Allison Gandey

December 04, 2009

December 4, 2009 (Boston, Massachusetts) — Complete freedom from seizures is not possible for everyone, but specialists presenting here at the American Epilepsy Society 63rd Annual Scientific Conference say that goal is more realistic than most people think.

"We are very fortunate to have many new diagnostic tests and treatments," Steven Schachter, MD, president of the epilepsy society, told reporters attending a media briefing today. "But a consequence of all this progress has been a widening of the treatment gap between what is currently being done and what is possible."

Dr. Eric Hargis speaking at the press conference. Edward Hogan, Steven Schachter, and Patrick Kwan also briefed reporters.

Significant advances in epilepsy have taken place during the last 15 years, but despite these developments, Dr. Schachter said, "prescribing practices have remained pretty much unchanged."

The result: uncontrolled epilepsy diminishing quality of life and increasing the risk of disability and death.

An estimated 45% of people with epilepsy in the United States continue to have seizures despite treatment, report the Centers for Disease Control and Prevention. The numbers internationally are even more staggering — three-quarters of the global population with epilepsy receives no treatment whatsoever, says the World Health Organization.

"Progress has been so rapid, it has been hard for physicians to keep up," Edward Hogan, MD, from Washington University in St. Louis, Missouri, said at the briefing.

Eric Hargis, MD, president and chief executive officer of the Epilepsy Foundation, added that communication problems can also factor in. "People are often not forthcoming about providing information on how their seizures are affecting their lives," he said. "Physicians need to ask."

Dr. Hargis pointed out that patients may say their epilepsy is fine and yet they are still having seizures. "This may mean they are not driving and their work and personal relationships could be affected."

Eliminate Seizures

Dr. Hargis said that people often assume that this is what it is like to have epilepsy and they settle. He suggests that clinicians and patients need to raise their expectations and work to eliminate seizures.

Dr. Hargis noted that patients with epilepsy face other hurdles as well. He says that most will experience adverse events from treatment — and many of these effects will be debilitating. "In some cases," Dr. Hargis said, "drug toxicity and mood disorders will affect quality of life even more than the frequency or severity of seizures." These issues must be addressed, he emphasized.

Drug toxicity and mood disorders will affect quality of life even more than the frequency or severity of seizures.

Variations in defining refractory epilepsy have not helped matters, added Patrick Kwan, MD, from the Chinese University of Hong Kong. Dr. Kwan is taskforce chair of the International League Against Epilepsy commission, which will be presenting the first-ever global consensus definition of refractory epilepsy Tuesday.

"We believe its adoption into clinical practice can have a significant impact in improving patient care by providing clinicians a framework to recognize and promptly refer patients fulfilling the definition to specialist centers."

The new definition will be presented during a special symposium at the meeting and will be reported by Medscape Neurology.

The presenters have disclosed no relevant financial relationships.

American Epilepsy Society (AES) 63rd Annual Scientific Conference: Media briefing. Presented December 4, 2009.