Sharp Waves: ILAE's epilepsy podcast

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Functional seizures, also known as psychogenic nonepileptic seizures (PNES), resemble epileptic seizures. Unlike epilepsy, they are not prompted by any electrical activity in the brain. People with functional seizures live with stigma, stress, and emotional and financial burden — and so do their care partners.

Joy Mazur spoke with Shannon Guinard, who cares for her husband, about the challenges and stigmas that face care partners of people with functional seizures.

Resources and relevant articles: 

Information about psychogenic non epileptic seizures

Depression and anxiety in caregivers of patients with functional seizures Tsamakis K, et al., 2023

Social aspects of life in patients with functional seizures: Closing the gap in the biopsychosocial formulation Asadi-Pooya AA, et al., 2021

Welfare consequences for people diagnosed with nonepileptic seizures: A matched nationwide study in Denmark Jennum, et al., 2019

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.

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Do seizures have daily, weekly, monthly, or other rhythms? In Part 2 of our two-part series on circadian rhythms, Dr. Laurent Sheybani talks with Dr. Maxime Baud about the latest research on circadian and multidien rhythms in epilepsy.

Selected publications:

Seizure cycles in focal epilepsy - MG Leguia, et al. (2021) JAMA Neurology

Endogenous multidien rhythm of epilepsy in rats - MO Baud, et al. (2019) Experimental Neurology

Lamellar bone is an incremental tissue reconciling enamel rhythms, body size, and organismal life history - TG Bromage, et al. (2009) Calcified Tissue International

Multi-day rhythms modulate seizure risk in epilepsy - MO Baud, et al. (2018) Nature Communications

Seizure forecasting: Bifurcations in the long and winding road - MO Baud, et al. (2022) Epilepsia

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.

Send comments and feedback

 The cyclic properties of seizures have been known for more than 100 years, but does everyone with epilepsy have a seizure pattern? What can be learned from seizure diaries, RNS data, and animal models, and how can this information guide further research and clinical care? Dr. Laurent Sheybani talks with Dr. Mark Quigg about circadian rhythms in epilepsy.

Selected publications:
Electrocorticographic events from long-term ambulatory brain recordings can potentially supplement seizure diaries - Quigg M, et al. (2020) Epilepsy Research

Circadian and ultradian patterns of epileptiform discharges differ by seizure-onset location during long-term ambulatory intracranial monitoring - Spencer DC, et al. (2016) Epilepsia

Interrater reliability in interpretation of electrocorticographic seizure detections of the responsive neurostimulator - Quigg M, et al. (2015) Epilepsia

Variation of seizure frequency with ovulatory status of menstrual cycles - Herzog AG, et al. (2011) Epilepsia

Is there a circadian variation of epileptiform abnormalities in idiopathic generalized epilepsy? Pavlova MK, et al. (2009) Epilepsy & Behavior

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.

Send comments and feedback

Sudden Unexpected Death in Epilepsy (SUDEP) affects about one out of every 1.000 people with epilepsy.  Despite its rarity, SUDEP is important to discuss, but some physicians are wary of having the conversations. Dr. Emma Carter spoke with Dr. Suvasini Sharma about SUDEP, why it's important to inform patients and families about it, and how to manage risk factors.

The greatest risk factor for SUDEP is uncontrolled generalized tonic-clonic seizures (previously called grand mal seizures). Nocturnal seizures and certain comorbidities, such as developmental delay, also are risk factors.

SUDEP information for families from the ILAE (ilae.org)

Relevant articles:

Sudden Unexpected Death in Epilepsy (SUDEP) - What pediatricians need to know Garg D, Sharma S, 2020

Effect of counselling of parents of children with epilepsy focusing on sudden unexpected death in epilepsy Kumari S, et al., 2022

Counseling about sudden unexpected death in epilepsy (SUDEP): A global survey of neurologists' opinions Asadi-Pooya AA, et al., 2022

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.

Send comments and feedback

Discussions of artificial intelligence and ChatGPT are everywhere. How will this technology affect epilepsy research and care? What are the dangers and pitfalls, and what do we need to know when designing research studies that use AI technology?

Dr. Alina Ivaniuk interviewed Dr. Christian Bosselmann, an epilepsy precision medicine research fellow at the Cleveland Clinic, about the history of chatbots, the promise and pitfalls of artificial intelligence, and tips for critically evaluating studies that utilize AI.

Mentioned in the discussion:
Are AI language models such as ChatGPT ready to improve the care of individuals with epilepsy?

Comparing physician and artificial intelligence chatbot responses to patient questions posted to a public social media forum

This episode was reported by Alina Ivaniuk, and edited and produced by Nancy Volkers.

Feedback and ideas welcome: [email protected]

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.

Send comments and feedback

Neurocysticercosis - an infection of the brain by a pork tapeworm (Taenia solium) – is one of the most common causes of seizures worldwide. People with neurocysticercosis have incidentally ingested tapeworm eggs, which are found in the feces of people who have tapeworms in their digestive systems (a condition called taeniasis). The eggs can migrate to any organ and form larval cysts; the brain is one of the most common sites.

Pigs are intermediate hosts, so neurocysticercosis occurs in regions where humans live in close contact with pigs and eat undercooked pork. Poor sanitation that leads to environmental fecal contamination is a major factor in transmission. 

Selected publications from the Cysticercosis Working Group in Peru:
Quality of life in patients with symptomatic epilepsy due to neurocysticercosis (2022)

New animal models of neurocysticercosis can help understand epileptogenesis in neuroinfection (2022)

Geographically targeted interventions versus mass drug administration to control Taenia solium cysticercosis in Peru (2021)

Current diagnostic criteria for neurocysticercosis (2021)

Neurocysticercosis: A frequent cause of seizures, epilepsy, and other neurological morbidity in most of the world (2021)

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.

Send comments and feedback

Most people with epilepsy have difficulty always taking their medications as prescribed. How can clinicians and patients talk about the issue and find solutions? Sharp Waves spoke with Dr. Avani Modi and Dr. Desiree Williford, authors of a recent study on pediatric adherence in epilepsy.

During the episode, Dr. Modi mentions online resources that can help individuals and families find ways to take medication as directed. These are available in English and Spanish on the Epilepsy Foundation website.

The STAR trial (Supporting Treatment Adherence Regimens) was a randomized controlled trial. Results can be found at this link.

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.

Send comments and feedback

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.

Send comments and feedback

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.

Send comments and feedback

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.