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“If the workplace is educated, they are helpful. Co-workers have to know what to do if a seizure occurs. I’ve been working with a researcher in Italy who has been interviewing teachers that had to deal with small children with epilepsy.They had some knowledge, but mostly they were unable to manage a seizure.The first thing they did was call an ambulance, which is not necessary.They need to be educated to know what to do and not be afraid, then the other children in the class will not be afraid.” Treatments for epilepsy Treatment for epilepsy is predominately anticonvulsant drugs, which block neuronal ion channels. “If you consider the present drugs, they are pure symptomatics.These drugs are useful to control seizures, but they don’t offer a cure. Surgery is an option in drug-resistant patients. About 20% of people with epilepsy are drug-resistant and some of them may have an operable lesion in the brain. If the lesion is removed, there is a 50% probability of no more seizures. “There are studies now underway, still mostly with animals, that are investigating the use of anti- inflammatory drugs for treating epilepsy. So, there is the idea that any seizure makes a lot of inflammation, and this inflammation may be the cause of persisting seizures.These drugs are under development at present, but so far we have no positive findings.” Dr Beghi’s current research In Italy, Dr Beghi is currently co-ordinating two trials related to epilepsy: 1. The speed of treatment withdrawal in seizure-free patients. This study is comparing slow withdrawal of treatment with rapid withdrawal of treatment in patients who have become seizure free. 2. Target dose for a newly diagnosed patient with epilepsy. This study is looking at whether new patients can be treated effectively with small doses of drugs. It involves a randomised trial that compares relapse rates of patients receiving the standard dose versus patients receiving half the standard dose. The EpiNet Study Group Research into epilepsy is now greatly assisted by the advent of the EpiNet Study Group, which was formed 10 years ago by New Zealander Peter Bergin through funding by the Neurological Foundation. EpiNet is a group of neurologists and epileptologists from many countries who are using a secure international database to undertake research into the clinical management of epilepsy. Data from more than 10,000 patients is included in this database. “The big benefit of EpiNet is that you can study rare situations related to epilepsy, even when there are not sufficient numbers in your own country.You can do pragmatic studies in an international context, like the one I am co-ordinating now in Italy, which is looking at different dosages. I am also working with Peter Bergin to study sudden and unexpected death in epilepsy, which happens more frequently in drug-resistant patients. “EpiNet also supports the study of psychogenic seizures, so you can see if a different social cultural background might be the source of a different phenotype in this seizure, because they reflect the personality of the patient and their social cultural background. Having cases that come from different countries and different parts of the world is a very big advantage.” Headlines / 13