Epilepsy Benchmarks Area IV: Limit or Prevent Adverse Consequence of Seizures and Their Treatment Across the Life Span

Shaping the future of European epilepsy research: Final meeting report from EPICLUSTER

Collaboration is essential to the conduct of basic, applied and clinical research and its translation into the technologies and treatments urgently needed to improve the lives of people living with brain diseases and the health professionals who care for them. EPICLUSTER was formed in 2019 by the European Brain Research Area (EBRA) to support the coordination of epilepsy research in Europe. A key objective was to provide a platform to discuss shared research priorities by bringing together scientists and clinicians with multiple stakeholders including patient organisations and industry and the networks and infrastructures that provide healthcare and support research. Additional objectives were to facilitate access and sharing of data and biosamples, working together to ensure epilepsy is a priority for research funding, and embedding a culture of public and patient involvement (PPI) among epilepsy researchers. In this meeting report, we summarise the shared research priorities discussed by the leadership of EPICLUSTER at the recent final meeting. We also briefly review the discussion on patient and industry priorities, guidance on starting PPI for epilepsy researchers, and the sustainability of funding and infrastructures needed to ensure a comprehensive stakeholder-embedded community for epilepsy research.

Caring for women with epilepsy: Qualitative exploration of key challenges and future directions in a resource poor healthcare system

OBJECTIVE

This qualitative explorative study was conducted to explore the key challenges and future directions of caring for women with epilepsy (WWE) from the perspectives of healthcare professionals who provide care for WWE in Palestine.

METHODS

A qualitative explorative design was used in this study in adherence to the consolidated criteria for reporting qualitative research. The study participants were interviewed in semi-structured in-depth interviews using a pre-validated and pilot-tested interview schedule. The interpretative description approach was used to qualitatively analyze the contents of the interviews.

RESULTS

Interviews were conducted with 6 neurologists, 5 gynecologists, 3 psychiatrists, 5 clinical pharmacists, and 1 internal medicine specialist. The current challenges and future directions in caring for WWE were grouped under healthcare system-, healthcare provider-, patient-, and society-related. Lack of adequate availability, accessibility, and affordability of neurology services and safe antiepileptic drugs (AEDs) were the main challenges. Increasing access of WWE to specialized neurology services and improving acceptance in the society were the main future directions.

CONCLUSION

Findings of this study highlighted the key challenges and future directions of caring for WWE in a resource-poor healthcare system. Decision makers in health authorities, professional bodies, and patient advocacy groups should consider improving availability, accessibility, and affordability of neurology services and safe AEDs for WWE. Future studies are still needed to investigate if addressing these challenges can improve the care of WWE in Palestine.

Circulating glial fibrillary acidic protein and ubiquitin carboxy-terminal hydrolase-L1 as markers of neuronal damage in children with epileptic seizures

BACKGROUND

Epilepsy is a common neurological disease that has a negative impact on physical, social, and cognitive function. Seizure-induced neuronal injury is one of the suggested mechanisms of epilepsy complications. We aimed to evaluate the circulating level of glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase-L1 (UCH-L1) as markers of neuronal damage in children with epilepsy and its relation to epilepsy characteristics.

STUDY DESIGN

METHODS: This case control study included 30 children with epilepsy and 30 healthy children as a control group. Seizure severity was determined based on Chalfont score. Serum level of GFAP and UCH-L1were measured, and their associations with epilepsy characteristics were investigated.

RESULTS

Circulating levels of GFAP and UCH-L1 were significantly higher in children with epilepsy than in controls (17.440 ± 6.74 and 5.700 ± 1.64 vs 7.06 ± 3.30 and 1.81 ± 0.23, respectively) especially in those with generalized and active seizures. GFAP and UCH-L1 were significantly correlated to the severity of seizures in the previous 6 months. Elevated GFAP level was a predictor for active seizures (OR 1.841, 95%CI 1.043-3.250, P = 0.035).

CONCLUSION

Circulating GFAP and UCH-L1 expression is increased in children with epilepsy especially those with active seizures.

SIGNIFICANCE

GFAP and UCH-L 1may serve as peripheral biomarkers for neuronal damage in children with epilepsy that can be used to monitor disease progression and severity for early identification of those with drug-resistant epilepsy and those who are in need for epilepsy surgery.