The Latest Stem Cell Therapy and Epilepsy

ARTICLE HIGHLIGHTS

  • Stem cell therapy for epilepsy is a possible treatment option in the future.
  • Stem cell therapy may prove useful for:
    • Improving seizure control
    • Improving memory issues
    • Stem cell therapy is not yet approved for the treatment of epilepsy- the safety and effectiveness of such treatment has to be thoroughly studied and approved by the FDA.

INTRODUCTION

There are many exciting areas in epilepsy research. One topic of great interest is the use of stem cells to treat seizures. Although stem cell research related to epilepsy is in its early stages, preliminary data would suggest promise for this treatment option. The writing of this article has been prompted by several people in clinic and on our Facebook page asking for information on stem cell therapy for epilepsy. The goals of this article are to: 1) provide a basic understanding of stem cell therapy; and 2) to review stem cell therapy in epilepsy.

WHAT IS A STEM CELL? HOW DO STEM CELLS STOP SEIZURES?

When an organism (a human, mouse, etc) is developing, the organism will start as a single fertilized cell. This cell will begin dividing. As the cells divide, groups of cells are programmed to form parts of the body- heart, lungs, skin and brain, for example. These early dividing cells are called stem cells. Stem cells are cells that have the ability to develop into a wide variety of cell types. Some stem cells have the potential to become any cell type in the body. Cell types include muscle cells, skin cells or brain cells, such as neurons. In addition, stem cells have the special ability to renew themselves for long periods of time.

It has been shown that stem cells can be transplanted into the brain and produce functioning neurons. One strategy for the use of stem cells in neurological conditions is to transplant stem cells into abnormally functioning brain tissue—this will allow the stem cells to develop into normally functioning brain cells and produce normal brain function.

Illustrative case: Consider a patient with a small area of scarring in her left temporal lobe. Her seizures are coming from that area of scarring. This area of scarring has very abnormally functioning neurons. Properly functioning neurons are supposed to have a nice normal flow of electricity, from one neuron to the next. In our patient’s area of scarring, the neurons are electrically abnormal—the electrical charge is way too high. This abnormal electrical activity can lead to spreading electrical charge that results in a seizure (see our article “What is a seizure?” for details). Now, imagine that you could place stem cells in her brain in the area of scarring. This would result in relatively normal cells replacing the abnormal cells. Instead of excessive electrical activity, you would have normal electrical activity. Because the neurons are now functioning properly and not causing excessive electricity, the seizures are stopped! That is the hope of how stem cells could work.

TYPES OF STEM CELLS

Photo credit: digitalart @ freedigitalphotos.net

Embryonic stem cells: Cells derived from embryos. An embryo is defined as a young animal (human, mouse, etc), early in the stages of development within the womb.

Adult stem cells: The study of adult stem cells for clinical use has been prompted for several reasons, including the ethical issues related to the use of embryonic stem cells. In 2006/2007, researchers identified conditions that would allow some specialized adult skin cells to be “reprogrammed” into stem cells. This is almost like turning the clock back in time—adult cells are reverted to an early stage in cell development—the stem cell. The stem cell could then be used to create a variety of different types of cells (heart cells, brain cells, etc).

This discovery leads to a great hope! Imagine this futuristic treatment plan: 1) patients could have some of their own skin cells removed; 2) skin cells are reverted to stem cells; 3) these stem cells are placed into the patient’s brain – they become normally functioning brain cells and replace the neurons that caused seizures; 4) seizures are stopped! Obviously, this is not reality at this time—but the potential is very exciting!

POSSIBLE WAYS THAT STEM CELLS COULD HELP PEOPLE WITH EPILEPSY (Shetty, Stem Cells, 2007):

  • Replace neurons that are lost or dysfunctional- to stop seizures: It has been shown that patients with chronic epilepsy can have a reduced number of neurons in the area where their seizures originate (= the seizure focus). Also, the neurons in the region of the seizure focus may not function correctly – for example, they may be overly electrically active. This abnormally high electrical activity is what can produce seizure activity. Stem cells could be transplanted into the area of the seizure focus and replace the lost or abnormal neurons. The stem cells could be programmed to become normally functioning neurons. By replacing the abnormal function with the normal function, the potential for seizure activity could be potentially erased. This method to use stem cells is similar to the example described above (see above section: Illustrative case).
  • Replace neurons that are lost or dysfunctional- to help memory: Some patients with epilepsy have memory complaints. There are a multitude of possible reasons for people with seizures to have memory issues- medication side effects, seizure activity, and mood problems are commonly identified causes. Some patients have memory problems related to losing neurons or  dysfunctional neurons in the area of the seizure focus. By replacing the lost or dysfunctional neurons with normally functioning neurons derived from stem cells, memory problems could be potentially significantly improved.
  • Transplant stem cells that have the ability to produce a chemical to stop seizures: Stem cells can be programmed to become neurons that produce a neurotransmitter called GABA. This is a chemical which can stop the overly active neuronal function that can produce seizures. GABA results in inhibition of neurons (opposes the excitation of dysfunctional neurons). If stem cell derived neurons could produce a high quantity of GABA and were placed in the area where seizures started (seizure focus), the seizures could be stopped before they started!

