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Is there a fast, simple way to measure whether someone with epilepsy is doing "better" or "worse" compared with a past clinic visit? Not really. Seizure count is often considered a standard, but multiple small seizures may have less impact on someone's life than a single generalized tonic-clonic seizure. In this episode, we talk with authors of a study on an outcome measure that factors the impact of seizures as well as the impact of treatments.

The study: Validation of the seizure-related impact assessment scale 

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

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Closing the epilepsy treatment gap relies heavily on social and cultural acceptance of epilepsy as a brain disorder that can be managed with medication or other therapies. Dr. Rugare Mugumbate discusses the five disadvantages faced by people with epilepsy, as well as the important role of social workers and the need to focus on lessons learned from previous pilot projects and awareness campaigns.

Dr. Mugumbate's book - Epilepsy in Resource Limited Settings: Managing Quality of Life - provides a thorough examination of the impact and understanding of epilepsy in resource-limited areas.

Aimed at a wide variety of health practitioners and stuents, The book is available in multiple formats.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

Somatic genetic epilepsies arise from mutations that occur early in fetal development. They are usually only detectable by genetic sequencing of tissue. For these epilepsies, the timing of the mutation is key: For example, research has shown that focal cortical dysplasia type IIB and hemimegaloencephaly are genetically the same disease, but arise from somatic mutations at different developmental time points. This relatively new area of research is discussed by Dr. Alina Ivaniuk and Dr. Christian Bosselmann.

Resources:

Analysis of 1,386 epileptogenic brain lesions reveals association with DYRK1A and EGFR (Nature Communications 2024 - C. Bosselmann et al.)

Neocortical development and epilepsy: Insights from focal cortical dysplasia and brain tumours (The Lancet Neurology 2021 - I. Blumcke et al.)

Contribution of somatic Ras/Raf/Mitogen-activated protein kinase variants in the hippocampus in drug-resistant mesial temporal lobe epilepsy (JAMA Neurology 2023 - S. Khoshkhoo et al.)

Somatic mosaicism and neurodevelopmental disease (Nature Neuroscience 2018 - AM D'Gama and CA Walsh)

BRAF somatic mutation contributes to intrinsic epileptogenicity in pediatric brain tumors (Nature Medicine 2018 - HY Koh et al.)

SLC35A2 loss-of-function variants affect glycomic signatures, neuronal fate and network dynamics (Brain 2025 - D Lai et al.)

Precise detection of low-level somatic mutation in resected epilepsy brain tissue (Acta Neuropathologica 2019 - NS Sim et al.)

Toward a better definition of focal cortical dysplasia: An iterative histopathological and genetic agreement trial (Epilepsia 2021 - I Blumcke et al.)

Seizure outcome and use of antiepileptic drugs after epilepsy surgery according to histopathological diagnosis: A retrospective multicentre cohort study (The Lancet Neurology 2020 - HJ Lamberink et al.)

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

In a retrospective study of 31 patients with highly refractory epilepsy, 29% had more than a 50% reduction in seizures for at least 12 months after being treated with immunotherapy. Three of these patients became seizure free. Other than a trend toward a diagnosis of focal epilepsy, researchers did not identify any specific features predictive of treatment response. Sharp Waves spoke with the first author about the study and its implications.

The study was published in Epilepsia in April 2025.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

What are variants of uncertain significance (VUS) in epilepsy genetic testing? How are they defined, and can those definitions change over time? Sharp Waves talks with Dr. Gemma Carvill as part of our genetic testing series.

