Epilepsy was recognised as far back as the 5th millennium BCE and our understanding of it continues to evolve, as does our approach to its management, namely diagnosis and treatment. History remains the cornerstone of the correct diagnosis but this is refined with better monitoring and in depth evaluation, using techniques aimed to predict the onset of seizures and define circumstances that may influence intervention.
There is a continuous development of new anti-seizure medications (ASM) but it is imperative that one does not ‘throw away the baby with the bath water’ for which medications, such as carbamazepine and its later ‘cousins’ with similar formulae, still have a positive role to play and retain a viable place within the available armamentarium. It must be appreciated that, while some ASM may be very effective in controlling seizures, they also may exert a negative psychotropic effect which has poor long term impact on patient wellbeing.
The patients’ wellbeing is even more important than is seizure control, acknowledging that the principal reason for wanting to control seizures is to improve quality of life. Issues related to quality of life include an appreciation of the ongoing stigma that attaches to epilepsy. Epilepsy can impact on education, employment, driving and psychosocial factors that are often overlooked when people are asked to contemplate what it means to have epilepsy, with many people still talking about ‘epileptics’, implying that those with epilepsy are less than people who have a simple diagnosis and are defined by their diagnosis.
There remain many issues which demand further consideration, such as risk of injury or even death, with consideration of sudden unexpected death in epilepsy. Adaptation of novel interventions, employing devices to predict and possibly even stop seizures are becoming a reality. Home-based video-telemetry and ambulatory telemetry have the potential to capture seizures, within everyday life, and offer the person to continue within their usual environment while still undergoing comprehensive evaluation. Cerebral imaging is improving, with enhanced lesion identification, which complements the supposition of aetiological causes for focal seizures.
A better understanding of the underlying genetic predisposition to epilepsy has the potential to generate a better appreciation of inherited factors which may allow genetic engineering to protect susceptible individuals. While this has seemed lightyears away, more recently, the growth in genetic understanding has realised treatment options for illnesses, hitherto devoid of any form of intervention, and there is no reason to assume that this will not have a role to play in some forms of epilepsy.
From the above, it remains self-evident that it behoves all those interested in epilepsy to maintain an heightened level of curiosity and awareness and to always be on the look out for news ways to deal with a long standing illness which has the capacity to affect every facet of a patient’s life.
It is my pleasure to invite you to submit manuscripts on the subject “Neuroscience and Epilepsy: History and Potential Lessons” for this Special Issue. Full papers and communications, as well as comprehensive reviews, are welcome. Please feel free to contact me, the guest editor, in case of further questions.
Prof. Dr. Roy Beran
Manuscripts should be submitted via our online editorial system at https://imr.propub.com by registering and logging in to this website. Once you are registered, click here to start your submission. Manuscripts can be submitted now or up until the deadline. All papers will go through peer-review process. Accepted papers will be published in the journal (as soon as accepted) and meanwhile listed together on the special issue website. Research articles, reviews as well as short communications are preferred. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office to announce on this website.
Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts will be thoroughly refereed through a double-blind peer-review process. Please visit the Instruction for Authors page before submitting a manuscript. The Article Processing Charge (APC) in this open access journal is 1900 USD. Submitted manuscripts should be well formatted in good English.