#USA #New York #NYU Langone #Epilepsy Treatment #Focal Epilepsy

Promising Progress in Focal Epilepsy Treatments

Recent findings from researchers at NYU Langone Health shed light on the treatment of focal epilepsy, a prevalent neurological condition affecting a large number of patients. Approximately one in three individuals diagnosed with focal epilepsy do not initially respond well to standard therapies. However, a groundbreaking study suggests that these patients may see significant improvements over time, challenging the longstanding belief that treatment-resistant cases yield little hope for recovery.

The study is part of the international Human Epilepsy Project and focuses specifically on patients regarded as treatment resistant—those who have experienced seizures despite trying at least four different medications. Monitoring nearly 150 participants over three years, the study found that around 70% of these individuals had a noticeable reduction in the frequency of their seizures. These results are particularly encouraging, as they contradict previous assumptions regarding the bleak outlook for patients who do not respond to first-line treatments.

Focal epilepsy is characterized by irregular electrical activity in specific regions of the brain, leading to focal seizures that can manifest as unusual emotions, sensations, or behaviors. The uncontrolled electrical firing can cause a wide range of symptoms, prompting urgent need for effective treatments.

Study lead author and neurologist Dr. Ojas Potnis emphasized that although medications rarely eliminate seizures entirely, they can extend the intervals between seizure episodes. Among participants, nearly 13% reported being seizure-free for at least three months, and roughly 8% experienced six months without seizures. Encouragingly, 3% achieved seizure freedom lasting one year or more. These results, albeit modest, are significantly higher than outcomes from earlier studies that generally monitored patients for shorter durations.

The investigation involved comprehensive data collection from ten epilepsy centers across the United States, covering patient demographics, medical history, and detailed seizure records. Patients maintained an electronic diary to track their seizure occurrences, providing detailed notes on frequency, time, duration, and type of each episode, as well as documenting their experiences with various treatment methods, including antiseizure medications and surgical interventions. Throughout the three years, patients participated in follow-ups every six months, allowing researchers to gather a wealth of longitudinal data.

The findings revealed a correlation between initiating new antiseizure medications and improvements in seizure frequency. Specifically, over half of the participants who experienced reduced seizure activity had recently begun new treatment regimens during the study period. Importantly, results indicated that the number of previously failed medications did not influence patients' probabilities of achieving seizure reduction.

As co-senior author Dr. Jacqueline French stated, "These results offer hope that focal epilepsy will get better over time for most people. Health care providers should continue to explore various treatment options for their patients, regardless of how many therapies have been tried previously."

Although the study provides valuable insights, there remains an open question regarding whether the observed reductions in seizure frequency are attributed to the natural progression of treatment-resistant epilepsy or improvements from ongoing management and therapy adjustments. This area prompts a necessity for further research to explore patterns in generalized epilepsy, another form of the disorder affecting about 25% of epilepsy patients.

Funding for the study was generously provided by pharmaceutical companies including UCB, Neurelis, and SK Life Science. The implications of this research not only enhance our understanding of focal epilepsy but also pave the way for improved management strategies that could significantly benefit countless individuals living with this challenging condition.