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: podcast@ilae.org.

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, X (Twitter), 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 Asia

Announcement 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 - Epilepsia

Renaming 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: podcast@ilae.org.

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, X (Twitter), 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: podcast@ilae.org.

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, X (Twitter), Instagram, and LinkedIn.

Some people with epilepsy also experience memory and learning issues, as well as depression or anxiety. A small study in Australia screened people for these conditions at a first seizure clinic before any anti-seizure medications had been prescribed. Compared with a control group, the people at the first seizure clinic had higher rates of all of these cognitive and neuropsychological issues.

The study is published in Epilepsia Open.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

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, X (Twitter), Instagram, and LinkedIn.

Juhn Atsushi Wada was a Japanese–Canadian neurologist known for research on epilepsy and human brain asymmetry, including his description of the Wada test to assess cerebral hemispheric dominance of language function. The Wada test is the gold standard for establishing cerebral dominance and is conducted worldwide prior to epilepsy surgery. He became a pioneer in the utilization of the kindling model of epilepsy, which permitted controlled studies of the development of epilepsy in the laboratory.

Drs. Maryam Nouri and Laurent Sheybani interviewed Drs. Jerome Engel Jr., Marilyn Jones-Gotman, and Solomon Moshe about their memories and relationships with Dr. Wada and his impact on epilepsy research and clinical care.

More information on Dr. Wada:
In memoriam: Juhn Atsushi Wada (Epilepsia Open)

Juhn Wada 1924-2023 (ILAE website)

Dr. Juhn Atsushi Wada (British Columbia Medical Journal)

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

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, X (Twitter), Instagram, and LinkedIn.

Previously thought to be mere connective tissue and support for neurons, astrocytes are now understood to have many functions in the nervous system that are linked with seizures and epilepsy. Dr. Cecilie Nome spoke with Dr. Peter Bedner about astrocytes' involvement in epilepsy and how identifying and resolving astrocyte dysfunction is a new frontier in drug development.

Relevant articles:
de Ceglia R., et al. 2023. Specialized astrocytes mediate glutamatergic gliotransmission in the CNS. Nature 622, 120–129.

Grote A., et al. 2023. ‘Hippocampal innate inflammatory gliosis only’ in pharmacoresistant temporal lobe epilepsy. Brain 146(2), 549-560.

Ravi V.M., et al. 2015. Astrocyte uncoupling as a cause of human temporal lobe epilepsy. 2015. Brain 138(5), 1208-1222.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

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, X (Twitter), Instagram, and LinkedIn.

Dr. Ashok Pillai is a professor of neurosurgery and neuroscience associated with Amrita Institute of Medical Sciences, Kochi, India. He underwent epilepsy surgery after a diagnosis of epilepsy in his mid-30s.

Dr. Pillai received his undergraduate degree and medical training in the United States before returning to Kochi in 1999. He experienced ecstatic seizures for nearly a decade before he was diagnosed. His personal experience with epilepsy and epilepsy surgery led him to train as an epilepsy surgeon, whereas previously he had focused on surgical neuro-oncology. The Amrita Advanced Centre for Epilepsy, which he heads, has performed more than 1,000 surgical procedures.

Dr. Parthvi Ravat spoke with Dr. Pillai about his experience with epilepsy, how it shaped his career path, and how it informs his clinical decision making.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

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, X (Twitter), Instagram, and LinkedIn.

Recent community-based studies suggest that people with chronic epilepsy have three times the risk of sudden cardiac death, compared with the general population. The studies also found that two-thirds of the cases of cardiac arrest in people with epilepsy did not occur directly before, during, or after a seizure.

How do seizures affect the heart, both acutely and chronically? Dr. Trudy Pang and Dr. Richard Verrier have introduced the concept of the "epileptic heart" as "a heart and coronary vasculature damaged by chronic epilepsy as a result of repeated surges in catecholamines and hypoxemia, leading to electrical and mechanical dysfunction." Dr. Parthvi Ravat talks with both of them about their work and its relevance to epilepsy treatment.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

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, X (Twitter), Instagram, and LinkedIn.