Drug-resistant epilepsy: From multiple hypotheses to an integral explanation using preclinical resources

Pérez-Pérez, Daniel; Frías‐Soria, Christian Lizette; Rocha, Luisa

doi:10.1016/j.yebeh.2019.07.031

Cited by 34 publications

(39 citation statements)

References 157 publications

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“…To date more than 500 epilepsy‐associated genes, which play a role in neuronal excitability, cortical development or synaptic transmission, have been described . Approximately one‐third of the patients suffer from untreatable epilepsy . However, most of patients can be treated either medications that aim to decrease the neuronal excitability, or by surgery, by neuromodulation devices, and by dietary interventions such as the ketogenic diet or triheptanoin …”

Section: Methodsmentioning

confidence: 99%

“…15 Approximately one-third of the patients suffer from untreatable epilepsy. 17 However, most of patients can be treated either medications that aim to decrease the neuronal excitability, 13,14 or by surgery, by neuromodulation devices, and by dietary interventions such as the ketogenic diet or triheptanoin. 14 Several epilepsy forms are characterised by impaired glucose metabolism, which leads to a lack of ATP and carbons to produce lipids and amino acids leading to seizures, the dysregulation of neuronal signalling due to the high energy need for the stabilisation of membrane potentials and the proper regulation of neural signalling.…”

Section: Triheptanoin For the Treatment Of Epilepsy And Other Neuromentioning

confidence: 99%

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Therapeutic potential of triheptanoin in metabolic and neurodegenerative diseases

Wehbe

Tucci

2019

J of Inher Metab Disea

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In the past 15 years the potential of triheptanoin for the treatment of several human diseases in the area of clinical nutrition has grown considerably. Use of this triglyceride of the odd-chain fatty acid heptanoate has been proposed and applied for the treatment of several conditions in which the energy supply from citric acid cycle intermediates or fatty acid degradation are impaired.Neurological diseases due to disturbed glucose metabolism or metabolic diseases associated with impaired β-oxidation of long chain fatty acid may especially take advantage of alternative substrate sources offered by the secondary metabolites of triheptanoin. Epilepsy due to deficiency of the GLUT1 transporter, as well as diseases associated with dysregulation of neuronal signalling, have been treated with triheptanoin supplementation, and very recently the advantages of this oil in long-chain fatty acid oxidation disorders have been reported. The present review summarises the published literature on the metabolism of triheptanoin including clinical reports related to the use of triheptanoin. K E Y W O R D Sanaplerosis, epilepsy and neurodegenerative diseases, metabolic diseases, triheptanoin

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Section: Methodsmentioning

confidence: 99%

Section: Triheptanoin For the Treatment Of Epilepsy And Other Neuromentioning

confidence: 99%

Therapeutic potential of triheptanoin in metabolic and neurodegenerative diseases

Wehbe

Tucci

2019

J of Inher Metab Disea

View full text Add to dashboard Cite

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“…An estimated 35% of epilepsy cases are directly linked to a genetic background whereas in the remaining cases, genetic risk in combination with acquired and environmental factors is considered to both contribute to epileptogenesis. Environmental causes may include cerebral insults such as trauma, tumors, strokes, traumatic brain injury, or infections 10 . Classic epilepsy therapy involves antiepileptic medications, epilepsy surgery, vagus nerve stimulator (VNS), and ketogenic diet.…”

Section: Introductionmentioning

confidence: 99%

“…Environmental causes may include cerebral insults such as trauma, tumors, strokes, traumatic brain injury, or infections. 10 Classic epilepsy therapy involves antiepileptic medications, epilepsy surgery, vagus nerve stimulator (VNS), and ketogenic diet.…”

Section: Introductionmentioning

confidence: 99%

The gut microbiome in drug‐resistant epilepsy

et al. 2021

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Drug‐resistant epileptic patients make up approximately one‐third of the global epilepsy population. The pathophysiology of drug resistance has not been fully elucidated; however, current evidence suggests intestinal dysbiosis, as a possible etiopathogenic factor. Ketogenic diet, whose effect is considered to be mediated by alteration of gut microbiota synthesis, has long been administered in patients with medically refractory seizures, with positive outcomes. In this review, we present data derived from clinical studies regarding alterations of gut microbiome profile in drug‐resistant epileptic patients. We further attempt to describe the mechanisms through which the gut microbiome modification methods (including ketogenic diet, pre‐ or probiotic administration) improve drug‐resistant epilepsy, by reporting findings from preclinical and clinical studies. A comprehensive search of the published literature on the PubMed, Embase, and Web of science databases was performed. Overall, the role of gut microbiome in drug‐resistant epilepsy is an area which shows promise for the development of targeted therapeutic interventions. More research is required to confirm the results from preliminary studies, as well as safety and effectiveness of altering gut bacterial composition, through the above‐mentioned methods.

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“…26 )3( www.nsj.org.sa E pilepsy is one of the most common neurological disorders, affecting approximately 70 million people globally. 1 Thirty percent of these patients have drug-resistant epilepsy, 2 and most cases referred for epilepsy surgery involve temporal lobe epilepsy )TLE(. 3 However, after standard temporal lobectomy, around 40% of these patients will experience recurrent seizures.…”

mentioning

confidence: 99%

Seizure semiology in temporal lobe vs. temporal plus epilepsy using intracranial EEG monitoring

Khoja¹,

Albaradei²,

Alsulami³

et al. 2021

NSJ

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Objectives: To utilize our tertiary center's experience with Temporal lobe epilepsy )TLE( and Temporal plus epilepsy )TPE( cases and determine whether a correlation exists between ictal semiology signs, their localization/ lateralization value after intracranial electroencephalography )EEG( monitoring, and surgical outcomes.Methods: A retrospective study was conducted among epilepsy patients who underwent resective surgery for TLE or TPE after intracranial EEG monitoring between January 2008 and December 2018 at King Faisal Specialist Hospital in Riyadh, Saudi Arabia. Data were retrieved for 464 patients; 181 had intracranial electrode monitoring.Results: Forty-eight patients with a mean age of 27 years )SD=8.4( were included; 15 patients had TPE. Auras were frequently reported, emotional auras, in the form of fear )35%(. The localization/lateralization value of aura was statistically significant for TPE patients, including visual hallucinations and vertigo, lateralized to the left and right temporo-occipital, respectively )p=0.009 and <0.001(. Early-onset ictal manual automatism, oral automatism, late-onset dystonic posture, and late head-turning were significant for TLE without significant lateralization value. The ictal onset zone's localization was significant between the scalp and intracranial EEG findings in mesial TLE patients. The probability of seizure freedom )Engel class I( was 74%, 60%, and 67% at 2-year follow-up for mesial, lateral TLE, and TPE, respectively. Conclusion:Our results are consistent with previous studies and confirm the importance of ictal semiology signs in TLE and TPE. The addition of intracranial EEG monitoring in these cases helped improve the surgical outcomes.

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Drug-resistant epilepsy: From multiple hypotheses to an integral explanation using preclinical resources

Cited by 34 publications

References 157 publications

Therapeutic potential of triheptanoin in metabolic and neurodegenerative diseases

Therapeutic potential of triheptanoin in metabolic and neurodegenerative diseases

The gut microbiome in drug‐resistant epilepsy

Seizure semiology in temporal lobe vs. temporal plus epilepsy using intracranial EEG monitoring

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