High-frequency oscillations and epilepsy: Clinical and basic science perspectives

High-frequency oscillations (80 to 500 Hz) are being studied as biomarkers of epileptogenic areas in the brain, as well as markers to be used in epilepsy surgery. Dr. Cecilie Nome leads a discussion about clinical research on HFOs and areas of uncertainty, as well as the importance of basic research in helping to understand this phenomenon.Publications mentioned during the episode: Roehri Eng N, et al. High-frequency oscillations are not better biomarkers of epileptogenic tissues than spikes. 2017. Annals of NeurologyJacobs J, et al. Removing high-frequency oscillations: A prospective multicenter study on seizure outcome. 2018. NeurologyZweiphenning W, et al. Intraoperative electrocorticography using high-frequency oscillations or spikes to tailor epilepsy surgery in the Netherlands (the HFO trial): a randomised, single-blind, adaptive non-inferiority trial. 2022. Lancet NeurologyLisgaras CP et al. High-frequency oscillations (250–500 Hz) in animal models of Alzheimer's disease and two animal models of epilepsy. 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] 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.

There are potentially hundreds of "epilepsy genes" - but what is an epilepsy gene? How do researchers discover these genes and associate them with epilepsy? Sharp Waves spoke with Dr. Allan Bayat, a pediatric neurologist in Denmark focused on rare monogenic neurodevelopmental disorders and epilepsy. 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] 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.

In the second episode of our genetics and epilepsy series, Sharp Waves explores how genetic insights can inform considerations and outcomes of epilepsy surgery. Dr. Alina Ivaniuk interviews Dr. Patrick Moloney, currently an epilepsy genomics fellow at the Chalfont Center for Epilepsy at University College London.Selected publications:Do germline genetic variants influence surgical outcomes in drug-resistant epilepsy? Epilepsy Res 2024Genomics in the presurgical epilepsy evaluation. Epilepsy Res 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] 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.

This first episode in a multipart series on genetics in epilepsy covers the basics of genetic testing. Dr. Alina Ivaniuk interviews Dr. Ilona Krey, a physician and researcher at the Institute of Human Genetics at Leipzig University Medical Center. 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] 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.

Christina Rezek and Brad Levy each have daughters who underwent epilepsy surgery, with dramatically different results. Sharp Waves talked with them about the journeys to and through epilepsy surgery, the consequences, and what they have learned.Brad Levy is a founder of Epilepsy Awareness Day at Disneyland, a free event held every November in Anaheim, California, USA. Visit epilepsyawarenessday.org for more information. 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] 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.

Sharp Waves spoke with a neurologist and a cardiologist who are part of a team researching the interactions among seizures, heart function, heart health, and SUDEP. Learn more about their research.Selected publications from Drs. Lin & Fialho and colleagues:Determining factors of electrocardiographic abnormalities in patients with epilepsy: A case-control study (2017, Epilepsy Research)Maximal/exhaustive treadmill test features in patients with temporal lobe epilepsy: Search for sudden unexpected death biomarkers (2017, Epilepsy Research)Echocardiographic risk markers of sudden death in patients with temporal lobe epilepsy (2018, Epilepsy Research)Increased cardiac stiffness is associated with autonomic dysfunction in patients with temporal lobe epilepsy (2018, 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] 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.

In this episode, we explore the science behind exercise as an adjunct treatment for epilepsy and debunk some common myths (spoiler alert: With very rare exceptions, exercise does NOT increase seizure risk). Dr. Ayushe Sharma talked with Dr. Jane Allendorfer, Dr. Halley Alexander, and Brian Wiedmeyer, who participated in an exercise research study.The episode refers to a 2016 report by the ILAE Task Force on Sports and Epilepsy - that report is freely available online at this link.Some of the other research papers mentioned in the episode are listed below.The relationship between physical activity and cognitive function in people with epilepsy: A systematic review Effects of physical exercise in people with epilepsy: A systematic review and meta-analysis Role of Physical Exercise as Complementary Treatment for Epilepsy and other Brain Disorders Epilepsy and exercise: An experimental study in female rats Effects of an exercise program on health of people with epilepsy: A randomized clinical trialA strength exercise program in rats with epilepsy is protective against seizuresEffectiveness of Yoga Intervention in Reducing Felt Stigma in Adults With Epilepsy Impact of exercise as a complementary management strategy in people with epilepsy: A randomized controlled trial 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] 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.

A recent practice guideline provides updated evidence-based conclusions and recommendations regarding in utero effects of anti-seizure medications and folic acid supplementation on the prevalence of major congenital malformations, adverse perinatal outcomes, and neurodevelopmental outcomes. Dr. Parthvi Ravat interviewed Dr. Alison Pack about the guideline, which was produced by the American Academy of Neurology, American Epilepsy Society, and Society for Maternal-Fetal Medicine.Review the practice guideline: Teratogenesis, perinatal, and neurodevelopmental outcomes after in utero exposure to antiseizure medication (Neurology, May 2024)Other studies mentioned in the episode: Risk of major congenital malformations and exposure to antiseizure medication monotherapy (JAMA Neurology, March 2024) 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] 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.

Some historic names for epilepsy have been derogatory and stigmatizing. An older term for “epilepsy” in Malay means “mad pig disease.” Neurologists in Malaysia collaborated to change the word to a medically accurate term. Sharp Waves spoke with Dr. Chong Tin Tan about the origins of the older term and how the new term was introduced.Resources:Name of epilepsy: Does it matter? - 2012 - Neurology AsiaAnnouncement of a new Chinese name for epilepsy - Lau - 2011 - Epilepsia Changing name of epilepsy in Korea; cerebroelectric disorder (noi‐jeon‐jeung,뇌전증,腦電症) - Kim - 2014 - EpilepsiaRenaming Korean epilepsy: Where are we? - Epilepsy & Behavior Awareness, knowledge and attitude towards epilepsy in Malaysia: A perspective of undergraduates in a private university | African Journal of Neurological Sciences Overcoming the stigma of epilepsy in Asia // International League Against Epilepsy  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] 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.

With all the best intentions, undertakings in global neurology can include assumptions and biases that lead to unforeseen negative consequences. Sharp Waves spoke with Drs. Melody Asukile and Deanna Saylor about their recent article on the perils and pitfalls of global neurology. They discussed specific examples of some of these unforeseen consequences and talked about the ingredients for productive, ethical, and sustainable global neurology initiatives.Resources:Asukile M et al. The Perils and Pitfalls of Global Engagement (JAMA Neurology)Global Neurology: Advancing Neurological Care Worldwide (YouTube)DiBiase R et al. Evaluation of Three Cohorts of the First Neurology Postgraduate Training Program in Zambia (P4-8.001) (Neurology)Zambia League Against Epilepsy Epilepsy care in Zambia: “Now that we have neurologists, we will have a voice” (ILAE Sharp Waves episode)Intersectoral global action plan on epilepsy and other neurological disorders (World Health Organization) 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] 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.