Sam DeStefano

Neurologist, Epileptologist, neurotech and squiggly line enthusiast.

[Sam DeStefano @SamDeStefanoMD]

Latest newsletter discusses #epilepsy and #epilepsysurgery to treat drug resistant #seizures https://t.co/u8UZu5OAtr

[Sam DeStefano @SamDeStefanoMD]

https://t.co/YDDTrzGx11

[Sam DeStefano @SamDeStefanoMD]

Why do some patients notice #mood and #thinking clarity getting worse days or weeks before a #seizure? Can the seizure itself serve to "reset" the system?

https://t.co/ESBmp2sgKK

[Sam DeStefano @SamDeStefanoMD]

What does an #epilepsy #surgery work up really entail? This week’s newsletter gives an overview.
https://t.co/I6jbwjC0n1

[Sam DeStefano @SamDeStefanoMD]

@foundmyfitness @hubermanlab non invasive potential of TMS tDCS and ultrasound to modulate networks is very exciting. In epilepsy, the challenge looks like a simultaneous imbalance between too much and too little activity in certain areas and also too much and too little neuroplasticity. Which to target?

[Sam DeStefano @SamDeStefanoMD]

#epilepsy
#neuro
#brainstimulation
#seizures
#TMS
#tdcs

[Sam DeStefano @SamDeStefanoMD]

https://t.co/EpOBJNzH2T

[Sam DeStefano @SamDeStefanoMD]

When the Brain Forgets to Breathe: How a Fear Center Controls our Breath https://t.co/fZdh5U5AdY

[Sam DeStefano @SamDeStefanoMD]

This week's #epilepsy newsletter is an attempt to create a framework for evaluating and researching different #brainhealth #supplements as they come onto the market. Let me know if you find this helpful.

https://t.co/FQOQ9NhglY

[Sam DeStefano @SamDeStefanoMD]

https://t.co/azpKkhRgtM

[Sam DeStefano @SamDeStefanoMD]

9/ This could lead to a new class of microbiome-based epilepsy therapies—no strict diet required.

10/ Still early days—this is in mice, and human studies are needed. But it gives new hope for personalized, gut-targeted epilepsy care. #epilepsy #gutbrain #ketodiet

[Sam DeStefano @SamDeStefanoMD]

1/ Can your gut bacteria help prevent seizures? A team from UCLA says yes. Here’s what they found, and why it could change how we treat epilepsy.

https://t.co/fMfP1YpaWr

[Sam DeStefano @SamDeStefanoMD]

7/ Giving a drug (GGsTop) to block gamma-glutamylation had the same protective effect. It mimicked the KD without the diet.

8/ The takeaway? Seizure protection may depend not just on what you eat, but what your gut bacteria do with what you eat.

[Sam DeStefano @SamDeStefanoMD]

6/ Bonus: these changes shifted the brain’s chemistry too. Mice with the microbes had higher GABA-to-glutamate ratios in the hippocampus—a known anti-seizure signal.

[Sam DeStefano @SamDeStefanoMD]

5/ These microbes lowered levels of certain gamma-glutamylated amino acids in the body—a class of molecules linked to seizure risk. Less of these = fewer seizures.

[Sam DeStefano @SamDeStefanoMD]

4/ Two bacteria in particular (Akkermansia and Parabacteroides) increased in mice on KD. Giving just these bacteria to mice without KD was enough to protect them from seizures.

[Sam DeStefano @SamDeStefanoMD]

3/ Mice on KD had fewer seizures—but only if they had gut bacteria. Germ-free mice or those given antibiotics? No protection from seizures, even on the same diet.

[Sam DeStefano @SamDeStefanoMD]

2/ The ketogenic diet (KD) is used for drug-resistant epilepsy. But how it works has been a mystery. These researchers asked: is the gut microbiome the missing link?

[Sam DeStefano @SamDeStefanoMD]

What this means for neurologists:
•We may soon have a disease-modifying therapy for TLE
•Especially useful for patients who refuse or are not candidates for resection
•A fourth option that repairs rather than removes (6/)

[Sam DeStefano @SamDeStefanoMD]

A new kind of epilepsy treatment is being tested in humans—and it doesn’t involve resection, ablation, or devices.

It’s made from stem cells.
And it’s designed to rebuild what seizures destroyed.

Let me explain. (1/)

https://t.co/Z9QleLla2W

[Sam DeStefano @SamDeStefanoMD]

Animal studies showed these cells:
•Migrate to the right places
•Form new inhibitory synapses
•Reduce seizures
•Improve mood and memory

And—critically—they may prevent the rewiring that leads to chronic epilepsy. (5/)