Epilepsy affects between 50 and 75 million people in the world, 6 million in Europe, around 500,000 in Italy and in addition to the relevant medical implications it can have an impact on the psychological well-being and social aspects of people’s lives. The causes are different and in 30% of cases the disease is drug-resistant. But today there are effective treatments for patients and important steps forward have been made towards precision medicine. This was underlined by Giuseppe Zaccaria, president of the Association Fuori dall’Ombra Insieme per l’Epilessia, on the occasion of International Epilepsy Day which is celebrated on 12 February.
“Ignorance must be defeated – says Zaccaria -. It is necessary to remove the stigma that the diagnosis of epilepsy still carries with it and which causes discrimination and mistrust in the different worlds in which people affected by epilepsy live; to inform and update on the progress achieved in understanding the pathophysiological mechanisms of the disease and the treatment options. We need to talk about epilepsy at all levels, with the affected person, with his family, at the level of civil society; it is a fundamental element to clear the pathology and to break down the knowledge that limits and has severely limited the lives of people with this disease.” Research in the field of epileptology has made giant strides since the middle of the last century. Currently, in approximately 70% of cases, the available therapies are adequate, allowing excellent control of epileptic seizures and a favorable prognosis. However, the problem of drug resistance and relapses remain to be resolved. In the treatment of epilepsy we are moving towards precision medicine, an increasingly individualized medicine, based on the sex, age, general condition of the patient and the underlying cause.
Great advances are being made, for example, in the field of immunology and genetics of epilepsy, explains Stefano Sartori, pediatric neurologist and epileptologist at the Pediatric Clinic of the University Hospital of Padua: “A significant portion of the epilepsies that occur at an older age childhood and pediatric more generally is due to genetic defects. The identification of a specific genetic basis can favor the choice of the most effective anti-seizure drugs in that specific condition and lays the foundations for future etiological therapies, that is, which act directly on the cause underlying, as already happens in other genetically determined neurological diseases”. Great attention is also paid to the role of neuroinflammation in epileptology. Drugs directed against neuroinflammation “could represent the future of the treatment of some forms of epilepsy – adds the expert -. Another aspect that remains crucial and of the foreground for the treatment of the disease is surgery which, in selected cases, can guarantee healing or a significant reduction in seizures”.
For this reason, he concludes, “it is important to establish epilepsy surgery centers in the various regions for both pediatric and adult age. A shared commitment is needed”.
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