International Conference on Epilepsy & Treatment September 21-22, 2015 Baltimore, USA

Mark Stuntz has joined Deerfield Institute in 2015 as an Epidemiology Senior Research Associate, responsible for evaluating and modeling epidemiological aspects of various diseases. Prior to joining Deerfield, he was as an Epidemiologist at Global Data where he developed ten year country-specific forecast models and reports for multiple indications including prostate cancer, methicillin-resistant Staphylococcus aureus (MRSA) and gram-negative bacterial urinary tract infections. He holds a Master of Public Health degree from the Yale School of Public Health with a concentration in Epidemiology of Microbial Diseases.

Objectives: To estimate the prevalence of status epilepticus (SE), refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE) in the United States using an incidence-survival model. Methods: Yearly survival data for each SE etiology (acute symptomatic, progressive symptomatic, remote symptomatic and idiopathic/cryptogenic) were extracted from published research. Incident cases were calculated for each year using published rates. Applying the survival proportions and incidence estimates to the model for each etiology, we calculated an overall estimate of the prevalence of SE. RSE and SRSE prevalent cases were assessed as proportions of the total number of prevalent SE cases using published values. Results: The prevalence of SE was 17.6 cases per 10,000 population in the United States resulting in 566,241 cases in 2015 and increasing to 606,004 in 2024. The prevalence of RSE was 4.3 per 10,000 resulting in 139,295 cases in 2015, increasing to 149,077 in 2024. SRSE prevalence was 1.8 per 10,000 resulting in 56,624 cases in 2015, increasing to 60,600 in 2024. Conclusions: To our knowledge, this is the first attempt to calculate the prevalence of SE and its subtypes for all ages in the United States. Estimating the prevalence of SE, RSE and SRSE using population-based epidemiological methods is challenging because of the unpredictable nature of associated mortality. Our incidence-survival model provides an alternative and effective method to assess the prevalent population. Considering the high costs associated with treatment and hospitalization, prevalence estimates are necessary to quantify the burden of SE and its subtypes in the United States.

Jacquelin R Arguello is currently in her 4th year of Undergraduate Education (BS in Neurobiology/Physiology) at University of Maryland, College Park. She is interned at Mid-Atlantic Epilepsy & Sleep Center participating in research studies and patient care from February 2013-present. She is currently interning at a multispecialty office at Holy Cross Hospital.

Rationale: The number of respective surgeries for patients with refractory epilepsy in the US may be declining. Reasons for this are not clear. One suggested explanation has been that respective surgeries are being done in non-academic centers and therefore are not being registered in academic center-based studies. The purpose of this study was to evaluate this hypothesis. Methods: Charts were reviewed of all newly-evaluated patients seen in one private epilepsy center during a three year period from 6/1/2010-5/31/2013. Results: 699 patients were evaluated (F=389, M=310, mean age 46 range 14-93). Of these, 537 had focal epilepsy. 355/537 (66.1%) of patients with focal epilepsy had pharmacoresistant epilepsy. 110/355 (31.0%) of these patients were admitted to EMU for long term video EEG monitoring. 64 of these patients had unifocal, 22 multifocal and 20 had non-localizable or non-lateralizable findings ictal EEG abnormalities; 4/120 had normal LTVEEGs. Of the 64 patients with unifocal EEG findings, 44 were temporal, 12 were frontal, 4 were parietal and 2 were occipital. Of the unifocal temporal EEG abnormalities, 22 were right sided and 22 were left sided. 11/64 of the patients with unifocal EEG abnormalities agreed to further surgical evaluation and underwent further pre-surgical testing. 4/11 failed pre-surgical work up (3 because of failed pre-surgical memory evaluation, one for language lateralization). 7 patients underwent surgical resection. Conclusion: The number of respective surgeries done at a private epilepsy center is not high. It is unlikely that shift of surgeries from academic to private epilepsy centers explains the decline in respective surgeries noticed by academic epilepsy centers.

Yanquiel Barrios Hernandez has a Degree in Psychology from the University of Havana, besides has a Degree of Master of Social Sciences from the same university. He belongs to the Society for Neuroscience in Cuba and is an Active Member of the International Bureau Against Epilepsy Chapter of Havana. He has published a dozen articles and collaborates on several psychology blogs.

