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Newsletter: EPIHEALTH

Epi-Health covers various seizure therapies such as Multimodal seizure detection that helps to improve patient safety and lowers the risk of false-positive alarm. Thus we can conclude that it can be clinically useful, however non–EEG-based seizure detection and alarming device will likely be multimodal as studies shows promising results. Another aspect that it covers is the Rescue therapy for seizure cluster the effective rescue therapy exhibit high potency, rapid absorption and consistent bioavailability. The third one Forecasting cycles of seizure likelihood include self-reported seizure time, combination of fast and slow cycles and optimization of high and low risks states. Finally, it talks about current advance on post stroke seizure a single late-onset seizure qualifies as symptomatic seizures due to the high risk of seizure recurrence within the next 10 years. We can conclude that mechanisms of post-stroke seizures remain to be clarified. Furthermore, preclinical and clinical research is needed to find out new targets for the treatment and prevention of post-stroke seizures.

Automated seizure detection and alerts are helpful as it improves patient safety

Why multimodal sensing?

Conclusion

A clinically useful, non–EEG-based seizure detection and alarming device will likely be multimodal as studies shows promising results.

Future studies should be designed more rigorously, especially when sophisticated algorithms are developed and tested

Reference

  1. Leijten FS, Dutch TeleEpilepsy Consortium, van Andel J, Ungureanu C, Arends J, Tan F, van Dijk J, Petkov G, Kalitzin S, Gutter T, de Weerd A. Multimodal seizure detection: A review. Epilepsia. 2018 Jun;59:42-7.

Effective rescue therapies should exhibit high potency, rapid and extensive absorption, and consistent bioavailability

Primary goal

Avoid progression to more severe conditions such as prolonged seizures and status epilepticus as well as a large therapeutic index

Rescue therapies approved for seizure clusters

Key pointers

  • Benzodiazepines are the key rescue therapies
  • Benzodiazepines increase chloride conductance of γ-aminobutyric acid A (GABAA) receptors, resulting in neuronal hyperpolarization and a reduction in excitation

Conclusion

Future studies are needed that examine new drug formulations and routes of administration, as well as drugs that have been used successfully off-label for the treatment of seizure clusters

Reference

  1. Gidal B, Detyniecki K. Rescue therapies for seizure clusters: pharmacology and target of treatments. Epilepsia. 2022 Sep;63:S34-44.

Seizure unpredictability is rated as one of the most challenging aspects of living with epilepsy

Seizure forecasting methods

Conclusion

Seizure diary apps can provide personalized forecasts of seizure likelihood that are accurate and clinically relevant for electrographic seizures

Future perspectives

There is a hope that seizure forecasting apps will give people with epilepsy greater confidence in managing their daily activities.

Reference

  1. Karoly PJ, Cook MJ, Maturana M, Nurse ES, Payne D, Brinkmann BH, Grayden DB, Dumanis SB, Richardson MP, Worrell GA,  Schulze-Bonhage A. Forecasting cycles of seizure likelihood. Epilepsia. 2020 Apr;61(4):776-86.
  • According to the International League against Epilepsy,

  • Early seizures - alone are not sufficient to make an epilepsy diagnosis as they are thought to be provoked,

  • Single late-onset seizure- qualifies as symptomatic seizure due to the high risk of seizure recurrence within the next 10 years

As the mechanisms of early and late seizures are distinct, it is important to choose appropriate ASM for early and late epilepsies

Conclusion

Mechanisms of post-stroke seizures remain to be clarified. Further preclinical and clinical research is needed to find out new targets for the treatment and prevention of post-stroke seizures

Reference

  1. Fu Y, Feng L, Xiao B. Current advances on mechanisms and treatment of post-stroke seizures. Acta Epileptologica. 2021 Dec;3(1):1-5.
MAT-IN-2300826-V0.2-03/2023