SAFETY ISSUES AND STEM CELLS (Naegele, Neuropharmacology, 2010)

There are several challenges that need to be worked out before stem cell therapy will be widely considered as safe:

  • Stem cells can lead to the development of tumors. As noted above, stem cells have the ability to renew themselves for a long-term. This is a good thing- by continuously dividing, stem cells can produce a supply of new cells for therapy. An important negative- the long-term dividing process can lead to the development of tumors, in some cases. This issue is being studied. This issue needs to be considered safe before widespread clinical use will be possible.
  • Stem cells can lead to rejection by the body’s defense system. When stem cells are placed into the brain, there is the potential for the body’s immune system to have a reaction to the stem cells- as if the stem cells are an infection that the body needs to get rid of. This can lead to the stem cells being cleared away by the body’s immune system. Obviously, the stem cells will not be able to provide therapy if this occurs. Again, this issue is being studied.

CAN CLINICIANS PRESCRIBE STEM CELL THERAPY FOR EPILEPSY NOW?

The answer is no. Essentially all the research on stem cell therapy for epilepsy has been carried out in animal models (rodents, for example). There are currently no FDA approved stem cell therapies for epilepsy. In the coming years, large scale human studies using stem cell therapy for the treatment of epilepsy will hopefully be carried out. Such studies will look at the safety and effectiveness of such treatment. These studies will be necessary to obtain FDA approval- so that patients can receive stem cell therapy in the clinic setting. An important question is- when will stem cell therapy be approved by the FDA? The answer to this question is unknown, although experts in the field are hopeful for significant advances in the next 10 years.

CONCLUSIONS

Stem cell therapy is a promising treatment for patients with epilepsy. More studies need to be performed to determine the safety and effectiveness of this treatment. Hopefully, in the not too distant future, stem cell therapy could be offered as a treatment for our patients.

References

Naegele J, Maisano Xu, Yang Jia, Royston S, Ribeiro E. Recent advancements in stem cell and gene therapies for neurological disorders and intractable epilepsy. Neuropharmacology 2010;58:855-864.

Riban V, Fitzsimons HL, During MJ. Gene therapy in epilepsy. Epilepsia 2009;50:24-32.

Shetty AK, Hattiangady B. Concise review:prospects of stem cell therapy for temporal lobe epilepsy. Stem Cells 2007;25:2396-2407.

Stem Cell Information: NIH resource for stem cell research http://stemcells.nih.gov

Dr. White has been practicing as a full-time epileptologist since 1999. His practice focuses on optimizing the diagnosis and treatment of patients with seizure disorders. Dr. White’s special interests include patient education, improving the side-effect profile of seizure medications, and epilepsy surgery.

30 Responses to “The Latest Stem Cell Therapy and Epilepsy”

  1. Dr. White,

    What a great article! Thank you for taking the time to write it. It is very exciting to think that perhaps in the somewhat near future stem cells could not only help treat people with epilepsy, but from what I’ve read, perhaps a variety of hard to treat medical conditions. The hard part is waiting, and hoping they can overcome some of the obstacles standing in the way for it to actually be deemed as safe, approved by the FDA, and used as a feasible treatment option. To your knowledge are they currently implementing stem cell therapy in other countries?

    When you wrote in your article about the adult stem cells from skin being used, you mentioned that (potentially), “patients could have some of their own skin cells removed”. If they could find a way to create stem cells from the patient’s own skin, would this reduce (eliminate?) the chance that the body’s immune system would reject the stem cells?

    Thanks again for your time,
    Deb T.

  2. Thank you for your excellent comments Deb.

    Stem cell research for epilepsy and other neurological conditions is active in several countries outside of the United States. In my review of the literature, I did not see any approved therapies for stem cell use in epilepsy–in the US or outside of the US.

    I agree with your comment on the use of a patients own skin cells to produce stem cells. In theory, such cells would be less likely to produce an immune response. After all, these are cells that are from your own body (as you suggested).

    I really appreciate your reading our posts and your thoughtful comments!

