Recent Developments in Diagnosis of Epilepsy: Scope of MicroRNA and Technological Advancements

Abstract

Epilepsy is one of the most common neurological disorders, characterized by recurrent seizures, resulting from abnormally synchronized episodic neuronal discharges. Around 70 million people worldwide are suffering from epilepsy. The available antiepileptic medications are capable of controlling seizures in around 60–70% of patients, while the rest remain refractory. Poor seizure control is often associated with neuro-psychiatric comorbidities, mainly including memory impairment, depression, psychosis, neurodegeneration, motor impairment, neuroendocrine dysfunction, etc., resulting in poor prognosis. Effective treatment relies on early and correct detection of epileptic foci. Although there are currently a few well-established diagnostic techniques for epilepsy, they lack accuracy and cannot be applied to patients who are unsupportive or harbor metallic implants. Since a single test result from one of these techniques does not provide complete information about the epileptic foci, it is necessary to develop novel diagnostic tools. Herein, we provide a comprehensive overview of the current diagnostic tools of epilepsy, including electroencephalography (EEG) as well as structural and functional neuroimaging. We further discuss recent trends and advances in the diagnosis of epilepsy that will enable more effective diagnosis and clinical management of patients.

Advances in understanding the pathogenesis of epilepsy: Unraveling the molecular mechanisms

“…Physical examination, EEG analysis, CT scan, and MRI are considered current methods for investigating epilepsy pathogenesis. These methods are limited by their low resolution and their inability to capture the dynamic changes that occur in the brain during an epileptic seizure 13 . Besides lacking accuracy in diagnosis and investigation, patients may be exposed to hazardous radiation and may present allergies to certain contrast materials 13 .…”

“…Not very specific to epilepsy. [13] EEG analysis Recording of the electrical movement of the cerebrum. Epilepsy's etiology cannot be identified by EEG, but abnormal electrical activity in the brain can be.…”

Circulating miRNAs as Novel Clinical Biomarkers in Temporal Lobe Epilepsy

“…The basis of these techniques is different, but they may offer high-quality images that considerably facilitate the diagnosis of TLE. Although these techniques are very helpful in detecting brain abnormal electrical discharges or identifying probable causes of epilepsy, they might lead to false positive or false negative results [ 26 , 27 ]. Poor diagnosis often results in inappropriate pharmacotherapy leading to high morbidity of epileptic patients.…”

Improving the generalization of patient non-specific model for epileptic seizure detection

“…Therefore, an early and correct detection of seizures is crucial for management of epilepsy. Currently Video-EEG (Electroencephalogram) monitoring of epilepsy is the golden standard at hospital for pre-surgical evaluation [3]. EEG is a noninvasive recording of brain activities and has high temporal resolution, which makes it efficient to accurately detect the onset of seizure and its type.…”