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Researchers try to predict epilepsy

24 April, 2007

Research is underway to find ways to predict who is most at risk
of developing epilepsy from brain injury and find methods of protecting
their brains. The research includes studies to see if the newer
anti-epileptic drugs Topamax and Keppra might actually prevent epilepsy
if they're taken immediately after a serious brain injury.

"It
is among the most frustrating things in medicine to know that someone's
at risk ... and be unable to do anything about it," says Dr. Marc
Dichter of the University of Pennsylvania, who is leading the Topamax
study.

After the initial injury and treatment there is a
'silent period' during which the brain works to recover. It can be
months or even years before epilepsy appears.

"This silent
period is not really silent," said Dr. Shlomo Shinnar of the Albert
Einstein College of Medicine at a meeting of epilepsy specialists at
the National Institutes of Health.

Misfiring connections
can form in the brain as it tries to rewire itself during a crucial
process called plasticity. Damaged neurons can make new connections in
the wrong places, or make overly excitable connections. Even the
brain's genes change the way they work after head injury.

"You
need the plasticity for recovery. You don't want to stop it. You just
want to structure it in a way that it aids recovery without causing
seizures," Temkin explains.

It's not clear yet how to
guide plasticity, so scientists are testing seizure-controlling drugs
as possible preventers of epilepsy. Three existing medications have
failed and Topamax and Keppra are currently being tested.