Free Radicals and Antioxidants: Opportunities for Enhancing Treatment of Epilepsy with Personalized Medicine

Introduction: Epileptic seizures and antiepileptic drugs (AEDs) are a source of oxygen stress. Oxygen stress can have negative effects. These effects which can be prevented are largely unknown in clinical epileptology. Objective: The objective of the study is to discuss (a) homeostatic oxidant, antioxidant imbalance due to epileptic seizures and AEDs, (b) the protective factors that help prevent oxygen stress (OS), and personalized medicine based on pharmacogenomics and diet as therapeutic challenges in epilepsy. Discussion: Experimental models of epileptic seizures evoked by various means suggest that seizures can cause neuronal destruction. This is accompanied by an increased activity of free radicals and a reduction of total antioxidant capacity (in red blood cells, blood serum, and cerebrospinal fluid). A number of antioxidants have been found to attenuate the negative effects of OS and act neuroprotectively if they are administered prior to seizure occurrence: vitamins (C, E), trace elements (Se, Zn), melatonin, erdosteine, or natural herbal extracts. New AEDs (GBP, LEV, LTG, and TGB) cause no, or very little, OS as opposed to other drugs (CBZ, PHT, PB, VPA, TPM, or OXC), which have pronounced albeit heterogeneous and dose-dependent effects. It is suggested that AEDs should be administered together with free radical sweepers (vitamins, trace elements, electrolytes, melatonin) and other anti-oxidizing substances. Conclusions: (1) Epileptic seizures and AEDs cause OS. The effects vary greatly depending, among other things, on the daily drug dose. (2) The findings of research using a variety of seizure models are more unequivocal than the findings of research on patients with epilepsy. This suggests that the relations among seizures, AEDs, OS etiology, and OS consequences are complex. (3) Since existing AEDs cause OS, it is necessary to develop a new approach to AED treatment. (4) It is important to know the patient’s specific characteristics, including previous history, lifestyle, age, gender, weight, diet, environment, etc. They can be valuable tools to improve the quality of life of a person suffering from epilepsy. This concept of managing the patient health is called targeted medicine or personalized medicine

Reactive Oxygen Species and Selenium in Epilepsy and in Other Neurological Disorders

Oxidative stress has been implicated in epilepsy and various neurodegenerative disorders. In this review, we elaborate oxidative stress-mediated neuronal loss and assess the role of selenium in some neurological disorders including epilepsy. Selenium as an essential trace element has attracted the attention of many researchers because of its potentialities in human health. It has an important role in the brain, immune response, defense against tissue damage, and thyroid function. Selenium forms part of the active site of the peroxide-destroying enzyme glutathione peroxidase (GSHPx), and it also has other functions, for example in biotransformation and detoxification. Functional and clinical consequences of selenium deficiency states in neurological diseases have been described, and the selenium requirement, which is influenced by various processes, has been discussed. Wide variations have been found in selenium status in different parts of the world, and populations or groups of patients exposed to marginal deficiency are more numerous than was previously thought. Chronic diseases, such as neurological disorders, heart disease, diabetes, cancer, aging, and others, are reported to associate with markers of oxidative damage. It is, therefore, not unreasonable to suggest that antioxidants would alleviate the oxidative damage, resulting in health improvements. In recent years, accumulated evidence in nutrigenomics, laboratory experiments, clinical trials, and epidemiological data have established the role of selenium in a number of conditions. Most of these effects are related to the function of selenium in the antioxidant enzyme systems. Current research activities in the field of human medicine and nutrition are devoted to the possibilities of using selenium as an adjuvant for the treatment of degenerative or free radical diseases such as neurological disorders, inflammatory diseases, and cancer

Personalized Management of Selected Neurological Disorders

Neurological disorders are medically complex diseases that affect the central and peripheral nervous systems. They can affect an entire neurological pathway or a single neuron. Some neurological problems can present years after a causative event. The World Health Organization reports that various types of neurological disorders affect millions of people around the world. So far, there are no therapies available to cure these disorders. Pharmacological and non-pharmacological interventions can at best relieve symptoms and perhaps delay the progression of the disease. However, there are a wide variety of helpful treatments for different disorders that may help an individual to learn better social skills and communication cues, in order to help them be able to interact socially, in a more natural fashion. For some neurological issues, the outlook can be quite good with treatment and adequate rehabilitation. Diet also plays an important role in the prevention of late-life cognitive decline. Deficits in cognition, low dietary quality and physical functioning, and cardio-metabolic risk factors are frequently reported in patients with neurological disorders. In this chapter we will briefly discuss research, as well as current opportunities and future prospects towards personalized medicine in relation to selected neurological disorders and diseases such as Down syndrome, neuronal ceroid lipofuscinoses (NCLs), and multiple sclerosis (MS)