When one thinks of clinical research in epilepsy, one usually thinks of antiseizure drug trials, which is still probably the most common form of clinical epilepsy research. This kind of research, along with fundamental drug discovery research, has now resulted in over 20 clinically available antiseizure medications. While the incidence of side effects is now lower than ever, the overall success of pharmacotherapy has not increased dramatically. Hence there is still room for better antiseizure drugs.
Another more recent focus is the search for antiepileptogenic drugs – that is drugs that can prevent the development of epilepsy following a sudden brain insult such as severe head trauma or stroke. Currently, standard antiseizure medications have not prevented the development of epilepsy.
In addition to drugs, special diets can control seizures. For example, the ketogenic diet is a commonly used diet and that sometimes may be very effective in the treatment of severe childhood epilepsy. Progress in new dietary approaches or dietary replacements, and the underlying mechanisms are being made.
There is now better and better technology for exploring epilepsy in the human brain, ranging from advanced EEG recording and signal processing systems, novel magnetic resonance imaging (MRI) protocols, magnetoencephalography (MEG), and cerebral blood flow measurement systems. All of these techniques are helping to better understand the cause of epilepsy and the effects of seizures on the brain. In addition, some of these techniques are helping to better identify the area of the brain generating seizures to be removed in patients undergoing epilepsy surgery investigations.
As a result of our being better in localizing the brain region causing seizures, often with the above technology, novel neurosurgical approaches are being examined, including the implanting devices into the brain that can anticipate and respond to a seizure (also known as neuromodulation) so as to prevent or diminish the seizure.
Other areas of clinical research include better understanding the causes and risk factors of epilepsy (epidemiology), how we deliver health care and how to improve it (health services research), or effects of seizures on our mental functions (neuropsychology). Also the study of genetics in epilepsy is gaining great momentum with the availability of cheaper technology for testing the human genome. For example, it is becoming increasingly apparent that many of the patients seen in clinic have a genetic component contributing to their epilepsy.