The main objective of the research is to characterize the social representation on epilepsy have the primary school teachers for which a sample of 218 teachers of this level was selected. Once characterized socio-demographically, their level of knowledge about the disease was determined, the attitudes that established modes of action regarding their children with this condition were evaluate to finally reveal the core of the social representation. The results were achieved by the use of quantitative techniques such as questionnaire and qualitative techniques such as: Free association of words, drawing and in-depth interview. Among the most significant results is that the social representation of epilepsy is linked to the experience of emotional and physical slippage. The core is integrated by concepts of disease and attacks from which prejudices among other unfavorable assume an attitude who suffers from epilepsy.

Dr. Essam Eldin Mohamed Nour Eldin is currently working as a professor of Clinical Biochemistry Faculty of Medicine at Umm Al-Qura University and also he is a Lab consultant at Al-Noor Specialist Hospital in Makkah,KSA.

Many risk factors are often encountered to the pathogenesis of epilepsy. The aim of this work is to study the effect of seizure frequency on free radical generation and antioxidants levels in epileptic patients and the correlation between their values and the level of antiepileptic drugs level in serum with the activity or the control of seizure which may be a prognostic value for seizure. This study was carried out on 15 healthy controls (GI) and 60 epileptic patients were they divided into 2 main groups; 30 controlled epileptic patient treated with antiepileptic drugs where they divided into 2 subgroups according to the frequency of seizure; 15 epileptic patients were free of seizure for more than one year (GIIA) and 15 epileptic patients were free of seizure for less than one year and more than six months (GIIB). 30 uncontrolled epileptic patients treated with antiepileptic drugs with uncontrolled seizure, this group was divided into 2 subgroups according to the frequency of seizure; 15 epileptic patients had a frequency of seizure less than 4 times per month (GIIIA) and 15 epileptic patients had a frequency of seizure more than 4 times per month (GIIIB). We found that urinary MDA/Creatinine ratio and Nitric oxide (NO) were significantly increased in GIIB, GIIIA and GIIIB compared to the control group where Vitamin A was markedly decreased in GIIIB group. Also vitamin E was significantly decreased in GIIIA and GIIIB groups. At the study the serum antiepileptic drugs and other investigated parameters it was found that no statistical correlation appear in all studed groups. NO had a significant negative correlation with serum vitamin E in group GIIA and GIIB. Also serum NO had negative correlation with vitamin A in group GIIIA. On the other hand serum NO had positive correlation with urinary MDA/Creatinine ratio. The imbalance between free radical generation and antioxidant system may be a cause of seizure attack.

Ann Marie Gillie is an Education Assistant for Grades K-12, where she works primarily with students who suffer from FAS/ADHD and ODD. She is also a Canadian Advocate for Epilepsy and the Vice President for the Edmonton and Northern Alberta Epilepsy Association. She has published two books and had several articles written on her behalf (Surgical Neurology International/Your Health Magazine/Spruce Grove Examiner) as well as she has been interviewed on Global Edmonton and Breakfast Television Edmonton. Her interviews can be found on Youtube or on her Linkedin profile; her topics of discussion are Women and Epilepsy/Sex and Seizures/Depression/Side effects of RX/Her surgery/Books published.

In Canada alone an average of 42 people a day learn that they have Epilepsy and over 50 million people worldwide suffer from the disorder. I can say that 'I Beat Epilepsy". It was 6:30 AM on December 03, 2002; I remember being wheeled down the hall at the University of Alberta Hospital in Edmonton, Alberta, Canada by the porter with the silence it felt like we were the only ones in the building. You could hear a pin drop. I had lived with Epilepsy for almost 20 years of my life and that was about to change. Left Selective Amygdalohippocampectomy is the surgery I was about to undergo and it is what cured me of my seizures. The left parahippocampal gyrus, left amygdale and left hippocampus were removed; structures within the left temporal lobe. I had 6 seizures 2 days before the surgery and I have not had one since. Since my surgery I have accomplished some amazing tasks in my life. I have written two books, was asked to be a Canadian Advocate for Epilepsy in 2012 and have been a motivational speaker for over 8 years. Helping others is my passion, is my calling. I want to educate others internationally from a patient’s point of view, help them understand that they are not alone when it comes to living with Epilepsy.