Epilepsy drug may protect eyesight for people with MS 

17/04/2015 00:00 
A UCLH-led clinical trial has found that a drug commonly taken to prevent seizures in epilepsy could also protect the eyesight and slow the accumulation of disability in people with multiple sclerosis.

Researchers from the National Hospital for Neurology and Neurosurgery and the Royal Hallamshire Hospital in Sheffield recruited 86 people experiencing early symptoms of acute optic neuritis. The participants received the epilepsy drug phenytoin or a placebo for three months, to assess whether the drug could help to protect nerves from damage.

Optic neuritis causes the nerves carrying information between the eye to the brain to become damaged and inflamed. It can result in sudden total or partial blindness, foggy or blackened vision and pain and is commonly experienced in people with MS.

NHNN consultant Dr Raj Kapoor said: “About half of people with MS experience acute optic neuritis at some point in their life. These are promising results and if our findings our confirmed by larger studies, could lead to a new treatment that may prevent nerve damage. This could bring benefits both in optic neuritis to help protect sight, and elsewhere in the central nervous system to protect against the accumulation of disability in MS.”

Dr Kapoor's team used medical imaging technology to measure the thickness of the optic nerve at the beginning of the study and then six months later. They found on average that the group who took phenytoin had 30% less damage to the nerve fibre layer compared to those who received the placebo. The vast majority of people fully recover from their first episode of optic neuritis and in this trial this was the case for people in both groups.

The trial was the result of 20 years of underpinning research to understand the cause of nerve damage in both optic neuritis and in MS, and to find ways that this could be improved. Phenytoin was identified as a drug which could prevent the degeneration of nerve cells in areas of inflammation throughout the nervous system.

The study was co-funded by the MS Society, the National Multiple Sclerosis Society, an unrestricted grant from Novartis, the National Institute for Health Research Clinical Research Network and University College London Hospitals Biomedical Research Centre.

The results will be presented by Dr Raj Kapoor at the American Academy of Neurology’s 67th Annual Meeting in Washington, DC, next week.

MS is a neurological condition where the immune system attacks myelin, a substance surrounding the nerves, which leads to delay and confusion in messages sent from the brain and spinal cord to parts of the body. It affects almost three times as many women as men and it’s an unpredictable condition which can leave people with MS unable to see or move.

There are over 100,000 people living with MS in the UK but currently no treatments which can slow or halt the progression of disability.

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