  3. Why is it that not much is discussed on the topic of using adult placental cells? They seem to be quite effective for treating epilepsy without the risk of developing tumors. They do not require the use of immunosurpressing drugs, do not need to be “piggy backed” in on a dormant virus and are not synthesized or altered. I have looked for studies but have not had much success. Most trials have used embryonic, adult bone marrow, or adipose. I know for a fact that Placental cells, even from an unrelated donor can be very effective and a possitive theraputic tool in treating difficult epilepsy. Full term, elective C-Sections are performed quite often and from healthy donors who are willing to donate what is left as medical waste. Why are we not utilizing this resource in the USA and in Canada? Non invasive implant proceedures using placental stem cells can go a long way to helping the most fragile of populations of young and old, possibly saving thousands from risky surgery or ineffective medications with horrible side effects. For the folks and their families suffering with intractable or refractory epilepsy, what have we got to lose for trying this?

  4. Thank you Kim for your great comments. At this time, we are in the early stages of stem cell therapy for epilepsy. I agree- different options should be explored. The use of adult cells, especially cells that would not cause rejection, would be a great strategy. As time goes on, hopefully effective therapies will be developed.

  5. Dr. White; you made what is a difficult topic and turned it into a very “easy read”. Great work. I appreciate all your hard work as both a physician and a researcher. Utilizing N.I.H. as one of your many resources to pharmacology, gives me great confidence as a patient, knowing you tapped into all areas of academia and experience in providing the best possible information possible. Again, Great work.

    I know the timeline is well into the future for any and all Stem Cell protocols. Let us just hope that it is more of an immediate nature than longterm. “I believe it’s up to the Stem Cells themselves to give us that answer”..

    Thanks again, take care,

    Eric

  6. Your comments are very kind and much appreciated.
    Thank you!
    James R. White, MD

  7. Thank you Dr. White for your response to my earlier post from back in April. Our Daughter has had placental stem cell treatment (implants/ injections) She has undergone this treatment in 2010 and again in 2011. Our little girl was diagnosed with Intractable epilepsy and has suffered from tens of thousand of seizures since her birth. She has multiple seizure types and is on the Ketogenic diet. Currently right now her daytime seizures are well controlled but she is experiencing 10 to 12 Grand Mal Nocturnal seizures lasting one minute. We have seen quite impressive results with the placental therapy with both treatments. We can not afford to return for more at this point which breaks my heart because although her Doctors on the Ketogenic team do not see the theraputic value in the stem cell everyone else has, even her family doctor and her initial Neurologist before we were refered to the ketogenic diet program. We noticed many things after the stem cell that were intruiging and worth documenting; the keto diet she was on for five months prior to her first stem cell treatment started to work more efficiently, she quickly developed a “tickle” response she had never had, her posture and muscle tone improved dramatically enabling her to walk upright, she successfully came off 2 of three anticonvulsants, and up untill 6 months ago her seizures were down to 2-3 slight Grand Mal <1 minute/per week and for her that was tremendous. I have researched different stem cells, therapies and doctors and what lead me to deciding on Adult Placental Cells was that we were getting fresh not frozen cells that had the unique ability to act like embryonic cells with out the risk of tumour developement or rejection. Our daughter has not had any known ill effects from her treatment infact regular bloodwork consistantly confirmed she had excellent neutrophil levels and liver funtion. She had a status episode months after her first treatment. She went into status three times in 48 hours and after one week she enjoyed a period of being seizure free for a full week after. two weeks after status her seizures returned but at a much reduced intensitiy and frequency than before status occurance, we were later able to reduce meds and maintain good control. The positive effects of the adult placental stem cell seem to last the duration of about one year, after which, the epileptic condition ensuses causing `new`damage. For the duration of that year though our daughter makes consistant, and remarkable gains, not just in seizure reduction but across the board. Her overall function, strength, mood, attention, skin colour, circulation, renewed curiosty and interest. Really many many improvements are noted till that tipping point of about a year when the theraputic effects of the treatment begin to waine. I do beleive if we could afford this treatment as a scheduled annual event her Intractable Epilepsy would be much less taxing on both our health care system but also on our daughter and our family. Intractable Epilepsy as I trust you are aware, has great cost and burden to families that survive it! There seems no to be a cure and no reasonable effective management. Placental Stem Cell has offered us hope as has the diet and that two is unproven as to it`s mechanism but it is being used in Canada and the USA, why not adult stem cell. I wish I had more pull. I would like to see this therapy covered even available to our daughter in our own country. It is very frustrating to find something that yields success and than find it unattainable to continue with.

    • hello kim, i am wondering where you recieved this treatment for your daughter. my ddaughter has uncontrolled epilepsy and is. rapidly geting worse, less all round function,using less words, increasing seizure activity. we have exhausted all options as far as treatment is concerned here in Australia. we are starting to get very desperate.

    • Carmen dorschner July 31, 2013 at 11:02 pm

      Where did you go for this treatment?and what do you know about Dr.William c. Rader?

