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Related Concept Videos

Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein01:20

Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein

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Antiepileptic drugs, such as levetiracetam (Keppra) and brivaracetam (Briviact), have emerged as crucial tools in managing epilepsy. These medications exert their therapeutic effects by targeting the synaptic vesicle protein SV2A, a transmembrane glycoprotein primarily found in the brain.
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
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Epilepsy and Seizures: Overview01:24

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Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
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Antiepileptic Drugs: GABAergic Pathway Potentiators01:18

Antiepileptic Drugs: GABAergic Pathway Potentiators

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γ-aminobutyric acid or GABA, plays a pivotal role as an inhibitory neurotransmitter in the brain. GABA pathway potentiators, also known as GABAergic drugs, are a class of pharmaceutical agents designed to enhance the functioning of the GABAergic system. These medications primarily treat epilepsy, a neurological disorder characterized by recurrent seizures.
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
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Antiepileptic Drugs: Glutamate Antagonists01:14

Antiepileptic Drugs: Glutamate Antagonists

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Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
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Antiepileptic Drugs: Potassium Channel Activators01:20

Antiepileptic Drugs: Potassium Channel Activators

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Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
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Antiepileptic Drugs: Sodium Channel Blockers01:08

Antiepileptic Drugs: Sodium Channel Blockers

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Antiepileptic drugs are specialized medications that prevent seizures in individuals diagnosed with epilepsy. These drugs primarily function by blocking the movement of sodium ions through channels in the neuronal membrane, inhibiting the repetitive firing of action potentials often associated with seizures.
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Updated: Oct 1, 2025

Non-Invasive Electrical Brain Stimulation Montages for Modulation of Human Motor Function
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Neuromodulation for Refractory Epilepsy.

Philippe Ryvlin1, Lara E Jehi2

  • 1Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.

Epilepsy Currents
|March 2, 2022
PubMed
Summary
This summary is machine-generated.

Neuromodulation therapies like VNS, ANT-DBS, and RNS offer seizure reduction for drug-resistant epilepsy. While palliative, about half of patients experience significant benefits, though long-term evidence is needed to optimize treatment pathways.

Keywords:
deep brain stimulationdrug-resistant epilepsyneuromodulationresponsive neurostimulationvagus nerve stimulation

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Area of Science:

  • Neurology
  • Neurosurgery
  • Biomedical Engineering

Background:

  • Three neuromodulation therapies (VNS, ANT-DBS, RNS) are FDA-approved for drug-resistant focal epilepsy.
  • VNS indications now include children as young as age 4.
  • Limited data exist for other epilepsy syndromes and status epilepticus.

Purpose of the Study:

  • To review the current landscape of neuromodulation therapies for refractory epilepsy.
  • To assess the efficacy and patient outcomes associated with VNS, ANT-DBS, and RNS.
  • To identify gaps in evidence for optimizing neuromodulation therapy selection.

Main Methods:

  • Review of approved neuromodulation devices and their indications.
  • Analysis of seizure reduction rates and long-term efficacy data.
  • Comparison of benefits and drawbacks against antiseizure medications.

Main Results:

  • Approximately 50% of patients with VNS, ANT-DBS, or RNS achieve ≥50% seizure reduction.
  • Efficacy of these therapies may increase over time.
  • Neuromodulation is generally palliative, suitable for non-surgical candidates, with a minority achieving seizure freedom.

Conclusions:

  • Neuromodulation therapies provide significant seizure reduction for many with difficult-to-treat epilepsy.
  • Long-term benefits and comparative effectiveness data are crucial for treatment pathway optimization.
  • Further high-level evidence is needed to guide the best positioning of each therapy.