Ongoing research: new epilepsy drugs and treatment
Written in association with:
Neurologist
Published: 08/01/2020
Edited by: Emma McLeod
While epilepsy treatment has dramatically improved the lives of people with epilepsy, there are still more treatment management options to explore. Professor Walker, a neurologist and pioneer in the research of epilepsy, explains five areas of research that are currently being investigated in the hope that people with epilepsy can achieve better seizure control.
Improving current medications
As the most commonly used form of treatment, medication is being investigated from different angles:
Epilepsy drugs can produce side effects such as dizziness, nausea, slurred speech, fatigue and mood changes. Researchers hope to develop new drugs with fewer side effects to reduce or remove these. There is research regarding drugs that could act in a more precise way. These would hopefully be able to target specific types of epilepsy better than non-specific drugs. For example, there is a severe form of childhood epilepsy called Dravet’s syndrome, which may respond best to specific therapies such as cannabidiol and stiripentol. Researchers are trying to create new medications for those who are resistant to present medication for epilepsy. People who are resistant to drugs have to rely on other treatment options or palliative care. Click here for Professor Walker’s full explanation of why some people are resistant to epilepsy medications and the next possible treatment options for them.
Drugs that modify the disease
It’s important to recognise that the drugs that we currently have available are designed to treat the seizures and prevent them from occurring, but they don’t modify the prognosis of the condition. If you took the medication away from patients, the epileptic seizures would be as bad as before they started taking it. There is preclinical evidence for novel approaches that indicate that they can affect the prognosis of epilepsy, but this research is in its very early stages and is still yet to be put through to clinical trials.
New dietary treatments
Currently, the ketogenic diet is one of the very few dietary treatments, but it isn’t tolerated well in adults and it’s difficult to maintain. Our research team at the University College London among other research groups are developing new dietary treatments that work as well as the ketogenic diet but are better tolerated.
Gene therapy
University College London has been developing gene therapy for epilepsy. Vectors can be injected into the brain to carry specially engineered genes into specific nerve cells. The desired result is that nerve cells can be prevented from generating seizures.
This has been very effective in preclinical work and will hopefully move towards a clinical trial within the next one to two years. The advantage of this gene therapy is that we’re not removing or risking damage to parts of the brain, which is a problem with surgery. Instead, we’re simply modifying how those parts of the brain behave.
Predicting seizures
One of the most disabling things about epileptic seizures is that people are unable to predict when they’ll happen. Even in those with very few seizures, they have the constant anxiety that one may occur at any moment.
Currently, therapies can be used after a seizure occurs to prevent further seizures, but knowing when a seizure will occur could enable people with epilepsy to prepare beforehand. This also opens up the opportunity of giving therapy only on the days when there is a high chance of a seizure occurring. There has been considerable progress in the ability to predict seizures but it’s still in the trial stages.
To see more resources about epilepsy among other neurological conditions and to book a consultation with Professor Walker, visit his Top Doctors profile.