New Study Reveals Predictors of Epilepsy Treatment Resistance

A new study published in The Journal of the American Medical Association (JAMA) by Northwell Health clinicians and researchers has found that individuals with newly diagnosed focal epilepsy who have a history of frequent seizures and psychiatric disorders are more likely to be resistant to anti-seizure medications. The study, co-led by neurologist Ruben Kuzniecky, MD, followed 448 patients with newly diagnosed focal epilepsy for up to six years through the Human Epilepsy Project (HEP). The research highlights the importance of identifying epileptic risks and triggers, as uncontrolled seizures can lead to injuries, accidents, and even death.

Key Takeaways:

• The study found that ~25% of participants were treatment-resistant after two adequate anti-seizure medication (ASM) trials, with half becoming resistant within the first year.
• Initial treatment efficacy was low, with only 27% of participants achieving seizure freedom on their first ASM.
• A history of psychiatric disorders prior to epilepsy diagnosis significantly increased the risk of treatment resistance, highlighting the importance of holistic care for individuals with epilepsy.
• The median time to first seizure freedom was 12.1 months, indicating an extended period during which many patients experience ongoing seizures.
• 23% of participants fell into an "indeterminate" category due to insufficient follow-up time or inadequate ASM clinical trials, highlighting the challenges in conducting long-term epilepsy research.

Statistics:

• ~25% of participants were treatment-resistant after two adequate ASM trials.
• 27% of participants achieved seizure freedom on their first ASM.
• The median time to first seizure freedom was 12.1 months.
• 23% of participants fell into an "indeterminate" category.

Sources:

• Northwell Health
• The Journal of the American Medical Association (JAMA)
• The Human Epilepsy Project (HEP)
• The Feinstein Institutes for Medical Research