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From the National Institute of Neurological Disorders and Stroke (Drs. Rogawski and Theodore, and M.P. Jacobs), NIH, Rockville, MD; Department of Epidemiology and Biostatistics (Dr. Davis), George Washington University School of Public Health and Health Services, Washington, DC; Department of Neurology (Dr. Dichter), University of Pennsylvania, Philadelphia; Department of Pharmacology (Dr. Dingledine), Emory University School of Medicine, Atlanta, GA; Harvard Medical School (Dr. Lowenstein), Boston, MA; College of Physicians and Surgeons (Drs. Fischbach and Morrell), Columbia–Presbyterian Medical Center, New York, NY; Department of Neurology (Dr. Noebels), Baylor College of Medicine, Houston, TX; and the Department of Neurology (Dr. Spencer), Yale University School of Medicine, New Haven, CT.
Address correspondence and reprint requests to Ms. Margaret Jacobs, NINDS, Suite 2138, 6001 Executive Boulevard, Rockville, MD 20892.
The authors propose that epilepsy research embark on a revitalized effort to move from targeting control of symptoms to strategies for prevention and cure. The recent advances that make this a realistic goal include identification of genes mutated in inherited epilepsy syndromes, molecular characterization of brain networks, better imaging of sites of seizure origin, and developments in seizure prediction by quantitative EEG analysis. Research directions include determination of mechanisms of epilepsy development, identification of genes for common epilepsy syndromes through linkage analysis and gene chip technology, and validation of new models of epilepsy and epileptogenesis. Directions for therapeutics include identification of new molecular targets, focal methods of drug delivery tied to EEG activity, gene and cell therapy, and surgical and nonablative therapies. Integrated approaches, such as coupling imaging with electrophysiology, are central to progress in localizing regions of epilepsy development in people at risk and better seizure prediction and treatment for people with epilepsy.
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