Spotlight on our NHMRC Fellowship winners: Dr Pablo Casillas Espinosa

Dr Pablo Casillas-Espinosa

by Anne Crawford

Dr Pablo Casillas Espinosa. NHMRC Early Career Fellowship: to progress research into a novel therapy for temporal epilepsy.

Temporal epilepsy, a condition characterised by recurrent, unprovoked seizures, is the most common and most difficult-to-treat form of the disease. Of the patients who have it, up to 40% have seizures that don’t respond to any form of treatment. The remainder will improve with medication that stops the seizures but will go back to having them if they stop taking this for any reason. As the disease worsens, all patients will experience behaviourial co-morbidities; depression, anxiety, and learning and memory disorders, which worsen as it progresses.


“So even if you stop the seizures there’s a constellation of symptoms that affect the overall quality of life,” Dr Casillas Espinosa said. “It’s a great improvement if the patient doesn’t have the seizures but it’s very sad if they can’t go back to work or very frustrating if they know their memory isn’t as good as it used to be,” he said.

Temporal epilepsy is like a continuum and usually occurs after a traumatic brain injury (TBI), infection in the brain or stroke, along with the behavioural co-morbidities.

“The research we’re doing is to modify how epilepsy develops and progresses, to reverse the changes in the brain, including the behavioural consequences. It’s probably as close as you can get to a cure.

Researchers led by Professor Terry O’Brien have previously shown that sodium selenate prevents the development of epilepsy immediately after TBI in animal models. They are now leading international multi-centre trials to reproduce these results more broadly before sharing the data and going into clinical trials.

“The results look very promising for translating these results into clinical trials with actual patients,” Dr Casillas Espinosa said.

However, the majority of patients present to neurologists with already established, chronic TLE, he said. His proposal will test if sodium selenate is able to mitigate established chronic epilepsy.

“The idea of this grant is to test sodium selenate in preclinical models as the first ever drug able to modify the natural history of epilepsy.”

Importantly, sodium selenate has already been shown to have a favourable safety profile in early phase clinical trials, favouring the translation of the results of this preclinical study into a clinical trial.

The Fellowship will support Dr Casillas Espinosa’s work for four years.

“I was very happy to get it – I had to read the email twice to believe I’d got it!”

Dr Casillas Espinosa has been a Research Fellow with the Department of Neuroscience since October 2017. He did his clinical training at the University of Guadalajara in Mexico and came to Australia to carry out out his doctoral work at the University of Melbourne, supervised by Professor Terence O’Brien, now inaugural head of Monash’s Department of Neuroscience, and Dr Kim Powell, who has also joined the new department.