An overview of the shifting landscape of antiseizure medication and various neurostimulation devices is shared by the clinical assistant professor of neurology in the Comprehensive Epilepsy Center at NYU Langone Health. [WATCH TIME: 5 minutes]
WATCH TIME: 5 minutes
“I suspect, in the future, patients with focal epilepsy who would be considered for epilepsy surgery basically won't be considered candidates unless they had tried [cenobamate] and that medication had failed them. I would not be surprised, in the future, if before patients can be evaluated for post surgery, that they will be required to be on that medication.”
Surgical procedures to treat epilepsy, although effective, have been limited in use over the course of their time. The stigma associated with brain surgery and the difficulties in identifying the candidates who would most benefit from it are challenges that drive the lack of exploration around it in research.
Deep brain stimulation (DBS) and responsive neurostimulation (RNS) devices, FDA approved for the treatment of individuals with epilepsy, are some of the options for less-invasive therapy via neurostimulation. These approaches may help alleviate the difficulties in difficult-to-control seizures and create a new treatment avenue for clinicians to offer, particularly to refractory patients.
Recently in a conversation with NeurologyLive®, Christopher Elder, MD, clinical assistant professor, Comprehensive Epilepsy Center, NYU Langone Health, discussed the changing landscape of antiseizure medications and the impact the devices of DBS and RNS have had on the clinical care for seizure disorders. He also spoke about the positive progress that has been made in improving the stigma around surgery and the use of other minimally invasive approaches.