Current Pharmacologic Strategies for Treatment of Intractable Epilepsy in Children

Abstract

Epileptic encephalopathy (EE) is a devastating pediatric disease that features medically resistant seizures, which can contribute to global developmental delays. Despite technological advancements in genetics, the neurobiological mechanisms of EEs are not fully understood, leaving few therapeutic options for affected patients. In this review, we introduce the most common EEs in pediatrics (i.e., Ohtahara syndrome, Dravet syndrome, and Lennox-Gastaut syndrome) and their molecular mechanisms that cause excitation/inhibition imbalances. We then discuss some of the essential molecules that are frequently dysregulated in EEs. Specifically, we explore voltage-gated ion channels, synaptic transmission-related proteins, and ligand-gated ion channels in association with the pathophysiology of Ohtahara syndrome, Dravet syndrome, and Lennox-Gastaut syndrome. Finally, we review currently available antiepileptic drugs used to treat seizures in patients with EEs. Since these patients often fail to achieve seizure relief even with the combination therapy, further extensive research efforts to explore the involved molecular mechanisms will be required to develop new drugs for patients with intractable epilepsy.

Vojta Approach Affects Neck Stability and Static Balance in Sitting Position of Children With Hypotonia

“…Children who present with weakness, low muscle tone, abnormal reflexes, and sensory and motor problems have developmental delays and are considered hypotonia [ 6 ]. They are sometimes accompanied with seizures and organ malformation [ 7 , 8 ]. Many disorders, including neurological disorders, endocrine and metabolic disorders, Prader-Willi syndrome, and spinal muscular atrophy, often present with hypotonia as a clinical symptom [ 6 ].…”

Nitrosative Stress and Human Disease: Therapeutic Potential of Denitrosylation

“…In terms of aspects of individual subjects, patients with seizures that affect the motor cortex are susceptible to physical injury, such as abrupt falling, fractures, and even traffic accidents. At the microscopic level, sustained and prolonged excitation elicits the accumulation of neuronal damage and, finally, results in cell death [ 54 ]. The kainate receptor, specifically, the glutamate ionotropic receptor kainate type subunit 2 (GluK2), undergoes S-nitrosylation in an animal model of epilepsy.…”

Applications of artificial intelligence in urological setting: a hopeful path to improved care

“…Various methods and learning algorithms for motion recognition have been proposed. Most studies have used static algorithms such as ANNs ( Karmonik et al, 2019 ; Kim et al, 2020 ; Nikkola et al, 2020 ; Prabhakar et al, 2019 ) and K-means clustering ( Baser et al, 2020 ; Fraley and Raftery, 2002 ; Moon and Cho, 2021 ), or dynamic time warping ( Powar and Chemmangat, 2019 ) in combination with algorithms. However, a time series algorithm should be used to predict or classify dynamically changing time series data.…”