Science Magazine

Epilepsy's next frontier

As epilepsy drugs fail nearly one-third of patients, scientists seek root causes of seizures

19 December, 2019

Jennifer Couzin-Frankel

Science 13 December 2019 Vol. 366, Issue 6471, pp. 1300-1304. DOI: 10.1126/science.366.6471.1300

Afflicting about one in 26 people, epilepsy is defined by its most visible symptom: seizures, caused by abnormal electrical activity in the brain. About two dozen medications are prescribed for epilepsy, but roughly 30% of cases are classified as drug resistant because even with treatment, patients continue to suffer seizures. That percentage hasn't budged in decades despite many new drugs—suggesting a pivot in tactics is desperately needed.

After years of frustration, epilepsy research is shifting from targeting the seizures to seeking their cause, sometimes one patient at a time. Much about the condition remains a mystery, including why antiseizure medications fail so many people, among them more than 1 million in the United States. Leaps in gene sequencing and better animal models are changing how scientists and doctors understand, study, and sometimes treat the disease. The patients who stand to benefit include newborns with genetic syndromes who start to seize hours after birth and go on to suffer ruinous developmental delays, 10-year-olds who wake up wondering whether seizures will strike at school and battle difficulties with memory and learning, and adults whose head injuries might trigger epilepsy years later.

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