suffered a disturbing average of 95.3 convulsive seizures every month. Convulsive seizures are the more severe, violent kind; people with epilepsy can experience a wide variety of seizures, including some mild enough that they appear to be merely staring into space for a few seconds. Some of the subjects had taken as many as 10 different epilepsy drugs, with little success.

Sudden death in epilepsy: Researchers finger possible cause

By Jennifer Couzin-Frankel Sudden death, a mysterious and devastating outcome of epilepsy, could result from a brain stem shutdown following a seizure, researchers report today in Science Translational Medicine. Although the idea is still preliminary, it’s engendering hope that neurologists are one step closer to intervening before death strikes. Sudden unexpected death in epilepsy (SUDEP) has long bedeviled doctors and left heartbroken families in its wake. “It’s as big a mystery as epilepsy itself,” says Jeffrey Noebels, a neurologist at Baylor College of Medicine in Houston, Texas, and the senior author of the new paper. As its name suggests, SUDEP attacks without warning: People with epilepsy are found dead, often following a seizure, sometimes face down in bed. Many are young—the median age is 20—and patients with uncontrolled generalized seizures, the most severe type, are at highest risk. About 3000 people are thought to die of SUDEP each year in the United States. And doctors have struggled to understand why. “How can you have seizures your whole life, and all of a sudden, it’s your last one?” Noebels asks. In 2013, an international team of researchers described its study of epilepsy patients who had died while on hospital monitoring units. In 10 SUDEP cases for which they had the patients’ heart function and breathing patterns, the authors found that the patients’ cardiorespiratory systems collapsed over several minutes, and their brain activity was severely depressed. “Their EEG went flat after a seizure,” says Stephan Schuele, an epileptologist at Northwestern University Feinberg School of Medicine in Chicago, Illinois, who wasn’t involved in the study. © 2015 American Association for the Advancement of Science

Discovery, Guided by Morality

John Markoff MENLO PARK, CALIF. — Ann Lam delicately places a laboratory slide holding a slice of brain from a living human onto a small platform in a room the size of a walk-in refrigerator. She closes a heavy door and turns to a row of computers to monitor her experiments. She is using one of the world’s most sophisticated and powerful microscopes, the Stanford Synchrotron Radiation Lightsource, to learn about the distribution of metals in the brains of epilepsy patients. But she has another reason for being here as well. Traditional techniques for staining brain tissue produce byproducts and waste that are hazardous to the environment. And often, this sort of research is performed on animals, something Dr. Lam insists on avoiding. The radiation that illuminates the Stanford microscope was once a waste product produced by the particle accelerators. Now that it has been harnessed — recycled, in a sense — she is able to use it to examine tissue removed from living human patients, not animals. For Dr. Lam, those are important considerations. Indeed, scientists like her worry that neuroscience has become a dirty business. Too often, they say, labs are stocked with toxic chemicals, dangerous instruments and hapless animal subjects. Funding often comes from the military, and some neuroscientists fear their findings may soon be applied in ways that they never intended, raising moral questions that are seldom addressed. In 2012, Dr. Lam and Dr. Elan Ohayon, her husband, founded the Green Neuroscience Laboratory in a former industrial building in the Convoy District, an up-and-coming San Diego neighborhood. Solar panels rest on the roof, and a garden is lovingly tended on the second floor. © 2015 The New York Times Company

Related chapters from BN: Chapter 3: Neurophysiology: The Generation, Transmission, and Integration of Neural Signals; Chapter 1: Introduction: Scope and Outlook
Related chapters from MM:Chapter 2: Neurophysiology: The Generation, Transmission, and Integration of Neural Signals; Chapter 20:
Link ID: 20456 - Posted: 01.06.2015

Predicting epileptic seizures with 82 percent accuracy

By Lenny Bernstein There are 60 million epileptics on the planet, and while advances in medication and implantable devices have helped them, the ability to better detect and even predict when they will have debilitating seizures would be a significant improvement in their everyday lives. Imagine, for example, if an epileptic knew with reasonable certainty that his next seizure would not occur for an hour or a day or a week. That might allow him to run to the market or go out for the evening or plan a short vacation with less concern. Computers and even dogs have been tested in the effort to do this, but now a group of organizations battling epilepsy is employing "big data" to help. They sponsored an online competition that drew 504 entrants who tried to develop algorithms that would detect and predict epileptic seizures. Instead of the traditional approach of asking researchers in a handful of labs to tackle the problem, the groups put huge amounts of data online that was recorded from the brains of dogs and people as they had seizures over a number of months. They then challenged anyone interested to use the information to develop detection and prediction models. "Seizure detection and seizure prediction," said Walter J. Koroshetz, deputy director of the National Institute of Neurological Disorders and Stroke (NINDS), are "two fundamental problems in the field that are poised to take significant advantage of large data computation algorithms and benefit from the concept of sharing data and generating reproducible results."

Smartwatch detects skin's electricity to predict seizures

by Hal Hodson Yet another smartwatch launched this week. Called Embrace, it is rather different from the latest offerings from Apple, Samsung and Motorola: it can spot the warning signs of an epileptic seizure. Embrace was developed by Matteo Lai and his team at a firm called Empatica, with the help of Rosalind Picard at the Massachusetts Institute of Technology. It measures the skin's electrical activity as a proxy for changes deep in the brain, and uses a model built on years of clinical data to tell which changes portend a seizure. It also gathers the usual temperature and motion data that smartwatches collect, allowing the wearer to measure physical activity and sleep quality. Empatica launched a crowdfunding campaign on Indiegogo on Tuesday and has already raised more than $120,000. Backers who pledge $169 will receive an Embrace watch. The idea for the wristband came when Picard and her colleagues were running a study on the emotional states of children with autism, measuring skin conductance at the wrist as part of the study. Picard noticed that one of the children had registered a spike in electrical activity that turned out to have happened 20 minutes before they noticed the symptoms of a seizure. "It shocked me when I realised these things were showing up on the wrist," says Picard. The whole point of Embrace is to prevent sudden unexplained death in epilepsy (SUDEP). Its causes are not fully understood, but Picard says they understand enough to know how to reduce the chances of dying after an epileptic seizure. © Copyright Reed Business Information Ltd.

Epilepsy gives woman compulsion to write poems

2014 by Helen Thomson Shall I compare thee to... well, no one actually. A 76-year-old woman has developed an incredibly rare disorder – she has the compulsive urge to write poetry. Her brain is now being studied by scientists who want to understand more about the neurological basis for creativity. In 2013, the woman arrived at a UK hospital complaining of memory problems and a tendency to lose her way in familiar locations. For the previous two years, she had experienced occasional seizures. She was diagnosed with temporal lobe epilepsy and treated with the drug lamotrigine, which stopped her seizures. However, as they receded, a strange behaviour took hold. She began to compulsively write poetry – something she hadn't shown any interest in previously. Suddenly, the woman was writing 10 to 15 poems a day, becoming annoyed if she was disrupted. Her work rhymed but the content was banal if a touch wistful – a style her husband described as doggerel (see "Unstoppable creativity"). About six months after her seizures stopped, the desire to write became less strong, although it still persists to some extent. Doctors call the intense desire to write hypergraphia. It typically occurs alongside schizophrenia and an individual's output is usually rambling and disorganised. "It was highly unusual to see such highly structured and creative hypergraphia without any of the other behavioural disturbances," says the woman's neurologist, Jason Warren at University College London. © Copyright Reed Business Information Ltd

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