Epilepsy:

Epilepsy is a brain disorder involving
repeated, spontaneous seizures of any
type. Seizures ("fits," convulsions) are
episodes of disturbed brain function
that cause changes in attention or
behavior. They are caused by
abnormally excited electrical signals in
the brain.




EPILEPSY SURGERY WORKS: HALF
OF PATIENTS SEIZURE FREE FOR A
DECADE
In the first long-term study of post-
surgery epilepsy patients, researchers
followed 615 patients for up to 19
years following surgery.

They found 82 per cent of them were
seizure-free after one year, 52 per
cent recorded no seizures after five
years and 47 per cent still hadn't
suffered an episode after a decade.

Study leader Professor John Duncan
said: 'If the seizures aren't controlled
with medication, that's where surgery
should be considered.

'In those people, surgery has a good
chance of stopping the seizures.'

Epilepsy sufferers who cannot control
their condition with drugs should be
referred for surgery sooner, according
to researchers.

Scientists at University College London
found almost half of people with the life-
affecting condition are left seizure-free
for ten years if they undergo a brain
op.

Their report, published in medical
journal The Lancet, suggests surgery
could be an effective alternative for the
third of patients who don't respond to
costly drug treatment.

Jane de Tisi, from University College
London, and colleagues established
patterns of seizure remission and
relapse after epilepsy surgery to
identify the long-term outcome of
surgery in patients with refractory focal
epilepsy. A total of 615 adults who
underwent 497 anterior temporal
resections, 40 temporal
lesionectomies, 40 extratemporal
lesionectomies, 20 extratemporal
resections, 11 hemispherectomies,
and seven palliative procedures were
analyzed. Participants were followed
up annually for a median of eight
years. The time to first seizure was
assessed using Kaplan-Meier survival
analysis.

Surgery has a one-off cost of around
£13,000. Drug therapy, in contrast,
costs around £1,000 a year plus
ongoing costs of healthcare.




PFIZER STOPPED LYRICA TRIAL DUE
TO EFFICIENCY
In October 2011 Pfizer has ceased a
clinical study of its epilepsy drug Lyrica
ahead of schedule after results
showed that the treatment had already
met its efficacy goals.

The pharmaceutical company has
called an early end to a trial that aimed
to demonstrate the effectiveness of the
product as a monotherapy against
partial seizures, which is among the
most common symptoms of the
disease.

Interim results from the study
subsequently led a monitoring
committee to recommend an immediate
conclusion, with the treatment having
already shown its strong performance.

MacKay Jimeson, a spokesman for
Pfizer, told Bloomberg in an email:
"Pfizer has accepted the
recommendation and has stopped the
study."

Lyrica is currently approved as a
combination therapy for epilepsy and
fibromyalgia, with Bloomberg estimates
showing that it generated more than
$3 million  in sales in 2010.



POTIGA  TABLETS APPROVED FOR
EPILEPSY
Potiga (ezogabine) tablets have been
approved by the U.S. Food and Drug
Administration to treat partial epileptic
seizures in adults.

Partial seizures are the most common
seizure in people who have epilepsy.
The agency said Potiga is the first
among a class of drugs called
neueronal potassium channel openers
to be sanctioned for epilepsy in the
United States.

And as is the case with other
antiepileptic drugs, the agency said
Potiga "may also cause suicidal
thoughts or actions in a very small
number of people."

Potiga was developed by North
Carolina-based Valeant
Pharmaceuticals North America, and
will be distributed by GlaxoSmithKline




ZEBINIX  IS AN ADD-ON TREATMENT
FOR PARTIAL ONSET SEIZURES
Treatment of partial-onset seizures,
the most common type of epilepsy,
presents a constant challenge - up to
40% of patients with partial-onset
seizures do not achieve seizure control
with current anti-epileptic drugs.

Zebinix (eslicarbazepine acetate), an
add-on therapy for adults with partial-
onset seizures, with or without
secondary generalisation (where the
seizure spreads to both sides of the
brain), has been launched  in Spain by
Eisai and BIAL in a co-promotion.


KETOGENIC DIET REDUCES NUMBER
OF EPILEPSY SEIZURES IN DRUG
RESISTANT CHILDREN
A regimen, known as the ketogenic
diet, is now offered at more than 100
hospitals in the United States, Canada
and other countries.
Two randomized, controlled studies
published in 2008 support it.