RESOURCES

Standards for interpreting variants (American College of Medical Genetics)

Gene Reviews

ClinVar

GeneMatcher

Gnomad

ClinGen

ILAE genetic literacy series

EpiPred website for STXBP1 (developed by EpiMVP project - will be final by end of July)

Think Genetics paper – genetic testing in South Africa project

Link to Sharp Waves episode on genetic testing in LMICs

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

This episode covers a wide scope of issues, including treatment options, treatment response, prognosis and the role of seizures versus the underlying etiology, most common etiologies for different age groups, new-onset refractory status (NORSE), and the prevalence and special considerations of non-convulsive status epilepticus.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

In use since the 1970s, valproate is highly effective for genetic generalized epilepsies and some forms of pediatric epilepsy. The medication also is associated with a 10% risk of birth defects in children exposed to it in utero, as well as a 30% to 40% risk of neurodevelopmental issues, including autism. Sharp Waves spoke with Dr. Tony Marson about the reproductive risks for women and men taking valproate, discussing UK policies meant to ensure appropriate prescription of valproate and communication about its risks. The recent policy regarding men who take valproate, and the evidence used to support that policy, is discussed near the end of the episode.

Since the episode was recorded, the UK has changed its policy regarding men taking valproate; see this link for more information: February 2025 update on valproate policy in the UK

UK Drug Safety Update page - June 2025

February 2025 update on valproate policy in the UK

Regulatory safety and educational materials on valproate - for health care professionals and patients

Public assessment report: Managing reproductive risks in males under 55 taking valproate

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

ILAE's updated seizure classification position paper was published in Epilepsia in April 2025. Sharp Waves talked with Dr. Sandor Beniczky about the updates and how they will impact research and clinical care.

The position paper is open access and available online.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

Seizures cost Stacia Kalinoski her career in broadcast journalism and forced her to give up running. In her new memoir, Kalinoski recounts her journey from first seizure in college to epilepsy surgery years later, describing her seizures, struggles with medication, and challenges coming to terms with her epilepsy.

Kalinoski's book, Racing Uphill, is available July 1, 2025 and can be ordered or pre-ordered online.

Stacia Kalinoski is an Emmy Award–winning TV news journalist from the United States whose documentary Brainstorm was nominated for a regional Emmy Award. Before a seizure ended her broadcast journalism career, she reported for television stations in Nebraska, Oregon, and Michigan. She now shares her story as a motivational speaker.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

Work-related stress and burnout are common in physicians, with rates of burnout estimated between 25% and 60%. These stresses impact physician health, patient care, and health care systems as a whole. Sharp Waves spoke with Dr. Sheryl Haut about strategies to identify work stress and mitigate burnout.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

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Microglia can have protective and also potentially harmful effects in the brain. They seem to be involved in dampening the nervous system during acute seizures – but also appear to play a role in neuronal loss and cortical thinning. Dr. Cecilie Nome spoke with Dr. Amy Brewster about the many faces of microglia and the current understanding of their role in epilepsy and seizures.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

Many of the most common concerns of people with epilepsy are topics they don't usually talk about with physicians. This is one of many findings of a study using AI to analyze more than 55,000 posts about epilepsy on Reddit. Sharp Waves spoke with the study's first author and two epilepsy advocates about the results and how they could help initiate important patient-provider conversations. 

PLEASE NOTE: This episode includes discussion of suicidal ideation. If you are in crisis, call your local emergency number or crisis hotline.

The Reddit study is freely available online; no journal subscription is required:

Bridging the conversational gap in epilepsy: Using large language models to reveal insights into patient behavior and concerns from online discussions - Fennig - 2025 - Epilepsia 

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

Music can affect emotions, spark memories, and influence mood. In cases of musicogenic epilepsy, music can trigger seizures. In other cases, music may reduce seizure frequency. Dr. Cecilie Nome talks with Dr. Phillip Pearl and Prof. Nigel Osborne about the power of music and its effects on the brain.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Links:

Nigel Osborne - Wikipedia

Personalised music as a treatment for epilepsy - Epilepsy & Behavior

Neuroscience and “real world” practice: music as a therapeutic resource for children in zones of conflict - Osborne - 2012 - Annals of the New York Academy of Sciences - Wiley Online Library

