Irish scientists help in study that may prevent epilepsy after sudden brain injury

Dr Tobias Engel, senior lecturer in the RCSI Department of Physiology and Medical Physics said the research has 'the potential to prevent epilepsy before it develops, sparing patients from seizures and the burdens of ongoing medication'.

It may be possible to prevent epilepsy developing after a sudden brain injury, “exciting” new research involving Irish scientists has discovered.

Sudden brain injuries often lead to the person developing post-traumatic epilepsy, with up to 50% of these patients facing this devastating long-term complication.

The researchers discovered a receptor in the brain which helps transfer signals to the brain has a key role to play in this situation. They are hopeful that better understanding how this works could help reduce risks and predict who is most at risk.

This is vital as up to 30% of patients with this type of epilepsy do not respond to medication. They are left suffering with frequent seizures, tiredness, irritability and their quality of life is reduced.

When this particular receptor (P2X7) was blocked shortly after injury, they found it significantly reduced brain hyperexcitability, minimised brain damage, and improved behaviour.

The team includes Irish sites such as the Royal College of Surgeons Ireland (RCSI) as well as teams in Germany, Spain and China.

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Dr Tobias Engel, senior lecturer in the RCSI Department of Physiology and Medical Physics said: “Traumatic brain injury is a major cause of epilepsy in adults, with many patients unable to benefit from existing anti-seizure treatments.” 

Dr Engel, who is also an investigator with FutureNeuro, the Research Ireland Centre for Translational Brain Science, described the receptor as “a promising new target”.

It has “the potential to prevent epilepsy before it develops, sparing patients from seizures and the burdens of ongoing medication", he said.

They also used a PET scan to track activity of the P2X7 receptor. The team identified uptake by the brain of this receptor correlated with risks of seizures some weeks later.  It means doctors could identify anyone at risk at a much earlier stage and give more suitable treatment.

Dr David Loane, Associate Professor in Neuroscience at Trinity College Dublin, said this is really important for patients.

“While additional research is required to confirm our findings and explore their application in clinical settings, we’ve made a significant step forward in addressing the unmet need for early intervention in post-traumatic epilepsy”, he said.

Reacting to the news, Epilepsy Ireland CEO Peter Murphy said this is “an exciting discovery” for patients. “A diagnosis of epilepsy can be extremely difficult for a person,” he said.

Not only is there the impact from having seizures, but there are invisible impacts such as side-effects from medications, being restricted from driving and there can be social isolation stemming from a person's anxiety as to how their epilepsy may be viewed or responded to by the public. 

This discovery could lead to epilepsy being prevented after traumatic brain injury. He said this would shield against “the known and unknown challenges that a diagnosis can bring” for patients.

“We look forward to seeing what this research leads to and would like to congratulate everyone involved, particularly our colleagues at FutureNeuro, for their work on this exciting discovery,” he said.

The paper can now be read in the journal Theranostics.