Innovative Treatment for Epilepsy

The New York Times recently published an article regarding a young girl named Charlotte Figi, who had passed away from what was believed to be Covid-19. She had been diagnosed with Dravet syndrome, a severe form of epilepsy, as an infant. At five years old, she had tried dozens of medications and was in an extremely restricted state, fed through a feeding tube and stuck in a wheelchair. Finally, her mother began to research CBD, and Charlotte “became the face of the medicinal CBD movement” when it relieved many symptoms of her severe epilepsy and drastically improved her quality of life. Six years later, the FDA approved a CBD-based medication as the first medication to treat seizures caused by Dravet syndrome, as well as the first medication made from marijuana in the US.

This drug, Epidiolex, is one of many attempts to treat epilepsy, a neurological disorder characterized by abnormal brain activity which causes seizures. The symptoms of these seizures vary widely across the epileptic population, some causing momentary loss of awareness and others causing twitching throughout the body. The disorder can affect all ages and genders, and 1 in 26 Americans will develop the disorder over the course of their lives (epilepsy.com). While a variety of medications, therapies, and surgeries exist, a cure has not yet been found. Researchers continue to develop treatments and perform clinical trials, and some appear to be promising.

At Loyola University of Chicago, Dr. Hui Ye is using the brains of mice to experiment with seizure control using miniature magnetic coils. In his paper “Focal suppression of Epileptiform Activity in the Hippocampus by a High-frequency Magnetic Field” he articulates that while generation of electric current in the brain is a relatively common therapy for epilepsy, using miniature magnetic coils to do so allows for avoidance of direct contact between electrodes and neural tissue, as well as higher accuracy and precision when targeting the necessary brain areas. He tested multiple frequencies and durations of the magnetic field to inhibit epileptiform activity, and has found that higher frequency is more effective. While this therapy needs to be fleshed out before it can be used on humans, it shows promise where medication fails to treat epilepsy. Typical deep brain stimulation requires direct contact between electrodes and brain tissue, which often causes inflammatory and immune reactions, and reduced effectiveness of the stimulation due to scarring where glial cells attempt to reform around the electrode. Magnetic stimulation with miniature coils is less invasive and therefore does not have these effects.

Another therapy being continuously tested as an alternative to medication and more invasive therapies is the Ketogenic diet. This low carb, high fat diet has been proven to reduce seizures in children with epilepsy. Researchers at the Mayo Clinic wrote a paper, “The Ketogenic and Modified Atkins Diet Therapy for Children With Refractory Epilepsy of Genetic Etiology”, in which they studied the progress of children with a genetic etiology for refractory epilepsy when put on the Ketogenic or modified Atkins diet. The Atkins diet is similar to the ketogenic diet, but carbohydrate intake is slowly increased overtime. Although three children left the study early due poor compliance, severe reflux, and ketoacidosis, they found that the diet was an effective treatment for most children put on it, as their seizures were reduced by at least 50%. This therapy is beneficial for children because unforeseen side effects from medications could manifest in adulthood, and electrical therapies could induce a lot of stress in children due to fear.

Clinical trials being performed to find treatments for epilepsy expand far beyond CBD, miniature magnetic coils, and dieting. Researchers are testing new treatments across the globe to help the many people who have been diagnosed with this disorder. While this innovation is helpful and is improving every day, it is imperative that more attention is brought to the disorder in hopes of pushing for a cure. For those of us who are unaffected, it is extremely important to understand the disorder and the procedure for helping someone who is having a seizure. This education can help those living with epilepsy to live more normal and safe lives.

Ye H, Chen V, Helon J, Apostolopoulos N, (2020) Focal suppression of epileptiform activity in the hippocampus by a high-frequency magnetic field. Neuroscience 432 (1-14).

Garcia SE, (2020) Charlotte Figi, Who Helped Popularize CBD for Medical Use, Dies at 13. The New York Times. https://www.nytimes.com/2020/04/09/us/charlotte-figi-dead.html?searchResultPosition=1

Jagadish S, Payne ET, Wong-Kisiel L, Nickeles KC, Eckert S, Wirrell EC, (2019) The ketogenic and modified atkins diet therapy for children with refractory epilepsy of genetic etiology. Pediatr Neurol 94:32-37. https://www.ncbi.nlm.nih.gov/pubmed/?term=The+Ketogenic+and+Modified+Atkins+Diet+Therapy+for+Children+With+Refractory+Epilepsy+of+Genetic+Etiology.