Epilepsy Patients in Current:

GAIUS JULIUS CAESAR

Gaius Julius Caesar was an outstanding military commander and statesman at the end of the Roman Republic. The ancient Roman historian Suetonius recorded that Caesar had suddenly fell and twitched in the Senate. It is also recorded that Caesar suddenly fainted during the battle of Taphus in 46 BC. Plutarch, an ancient Greek historian, pointed out that Caesar's faint was a seizure. During this period, epilepsy was regarded as a "sacred disease", and the Romans believed that seizures were possessed by gods and were born with divine power.

VINCENT WILLEM VAN GOGH

Vincent Willem Van Gogh, he left us many wonderful works. But such a genius is also an epileptic. Van Gogh once used "brain storm" to describe his typical seizures, including continuous hallucinations, surging memories in his early years, as well as inexplicable anger, confusion and fear. When he had a seizure, it was at the peak of his career. He painted his life masterpieces "The Starry Night" and "Self-Portrait".

Hippocrates

In 500 BC, in his celebrated treatise "On the Sacred Disease", he described the relevant symptoms of epilepsy and indicated that epilepsy was not an indication of being possessed by demons or punished by gods.

John Hughlings Jackson

In the 19th century, he first postulated that epilepsy was caused by "the sudden, excessive, and rapid firing of neurons in the cerebral cortex". By meticulously observing clinical symptoms, he inferred the location of brain lesions in reverse and put forward the concept of "Jacksonian epilepsy".

Hans Berger

In 1929, he invented the electroencephalogram (EEG) for humans. This was a revolutionary breakthrough in the history of epilepsy. It enabled doctors to directly record and visualize the abnormal electrical activity in the brain, providing an objective basis for the diagnosis, classification, and localization of epileptic foci.

Current Situation

Widespread

Epilepsy accounts for a relatively high proportion of the global disease burden, affecting approximately 50 million people worldwide. At any given time, the estimated prevalence of active epilepsy (i.e., ongoing seizures or requiring treatment) in the general population is 4 to 10 per 1,000 people.It is estimated that 5 million people are diagnosed with epilepsy globally each year. In high-income countries, the estimated annual incidence is 49 per 100,000 people. In low- and middle-income countries, this figure may be as high as 139 per 100,000 people.

Few Ketone Drugs

The epilepsy treatment market is dominated by drugs, but there are very few or almost no products related to ketogenic diet therapy. The few ketone bodies available for sale are mainly targeted at fitness and are not cheap.

Deep Impact

Epilepsy has a multifaceted impact on patients, including physical, psychological, social, and quality of life aspects. Compared to the general population, epilepsy triples the risk of premature death for patients.In many parts of the world, people with epilepsy and their families face stigma and discrimination. Patients often feel ashamed, anxious, and depressed due to seizures, and may even develop psychological disorders.

Drug Therapy

Drug therapy is the most common treatment for epilepsy, but side effects are common. Long-term use may cause hypotension, rapid tolerance, and kidney damage, and even increase the mortality rate.Moreover, the drug has no effect on 30% of patients, which is drug refractory epilepsy.

Surgical Treatment

Surgical treatment is suitable for children with epilepsy, tumor-related epilepsy, but it causes trauma, which is irreversible and carries risks associated with craniotomy,such as postoperative infection. And the price of this therapy is relatively high.

Neuroregulation

Neuroregulation therapy is effective for patients with difficult-to-localize epileptic foci, but this treatment still causes trauma and the equipment placement is expensive and requires long-term maintenance. And the price of this therapy is relatively high.

Ketogenic Diet

Ketogenic diet therapy treats epilepsy by limiting high-fat and low-carbon diet to promote liver ketogenesis. This method is low-cost, suitable for most patients, and more long-term effective,but there are still some side effects..

Difficult to Cure

The Limitations of

the Ketogenic Diet Therapy

Poor patient compliance

The high-fat and low-carbohydrate diet structure is very difficult for normal people to accept, and the ketogenic diet therapy cycle is extremely long, usually measured in years. Patients often show an inability to adapt to the adjustment of the diet structure. The ketogenic diet has a poor flavor, reducing the patients' sense of happiness, and over time, it can have a significant impact on their mental health.

Side effects

The traditional ketogenic diet advocates a high-fat and low-carbohydrate diet structure. For adults, long term high-fat intake may also make people obese and increase the risk of cardiovascular and cerebrovascular diseases. The production of ketone bodies may lead to an increase in the pH of patients' blood, and excessive ketone bodies may even lead to ketemia, ketonuria, and ketoacidosis. In the ketogenic state, the precipitation of calcium from human bone will increase, increasing the deposition of calcium, which may lead to kidney stones. For children, incomplete dietary knot may lead to trace element deficiency and stunt children's development.

Difficult to replace directly

The amount of ketone bodies required to achieve the therapeutic purpose in the ketogenic diet therapy is approximately 4-5 mmol/L, while the normal ketone body concentration in the human body is only 0.03-0.5 mmol/L. Such a large demand for ketone bodies brings great metabolic pressure to patients. If used as a substitute for ketogenic diet therapy, the required amount of ketone bodies is huge, and the treatment cost will be extremely high. If ketone bodies are directly injected or orally taken, they need to be given frequently, and the effect is not good.

We anticipate synthesizing ketone bodies through synthetic biology approaches to replace the therapeutic efficacy of ketogenic diets. This aims to introduce novel, safe, and effective treatment modalities for epilepsy, thereby bringing new hope to avast number of epilepsy patients worldwide and fostering a moreinclusive world.