Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.


Teamwork aids management and raises new issues in epilepsy

Publications on epilepsy in 2018 have shed light on the aetiology and management of the condition and raised new questions. Translation from mechanisms to clinical practice, driven by cooperation among multiple fields, will be crucial to further advances.

Key advances

  • A longitudinal observational cohort study in newly diagnosed patients with epilepsy revealed that long-term outcomes have not improved with the introduction of new antiepileptic drug (AED) regimens1.

  • Mossy cells — key neurons in the hippocampal excitatory circuit — emerged as promising targets for new epilepsy treatments5.

  • A randomized trial of stereotactic radiosurgery (SRS) versus anterior temporal lobectomy in patients with mesial temporal lobe epilepsy indicated that SRS is a viable alternative to open surgery in selected patients6.

  • Advanced gene sequencing strategies that can detect parental mosaicism should allow more accurate genetic counselling of parents who have offspring with epileptic encephalopathies apparently caused by de novo mutations8.

  • An epidemiological study found that the incidence of sudden unexpected death in epilepsy (SUDEP) in children was comparable to that in adults, suggesting that SUDEP in the paediatric population is more common than previously thought10.

This is a preview of subscription content, access via your institution

Access options

Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.


  1. Chen, Z. et al. Treatment outcomes in patients with newly diagnosed epilepsy treated with established and new antiepileptic drugs: a 30-year longitudinal cohort study. JAMA Neurol. 75, 279–286 (2018).

    Article  Google Scholar 

  2. Chi, X. et al. Response to treatment schedules after the first antiepileptic drug failed. Epilepsia 59, 2118–2124 (2018).

    Article  CAS  Google Scholar 

  3. Gunning, B. et al. Cannabidiol in patients with seizures associated with Lennox–Gastaut syndrome (GWPCARE4): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet 391, 1085–1096 (2018).

    Article  Google Scholar 

  4. Tomson, T. et al. Comparative risk of major congenital malformations with eight different antiepileptic drugs: a prospective cohort study of the EURAP registry. Lancet Neurol. 17, 530–538 (2018).

    Article  CAS  Google Scholar 

  5. Bui, A. D. et al. Dentate gyrus mossy cells control spontaneous convulsive seizures and spatial memory. Science 359, 787–790 (2018).

    Article  CAS  Google Scholar 

  6. Barbaro, N. M. et al. Radiosurgery versus open surgery for mesial temporal lobe epilepsy: the randomized, controlled ROSE trial. Epilepsia 59, 1198–1207 (2018).

    Article  Google Scholar 

  7. Yu, T. et al. High-frequency stimulation of anterior nucleus of thalamus desynchronizes epileptic network in humans. Brain 141, 2631–2643 (2018).

    PubMed  Google Scholar 

  8. Myers, C. T. et al. Parental mosaicism in “de novo” epileptic encephalopathies. N. Engl. J. Med. 378, 1646–1648 (2018).

    Article  Google Scholar 

  9. Bailey, J. N. et al. Variant intestinal-cell kinase in juvenile myoclonic epilepsy. N. Engl. J. Med. 378, 1018–1028 (2018).

    Article  CAS  Google Scholar 

  10. Keller, A. E. et al. Incidence of sudden unexpected death in epilepsy in children is similar to adults. Neurology 91, e107–e111 (2018).

    Article  Google Scholar 

Download references


The author’s work is supported by grant no. 81420108014 from the National Foundation of Natural Science of China.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Dong Zhou.

Ethics declarations

Competing interests

The author declares no competing interests.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Zhou, D. Teamwork aids management and raises new issues in epilepsy. Nat Rev Neurol 15, 66–67 (2019).

Download citation

  • Published:

  • Issue Date:

  • DOI:


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing