ILAE spoke with Action Amos, from the International Bureau for Epilepsy (IBE) about plans and strategies for improving epilepsy care across Africa. Leveraged by the Intersectoral Global Action Plan on epilepsy and other neurological disorders, four "trendsetter" countries are taking a variety of approaches to engage governments, increase public awareness, and ensure the participation of people with epilepsy in all of their initiatives.

IBE aims to improve the lives of people with epilepsy and those who care for them.

Resources:

Making Epilepsy A Health Priority in Africa

Reducing epilepsy stigma in Africa

Discriminatory health laws and epilepsy: A report on 21 African countries

IGAP Unpacked

The BAND Foundation

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: [email protected].

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Dr. Anca Arbune interviews two authors of a recent critical review on managing epilepsy in the elderly, developed by the ILAE Commission on Epilepsy in Older Adults. They discuss choosing an anti-seizure medication, monitoring cognitive changes, assessing quality of life, status epilepticus, the potential of epilepsy surgery, and the need for more research.

Listeners interested in the newly formed consortium mentioned by Dr. O'Dwyer can contact her through the ILAE website. 

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: [email protected].

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Dr. Bruna Nucera interviewed Dr. Andrea Cheng-Hakimian about a retrospective study that included 28 years of data from women with epilepsy who gave birth in Washington State.

This US study compared the relative occurrence of selected pregnancy outcomes and postpartum rehospitalizations among women with and without epilepsy and their infants. It used linked hospital records of women with deliveries in Washington State between 1987 and 2014. 

Women with epilepsy had increased risks of preeclampsia (RR 1.23; 95 % CI 1.08-1.41) and gestational diabetes (RR 1.18; 95 % CI 1.02-1.36). Their infants had increased risks of malformation (RR 1.23; 95 % C: 1.08-1.42) and small for gestational age (RR 1.39; 95 % CI 1.25-1.54) , and were nearly three times as likely to not be breastfed. 

Mothers (RR 5.25; 95 % CI 2.46-11.23) and their infants (RR 1.64, 95 % CI 1.41-1.89) required more ICU admissions during hospitalization for delivery and more postpartum rehospitalization, with greatest risk in the first six months. 

Maternal mortality (up to 2 years after delivery) was increased (RR 7.11; 95 % CI 2.47-20.49). Risks of preterm delivery and low birthweight increased over the study time period (p <.05). 

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: [email protected].

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Can we improve epilepsy outcomes by bringing care closer to home? A cluster randomized trial compared home care with community health workers to standard clinic care.

ILAE spoke with Dr. Gagandeep Singh and Dr. Meenakshi Sharma, authors of the study publication, which was published in Epilepsia Open.

Twenty-four clusters, each comprising 10 people with epilepsy, were randomized to either home-based or clinic care. Home-care recipients had better medication adherence and fewer seizures, compared with clinic-care recipients. Significantly more people from clinic care (37%) than home care (19%) exited the trial (P = 0.003).

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: [email protected].

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

How has the crisis in Ukraine affected people with epilepsy and their families, as well as the physicians who care for them? Dr. Alina Ivaniuk speaks with Dr. Olha Tychkivska about the volunteer efforts to provide anti-seizure medication to people in Ukraine, as well as Ukrainians who fled to other countries.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: [email protected].

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Jessie Nyirenda's seizures began in her early teens. She was dismissed as attention-seeking and told she might be cursed. Years later, Jessie discovered information about her condition through library research and was formally diagnosed. She now works as a financial educator and is a mother of three children.

Jessie was part of an advisory board to the International Bureau for Epilepsy, which helped develop an advocate's toolkit on counteracting epilepsy stigma in Africa. The toolkit is the first of several that will be developed in different regions of the world.

Dr. Bruna Nucera interviewed Jessie about her experience with epilepsy, her advice to others with epilepsy, and how she has dealt with discrimination.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: [email protected].

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Stigmatizing people with epilepsy is a form of discrimination, and it can affect all aspects of someone's life: school, family life, work, friendships, relationships, and marriage.

The International Bureau for Epilepsy (IBE), ILAE's partner organization, consulted people with epilepsy and their families to produce a toolkit for addressing epilepsy stigma in Africa. The materials provide concrete, practical ways that advocates can work to reduce stigma in African countries.

IBE plans to produce similar toolkits customized to other regions of the world.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: [email protected].

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Bidirectional links between epilepsy and sleep have been known for thousands of years. Despite nearly a century of research using EEG investigations, the relationships are still not well understood.

Dr. Laurent Sheybani interviewed Dr. Birgit Frauscher, an epileptologist and sleep specialist at the Montreal Neurological Institute. They discussed what is known about sleep patterns, how sleep may influence epileptic activity and vice versa, and how sleep research may lead to more effective epilepsy treatments.

Studies mentioned in the interview include:
Interictal Hippocampal Spiking Influences the Occurrence of Hippocampal Sleep Spindles (Frauscher et al., 2015, Sleep)

Focal epilepsy disrupts spindle structure and function (Schiller et al., 2022, Nature Scientific Reports)

Origin and significance of the cyclic alternating pattern: Review article (Terzano & Parrino, 2000, Sleep Medicine Reviews)

SleepSEEG: automatic sleep scoring using intracranial EEG recordings only (von Ellenrieder et al., 2022, J. Neural Eng.)

Recurrent Hippocampo-neocortical sleep-state divergence in humans (Guthrie et al., 2022, PNAS)

Scalp spindles are associated with widespread intracranial activity with unexpectedly low synchrony (Frauscher et al., 2015, Neuroimage)

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: [email protected].

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Dr. Andres Kanner is one of the best known researchers in the behavioral aspects of epilepsy, and has authored more than 300 papers and book chapters. 

Dr. Kanner sat down with ILAE to talk about his original goal of becoming an artist, his path to epileptology, and how he has worked to become what patients call "an amazing, compassionate doctor".

He is director of the University of Miami School of Medicine's Comprehensive Epilepsy Center of Excellence, chief of the Epilepsy Division, and professor of clinical neurology. 

Dr. Kanner is quadruple-boarded in neurology, psychiatry, clinical neurophysiology and epilepsy. He has long-standing research interests in the areas of pharmacology of epilepsy, psychiatric aspects of epilepsy and surgical treatment of treatment-resistant focal epilepsy. 

He has served on the editorial boards of several journals and held leadership positions in many organizations, including the International League Against Epilepsy, American Epilepsy Society, and American Academy of Neurology.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: [email protected].

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Improving lesion detection in people with drug-resistant epilepsy is crucial for optimal surgical outcomes. The MELD Project is an open-science consortium using deep learning principles to develop automated lesion detection of clinical MRI data. Dr. Maryam Nabavi Nouri spoke with Dr. Konrad Wagstyl about the project, publications, progress, and goals.

Currently, the MELD project has three ongoing themes:

• Automated detection of lesions in patients with drug-resistant epilepsy
• Understanding the topographical distribution of focal cortical dysplasias (FCDs)
• Morphological characterisation of FCD lesions

Twitter: @meld_project

Website: MELD Project

Publications:

Atlas of lesion locations and postsurgical seizure freedom in focal cortical dysplasia: A MELD study (2021, Epilepsia)

Interpretable surface-based detection of focal cortical dysplasias: a Multi-centre Epilepsy Lesion Detection study (2022, Brain)

Networks Underlie Temporal Onset of Dysplasia-Related Epilepsy: A MELD Study (2022, Annals of Neurology)

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: [email protected].

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.