2^nd International Conference on Epilepsy & Treatment October 20-21, 2016 Rome, Italy

Rena Orman, PhD is a Research Assistant Professor in the Department of Physiology & Pharmacology at the State University of New York Downstate Medical Center in Brooklyn. Her research is focused on neurophysiological and neuroanatomical evidence for regional and long-range circuit properties. Specific attention has been paid to evidence for laterality of circuit activity in subcortical structures such as amygdala and the properties of hippocampal formation circuits for the generation and spread of seizure activity.

Field potential oscillations reflect synchronized rhythmic synaptic potentials and/or firing by populations of neurons. Such oscillations are characteristics of and perhaps a cause of a variety of physiological and pathophysiological states such as cognition, sleep and seizures. While it is known that very fast oscillations (100-500 Hz) can be observed in hippocampus under pathological conditions, a detailed spatio-temporal analysis of such a phenomenon does not exist. Rat ventral hippocampal brain slices were cut and maintained in a recording chamber with 64 simultaneous extracellular recordings. We found that single stimulus pulses in the presence of bicuculline and/or kainic acid in artificial CSF triggered epileptiform events that contained episodes of very fast oscillations lasting 50-150 msec. For both drugs, the oscillations of largest valley-to-peak amplitude were located in the CA3 region. These findings indicate that CA3 is involved in the generation of very fast oscillations in hippocampus, which may contribute to the epileptogenic properties of that area of hippocampus. Furthermore, the difference in duration of the events under disinhibition and excitation suggests an intrinsic oscillatory circuit that is modulated more by inhibition than by limitation of excitation.

Nanuli Doreulee has received her PhD from Beritashvili Institute of Physiology. She has completed her Post-doctoral studies at the Brain Research Institute, Moscow and H Haine University of Duesseldorf, Germany. She is the Head of Direction of Human and Animal Physiology at Tbilisi State University. She has published more than 20 articles in high impact factor journals in recent years.

In recent years the new treatment strategies for neurodegenerative disorders focuses on flavonoids-plant antioxidants, which are characterized with anti-allergic, neuroprotective activity. Flavonoids permeate the blood-brain barrier and are able to localize in the brain, particularly with significantly higher levels in hippocampus and cortex, suggesting that they are candidates for direct neuroprotective and neuromodulative actions. The hippocampus plays an important role in a learning/memory processes and it is also a common focal site in epilepsy. The progressive spontaneous recurrent seizures induce hippocampal neuronal loss, cognitive impairment and psychiatric comorbidities. Regular treatment with the antiepileptic drugs is useful for controlling seizures. However, more than 35% of people with temporal lobe epilepsy have a refractory seizure. Our previous experiments showed that early postnatal feeding with flavonoids from saperavi have beneficial effects on hippocampal related learning/memory mechanisms. Saperavi flavonoids significantly increase the number of BrdU positive cells in the dentatus gyrus of the rats. The aim of the present work was to investigate the effects of feeding with flavonoids from saperavi (8 days, 25 mg/kg per day) on kainic acid–induced epileptogenesis, epilepsy associated learning/memory disturbance and neurogenesis in the dentatus gyrus of the hippocampal formation. Behavioral and morphological experiments were performed. Our results demonstrate that exposure of rats with kainic acid epilepsy (15 mg/ kg, single administration) to flavonoids from saperavi induce correction of epilepsy induced memory impairment and this was in correlation with potentiation of the number of BrdU-positive cells in the dentatus gyrus of the hippocampus.

Suraj Muke has completed his MPharmacy from Pune University and is currently pursuing his PhD under the guidance of Dr. Sadhana Sathaye at Institute of Chemical Technology, Mumbai. He is currently working on isolation and purification of herbal products for its antiepileptic activity. Our research group focuses on the two major areas i.e. central nervous system disorders and metabolic disorders mainly diabetes mellitus. He wish to explore the molecular mechanisms leading to epilepsy and other neurodegenerative disorders and exploring herbal drugs in treatment of the above diseases either as drug or as nutraceutical is the goal of his research.