  8. Thank you Dr White for your article. I found it very useful.

  9. Kim my heart goes out to your little girl and I wish her the best life has to offer. I have been epileptic since childhood with lots of accidents, cuts and burns. I’m now a mother to three children. I don’t remember life without epilepsy but I thank God everyday and keep praying that someday I will be healed completely and I wish the same for your special little girl.

  10. Dear Kim and Dr White,

    Thank you Dr. White for doing all this research for the good of our sons.

    Thank you Kim for sharing your experience, How is your daughter doing?

    We are from Mexico and we will like to know where you were doing the adult placenta stem cell therapies?
    Our son David with epilepsy is 19 years old and we have the umbilical cord of our other son without epilepsy that he is know 3 years old.

    I heard in China they are doing the stem cell therapie

    Thank you Kim and Thank you Dr White and waiting for your kind comments.

  11. My grand daughter has grand mall epilepsy since she was 12 yrs. old she is now 20. We have talked to dr. Radar in referance to stem cell treatment at length but were unable to get any names for references. We have not talked to anyone who has expearance with china. Is there ANY ONE that has had expearance with stem cell?? If so please let me know!!!

    • Harry, if you are still looking for someone who can help I suggest David Mair at Soter Healthcare. He has a company that helps patients travel for medical care, and I’m betting he will be a good resource for you. I don’t have his number handy, but I think the website is soterhealth.com.

      Feel welcome to tell him I recommended you call.

  12. I have a 22 yo son who has epilpesy, hecant wait 10 years.Would be intersting if FDA people had a child who would benefit from stem cell treatment? Would they be happy to wait 10 years? We are off to China or Mexico or Panama for treatment..SEE YA FDA.

    • Hey Jimmy, see my note to Harry above. I think David Mair may be able to help, and he is local here in the Twin Cities.

  13. Thank you Doctor for your important work and sharing… has any research been done on the treatment of migraine headaches using stem cells.. please advise as so many of us are looking for help. Do you see an application….Thanks Mary Lou

  14. Hi. My name is Arica and my 3 year old son has epilepsy and autism. He is severely delayed. His pediatrician and I think stem cell treatment may benefit him. I’m trying to find offices that perform this procedure. Do you perform or know any that can help us?

  15. Considering that, in past years, insular foci were not sufficiently researched and many patients had resections that did not eliminate or significantly reduce seizure activity, there are persons who need stem cell treatment. Is it possible that, after possibly undergoing successful microscopic surgery to resect lesion(s) in the insular lobe, stem cell treatment can be used to “replace” injured brain tissue and “reconstruct” tissue that had previously been resected/scarred or do you believe it is too soon?

  16. I am a Epilepsy patient who is not recieving success from drugs or surgery. The idea of success from stem cell therapy is amazing to me. When and where can I use it to eliminate my epilepsy?

  17. I got hit by a car 6 yrs ago and every sinces then i have had sreuezs i have all kinds of them mostly the grama ones my doctor is playing trail and testing on me to see which ones work. i hate it because my friends don,t come around cause it scarys them to much so i, all by myself my dogs have trained the selfs on what to do when they happen i just hate when peole make fun of me . I have both typs of sreuezs elispie one and the pyocouct ones those are where you cant get mad ,anger,sad,depressed,,,anything can set them off i hate and i just don,t know how to live with it anymore even the squad guys from the parmedics make fun of me i hate my life. i have gone in and had one blood clot taken off my brain the other went away with blood thiners i have also had a stroke i just dont know how to deal with them i guess it just sucks to be me. thanks for your time kay -kay

  18. Hello, I just read all the information that was mentioned about stem cells for the cure of epilepsy in adults and children and was just hoping to find out roughly what year people will be able to have this treatment whether it is in the usa or GB.
    Thanks
    Stacey

  19. My son suffers from Epilepsy and I am very interested in learning more about stem cell therapy.

  20. Is there any proven data for the treatment of epilepsy’s with in India through stem cell kindly reply through e mails only asap,
    Regards,
    Manish Vyas.

  21. Hi Doctor,
    My daughter 5 year old has been having seizures since last 1 and half years. They are partial complex and mainly nocturnal. Buy she has plenty pf them when uncontrolled. Right now she is on high doses of cloba, LTG and trioptal. But still not under control. Quality of life deteriorating. Wanted to know your opinion and input about the same.
    Regards,
    Anjali shah
    INDIA

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  23. I was just inquiring as to if there has been any developments since this article has been published?

  24. I found out the place called ,,Stem cells of Amerika ” they made breakthrough,using fetal stem cell to cure the epilepsy.

  1. […] At the moment there are no FDA-approved stem cell therapies for epilepsy. Studies are only in the rat phase… http://www.mnepilepsyhudson.org/educ…-and-epilepsy/ […]

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