X-System Overview 

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

In lower- and middle-income countries, raising awareness of genetic etiologies in epilepsy and genetic testing options may ultimately shift national priorities toward making genetic testing part of the standard of care. Dr. Parthvi Ravat spoke with Dr. Jo Wilmshurst and Dr. Alina Esterhuizen about initiatives to increase awareness of genetics and genetic testing in epilepsy, including a decision tree model for epilepsy care in resource-restricted settings that has been implemented in Africa.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Publication mentioned in the episode:

Precision medicine for developmental and epileptic encephalopathies in Africa—strategies for a resource-limited setting 

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

As a neurological emergency, status epilepticus (SE) requires timely diagnosis and treatment. A US study found that 10% of people with SE were not diagnosed by emergency services. Among those who were diagnosed in an ambulance, 20% did not receive any first-line treatment, while others received lower-than-recommended doses. Sharp Waves spoke to senior author Dr. Elan Guterman about the study.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Publications mentioned during the conversation:

Status Epilepticus Identification and Treatment Among Emergency Medical Services Agencies  JAMA Neurology 

A Comparison of Lorazepam, Diazepam, and Placebo for the Treatment of Out-of-Hospital Status Epilepticus | New England Journal of Medicine

Paramedic-Identified Enablers of and Barriers to Pediatric Seizure Management: A Multicenter, Qualitative Study: Prehospital Emergency Care

Emergency response to out-of-hospital status epilepticus | Neurology

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

Folic acid supplementation is recommended for all women with epilepsy who may become pregnant. However, there is no agreed-upon dose for women with epilepsy taking antiseizure medication, and there may be risks of high-dose (>1 mg/day) folic acid supplementation. Dr. Bruna Nucera spoke with Dr. Marte Helene Bjørk about the risks and benefits of folic acid supplementation and what this means for pregnant women with epilepsy.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

High-frequency oscillations (80 to 500 Hz) are being studied as biomarkers of epileptogenic areas in the brain, as well as markers to be used in epilepsy surgery. Dr. Cecilie Nome leads a discussion about clinical research on HFOs and areas of uncertainty, as well as the importance of basic research in helping to understand this phenomenon.

Publications mentioned during the episode: 

Roehri Eng N, et al. High-frequency oscillations are not better biomarkers of epileptogenic tissues than spikes. 2017. Annals of Neurology

Jacobs J, et al. Removing high-frequency oscillations: A prospective multicenter study on seizure outcome. 2018. Neurology

Zweiphenning W, et al. Intraoperative electrocorticography using high-frequency oscillations or spikes to tailor epilepsy surgery in the Netherlands (the HFO trial): a randomised, single-blind, adaptive non-inferiority trial. 2022. Lancet Neurology

Lisgaras CP et al. High-frequency oscillations (250–500 Hz) in animal models of Alzheimer's disease and two animal models of epilepsy. 2022. Epilepsia

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

There are potentially hundreds of "epilepsy genes" - but what is an epilepsy gene? How do researchers discover these genes and associate them with epilepsy? Sharp Waves spoke with Dr. Allan Bayat, a pediatric neurologist in Denmark focused on rare monogenic neurodevelopmental disorders and epilepsy.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

In the second episode of our genetics and epilepsy series, Sharp Waves explores how genetic insights can inform considerations and outcomes of epilepsy surgery. Dr. Alina Ivaniuk interviews Dr. Patrick Moloney, currently an epilepsy genomics fellow at the Chalfont Center for Epilepsy at University College London.

Selected publications:
Do germline genetic variants influence surgical outcomes in drug-resistant epilepsy? Epilepsy Res 2024

Genomics in the presurgical epilepsy evaluation. Epilepsy Res 2022

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

This first episode in a multipart series on genetics in epilepsy covers the basics of genetic testing. Dr. Alina Ivaniuk interviews Dr. Ilona Krey, a physician and researcher at the Institute of Human Genetics at Leipzig University Medical Center.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

Christina Rezek and Brad Levy each have daughters who underwent epilepsy surgery, with dramatically different results. Sharp Waves talked with them about the journeys to and through epilepsy surgery, the consequences, and what they have learned.

