curing epilepsy

[Dianewest]

How far away do you think we are from finding a cure for epilepsy? I know there must be lots of research going into treatments etc at the moment so I was wondering if a cure is something that is likely to happen any time soon?

Thanks.

[Dr Hannah Cock]

Dear Diane,
It depends what you mean by cure. Some people would argue that if seizures are completely controlled by medication, without side effects, even though the individual stays on the medication, they think of themselves as "cured" in that the epilepsy doesn't interefer with their day to day lives in any significant way. We can already achieve that in 60-70% of patients.

If however, you mean something that completely takes away the epilepsy, so that they no longer need treatment or have a risk of seizures or other consequences of epilepsy (which I suspect is what you mean), I wish I could tell you that we were close to major breakthroughs in this area, but I'm afraid that isn't the case.

On a more positive note - albeit for a small minority of patients - we do already have a "cure" for some patients in the form of epilepsy surgery. For patients where the seizures can be shown to be coming from a small part of the brain, in a brain area which they can "afford" to be without, and where the rest of the brain is entirely normal - surgery to remove this area can stop seizures completely. Although we keep people on medication for at least a couple of years after such an operation, some do then choose to come off drugs also and remain seizure free, so are genuinely cured.

The other important thing when thinking about a "cure" is to remember that epilepsy isn't one condition - it has hundreds of different types and causes, so should really be referred to as "the epilepsies". One area where we are making good progress is in recognizing the importance of thinking about different subtypes of epilepsy when undertaking research into understanding the causes, and thus the possible best approches to treatment and a potential cure. For example epilepsy which develops due to a traumatic brain injury is a very different condition to epilepsy which arises followign meningitis or encephalitis (infections of the brain), or the genetic generalized epilepsies. The prospects of preventing epilepsy (or at least reducing the risks of developing it) after brain insults such as trauma, stroke or infection are probably more realistic than for genetic generalized epilepsies, and there is a lot of interest currently in the role of inflammation in these circumstances. However most of the work thus far in experimental models, and even if these approaches prove promising it typically takes 10-15 years before such work translates into clinical practice for patients.

Sorry I can't be more optimistic - but I can assure you there is broad recognition in the scientific community that we need to look for "antiepileptogenic" (approaches that stop epilepsy developing) treatments, rather than just "antiepileptic" (approaches that control the seizures in people who have epilepsy).

Kind regards

[Andrew Kelso]

Hi Diane

There's also load of fascinating research going on into alternative treatments for epilepsy, including some exciting work looking at electrical stimulation of the brain, and detection of seizures so that they can be prevented before they become established. Few of these exciting advances have made it into clinical practice yet, but there's plenty going on.

When I go to epilepsy conferences I'm always astounded at what my colleagues are discovering about epilepsy, and although we're not "there" yet, this is a fast moving field.

http://www.epilepsysociety.org.uk/epilepsy-research has some exciting pages on current UK epilepsy research