Epilepsy is a type of brain disorder characterized by seizures. An epileptic seizure is caused by brief, excessive and abnormal discharge of nerve cells in the brain. The ideal treatment for epilepsy should encompass aspects like minimal seizure occurrence and maximum therapeutic efficacy with least side effects. Eclipta alba (EA) has been used in traditional system of medicine as well as by traditional healers to treat epilepsy since ancient times. Coumarin extract was isolated from EA leaves. The aim of the present study was to evaluate coumarin extract in acute zebrafish and rodent models of epilepsy for its anticonvulsant activity. Coumarin extract was initially evaluated in pentylenetetrazole (PTZ)-induced seizures in zebrafish model of epilepsy. The experimental findings obtained from the zebra fish model evinced that coumarins had potent anticonvulsant activity. To further ascertain the anticonvulsant activity of coumarins, the extract was evaluated in rodent models. Pretreatment of coumarin extract at three dose levels exhibited significant delay in hind limb extension (HLE) compared to control group in maximal electroshock (MES) induced convulsions in rats. In PTZ model, treatment with coumarin extract produced significant prolongation of onset of myoclonic jerk, clonic seizure, HLE & exhibited a complete protection against mortality. The results demonstrated the anticonvulsant effect of the coumarin extract in zebrafish as well as rodent model of epilepsy. These studies endorse the antiepileptic effect of coumarin extract and its inclusion as a drug or drug adjuvant along with available drugs in management of epilepsy.

Natasa Radojkovic Gligic, received her medical degree from the Faculty of Medicine at the University of Belgrade in 1989. In 1994, she became a neurologist. Over the course of her career, she took part in many additional courses, most notably: A 6 month course in electroencephalography at the Institute of Neurology(1991), a pediatric and neonatal EEG course at the University Hospital for pediatrics (1996) and ultrasonography of main head and neck blood vessels and transcranial doppler training (2000). In regards to her work experience, she have worked from 1989 until 2002 at the General Hospital in Pozarevac. In 2002, she moved to the Hospital for cerebrovascular diseases “Sveti Sava” in Belgrade, and have been there since. Today, her work mainly revolves around the latest treatments of blood vessel thrombosis, thrombolysis and thrombectomy. Since 2008, she has published numerous research papers both domestically and internationally. In 2014 she obtained the title of a primarius, the highest domestic distinction for a clinical physician.

Annual incidence of status epilepticus puts it in the second place among neurological disorders (acute stroke, being the first), with high mortality risk. Occurrences of RSE have been mostly associated with acute, severe and potentially fatal underlying ethologies such as, encephalitis, massive stroke; or rapidly progressive brain tumors. This may be severe impairment of consciousness. In non-convulsive status epilepticus, brain is either continuously seizing or seizing so frequently that the patient never has a chance to recover from the period of extreme confusion that normally follows a seizure. This recovery period is called the post-octal state. Often, people in non-convulsive status epilepticus look like many other patients, who are unresponsive due to an encephalopathy. Firstly, we have to determine whether a patient really is seizing. Part of the reason is that NCSE is a relatively newly described occurrence, and by its nature it isn’t dramatically obvious as a convulsive status epilepticus. Treatment of NCSE is most commonly based either on benzodiazepine or an anesthetic agent.

Rena Orman, PhD is a Research Assistant Professor in the Department of Physiology & Pharmacology at the State University of New York Downstate Medical Center in Brooklyn. Her research is focused on neurophysiological and neuroanatomical evidence for regional and long-range circuit properties. Specific attention has been paid to evidence for laterality of circuit activity in subcortical structures such as amygdala and the properties of hippocampal formation circuits for the generation and spread of seizure activity.

The MORTality in Epilepsy Monitoring Unit Study (MORTEMUS) identified a consistent sequence of events in epilepsy patients beginning with a generalized tonic clonic seizure and ending in death. Ten (10) cases were used to establish that the end of the seizure was followed within minutes by terminal apnea and ultimately cardiac arrest. The MORTEMUS study used artifacts in EEG recordings as evidence of respiration. A critical finding in our experiments was that attempts to breathe during obstruction generated artifacts in EEG and ECG recordings that resembled artifacts associated with actual breaths. We demonstrate that the electrical artifacts of attempts to inspire during airway obstruction can be used as a practical biomarker of obstructive apnea. We show artifacts related to respiration on ECG and EEG recordings. Artifact size was highly correlated with peak inspiratory pressure. The specific biomarker is the upward trend in artifact size as a marker for increasing effort during airway obstruction. Bradyarrhythmia is present in most SUDEP patients and our animals. Our data show an abrupt change in RR interval variability and that the normal lengthening of the RR interval during inspiration could be reversed during the late occlusion period. This pattern represents a second biomarker for airway obstruction. These biomarkers can be applied to past cases and used to monitor patients to improve outcomes.