Brad Levy is a founder of Epilepsy Awareness Day at Disneyland, a free event held every November in Anaheim, California, USA. Visit epilepsyawarenessday.org for more information.

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

Sharp Waves spoke with a neurologist and a cardiologist who are part of a team researching the interactions among seizures, heart function, heart health, and SUDEP. Learn more about their research.

Selected publications from Drs. Lin & Fialho and colleagues:


Determining factors of electrocardiographic abnormalities in patients with epilepsy: A case-control study (2017, Epilepsy Research)

Maximal/exhaustive treadmill test features in patients with temporal lobe epilepsy: Search for sudden unexpected death biomarkers (2017, Epilepsy Research)

Echocardiographic risk markers of sudden death in patients with temporal lobe epilepsy (2018, Epilepsy Research)

Increased cardiac stiffness is associated with autonomic dysfunction in patients with temporal lobe epilepsy (2018, Epilepsia)

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

In this episode, we explore the science behind exercise as an adjunct treatment for epilepsy and debunk some common myths (spoiler alert: With very rare exceptions, exercise does NOT increase seizure risk). Dr. Ayushe Sharma talked with Dr. Jane Allendorfer, Dr. Halley Alexander, and Brian Wiedmeyer, who participated in an exercise research study.

The episode refers to a 2016 report by the ILAE Task Force on Sports and Epilepsy - that report is freely available online at this link.

Some of the other research papers mentioned in the episode are listed below.

The relationship between physical activity and cognitive function in people with epilepsy: A systematic review

Effects of physical exercise in people with epilepsy: A systematic review and meta-analysis

Role of Physical Exercise as Complementary Treatment for Epilepsy and other Brain Disorders

Epilepsy and exercise: An experimental study in female rats

Effects of an exercise program on health of people with epilepsy: A randomized clinical trial

A strength exercise program in rats with epilepsy is protective against seizures

Effectiveness of Yoga Intervention in Reducing Felt Stigma in Adults With Epilepsy

Impact of exercise as a complementary management strategy in people with epilepsy: A randomized controlled trial

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

A recent practice guideline provides updated evidence-based conclusions and recommendations regarding in utero effects of anti-seizure medications and folic acid supplementation on the prevalence of major congenital malformations, adverse perinatal outcomes, and neurodevelopmental outcomes. Dr. Parthvi Ravat interviewed Dr. Alison Pack about the guideline, which was produced by the American Academy of Neurology, American Epilepsy Society, and Society for Maternal-Fetal Medicine.

Review the practice guideline: Teratogenesis, perinatal, and neurodevelopmental outcomes after in utero exposure to antiseizure medication (Neurology, May 2024)

Other studies mentioned in the episode:
Risk of major congenital malformations and exposure to antiseizure medication monotherapy (JAMA Neurology, March 2024)

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

Send comments and feedback

Some historic names for epilepsy have been derogatory and stigmatizing. An older term for “epilepsy” in Malay means “mad pig disease.” Neurologists in Malaysia collaborated to change the word to a medically accurate term. Sharp Waves spoke with Dr. Chong Tin Tan about the origins of the older term and how the new term was introduced.

Resources:
Name of epilepsy: Does it matter? - 2012 - Neurology Asia

Announcement of a new Chinese name for epilepsy - Lau - 2011 - Epilepsia 

Changing name of epilepsy in Korea; cerebroelectric disorder (noi‐jeon‐jeung,뇌전증,腦電症) - Kim - 2014 - Epilepsia

Renaming Korean epilepsy: Where are we? - Epilepsy & Behavior 

Awareness, knowledge and attitude towards epilepsy in Malaysia: A perspective of undergraduates in a private university | African Journal of Neurological Sciences 

Overcoming the stigma of epilepsy in Asia // International League Against Epilepsy 

Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.

Let us know how we're doing: podcast@ilae.org.

The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.