One of the trials, by researchers at
University College London, found that
38 percent of patients on the diet had
their seizure frequency reduced more
than 50 percent and that 7 percent
had their seizure frequency reduced
more than 90 percent.
Those numbers may look low, but they
are not. These were patients for whom
antiepileptic drugs had already failed.

Dr Elizabeth Thiele is the head of the
pediatric epilepsy program at
Massachusetts General Hospital for
Children. For children with certain
kinds of drug-resistant seizures, Thiele’
s clinical data show an even better
response: 7 out of 10 were able to
reduce their count more than 90
percent with the diet. Those statistics
are as good as those for any
antiepileptic drug ever made.

The Atkins type diet drastically
reduces the amount of carbohydrates
the person  takes in, tricks his body
into a starvation state in which it burns
fat, and not carbs, for fuel.
Remarkably, and for reasons that are
still unclear, this process — called
ketosis — has an antiepileptic effect.

Not allowed to eat:  cookies,  candy,  
cake, ice cream, pizza, tortilla chips
and soda.  Macaroni and cheese are
not allowed either. Allowed however:
breakfast eggs  mixed with heavy
cream and served with bacon. A typical
lunch is full-fat Greek yogurt mixed with
coconut oil. Dinner is hot dogs, bacon,
macadamia nuts and cheese.

This diet is  just shy of 90 percent fat.
That is twice the fat content of a
McDonald’s Happy Meal and about 25
percent more than the most fat-laden
phase of the Atkins diet.


VAGUS NERVE STIMULATION TO
TREAT EPILEPSY
Cyberonics, Inc.  pioneered the Vagus
Nerve Stimulation (VNS Therapy)
System. Founded in 1987 to design,
develop and market implantable
medical devices for the treatment of
epilepsy and other debilitating
neurological disorders, Cyberonics has
emerged as a leader in the
neuromodulation industry.
The remarkable success of VNS
Therapy in the treatment of epilepsy
has served as a platform for continued
innovation. In 2005, after seven years
of extensive study and clinical trials,
VNS Therapy was approved by the
FDA as a long-term adjunctive
treatment for treatment-resistant
depression. It is also at various levels
of study as a potential treatment for
other chronic disorders, including
anxiety, Alzheimer’s, bulimia, and
migraine headaches.
Cyberonics is committed to advancing
the treatment of epilepsy through new
technologies.
Headquartered in Houston, Texas,  
marketing VNS Therapy system in
more than 70 countries worldwide.


DEEP BRAIN STIMULATION TO
TREAT EPILEPSY
Deep brain stimulation is a promising
therapy for epilepsy, US researchers
from Stanford University have said.
In a clinical trial, 110 people had
electrodes implanted in their brains
and their seizures were monitored.
Forty-one per cent of patients showed
a reduction in seizures after 13 months
while 56% experienced a reduction
after two years.


OTHER DEVELOPMENTS
A REVIEW OF THE EPILEPSY
PIPELINE
COMPANY/ PRODUCT/ DESCRIPTION

Advanced Neurometrics/ Ambulatory
EEG Cap/ EEG recording without the
nuisance of needles attached to the
scalp with glue; can be used for long-
term recording while the person walks
around or sleeps. In development.

BioLert/ Seizure alert system/ A motion
detector that senses seizures; can
send signal to alert family. In clinical
testing.  

Cyberonics/ Vagus Nerve Stimulation/
Seizure detector that can activate the
VNS signal; also could record seizures
as an electronic diary. In development.

IntelliVision/SmartWatch Alert/ A
motion detector that senses seizures;
can send signal to alert family. In
clinical testing.

Medtronic/ Deep brain stimulation/
Electrodes implanted in the brain can
stimulate the thalamus to abort
seizures. Successful studies led to
FDA review in March 2010.

Neuropace /Responsive
Neurostimulation System/ A small box
implanted under the skull bone with
electrodes into the brain delivers a
stimulus when seizures are detected.
Successful testing completed in 2009;
preparing for FDA review.

Visualase/ MRI-Guided laser surgery/
Lasers (guided by MRI images)
destroy only identified epileptogenic
tissue, making this approach more
selective than open surgical removal.
Clinical testing starting in 2010.