James W. Wheless, MD

“If I’m treating my seasonal allergies and I forget to take my antihistamine, I might sneeze more, but the risk is not so high. If I have seizure medicine that I’m supposed to take every day and I forget a couple days, then it’s high risk. If I have a seizure while I’m driving or at work—it’s a whole different risk factor.”

 spoke with James W. Wheless, MD, about one of the complicated nature of treating and managing patients with epilepsy. With a number of available interventions ranging from the dietary to pharmacokinetic to surgical, combined with the complexity of the disease and high rates of refractory patients, there can be wide variations in treatment regimens.

The professor and chief of pediatric neurology at Le Bonheur Children’s Hospital and the University of Tennessee Health Science Center spoke about the process of determining when a patient might benefit from monotherapy or polytherapy, and how physicians navigate those treatment decisions.

Wheless also shared his insight into addressing the challenges of patient adherence, which, despite its vital nature in epilepsy, is quite poor in that patient population. Adherence is a particular challenge, he said, due to the high risk of seizures that couples with poor adherence. According to Wheless, producing strategies to aid patients in maintaining high adherence and educating patients on  its importance is the first step.

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The professor and chief of pediatric neurology at Le Bonheur Children’s Hospital and the University of Tennessee Health Science Center discussed the decision-making process for choosing interventions for patients with epilepsy, and how to keep patients adherent.

James W. Wheless, MD: Making Treatment Decisions in Epilepsy

“The worst consequence, which is the one that is often not spoken, is the fact that you could die if you have a convulsive seizure. A lot of families are scared to death that they’re going to lose their loved one.”

When it comes to epilepsy, the most obvious symptom is the occurrence of seizures in these patients. Although, even with that knowledge, many patients go undiagnosed due to the various forms which seizures can take outside of the more widely thought convulsive seizures. Additionally, many patients struggle on antiepileptic drugs, and the consequences of not controlling this condition can be deadly.

For Janes W. Wheless, MD, professor and chief, pediatric neurology, Le Bonheur Children’s Hospital, University of Tennessee Health Science Center, there is no greater goal than seizure freedom for these patients and, ideally, to do so with only a single therapy. This leads to better tolerance, better adherence, and less worry. Although, as this isn’t always the case, Wheless shared his insight with 

 into how he goes about determining if a patient requires additional medications and which factors can impact that.

, June 22-26, in Bangkok, Thailand, Wheless spoke about the non-pharmacologic therapeutic methods—such as epilepsy surgery, device therapy, and dietary therapy&mdash;which can be used on top of their medications in order to control these treatments.

The professor and chief of pediatric neurology at Le Bonheur Children’s Hospital and the University of Tennessee Health Science Center spoke about the concerns of uncontrolled epilepsy and how to determine if a patient requires more than one treatment for their epilepsy.

James W. Wheless, MD

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