Shifting Goalposts: Redefining Success of Treatments in Epilepsy

Arun Swaminathan, MD, Assistant Professor of Neurology and Epilepsy at the University of of Nebraska Medical Center, Omaha, explains how the treatment goals of epilepsy are changing

The COVID-19 pandemic has affected medical care in myriad ways with newer and increasing difficulties noted with the patient burden, healthcare system overloads and medication and medical gear supply shortfalls and deficiencies, among others. The delivery of medical care has evolved quickly and efficaciously to combat these shortcomings produced by the pandemic and enable safe and prompt delivery of care to patients.

Did you know that epilepsy impacts an estimated 50 to 65 million people, globally?

When it comes to efficient treatment, there is an interesting and often difficult history that shadows the contemporary arena of available treatments. In the relatively recent past, the main treatment was anti-seizure medication. The results were often followed with severe side effects, which Dr Swaminathan describes as “unacceptable” – with individuals trading other elements of health for the sake of stopping a seizure.

Now, there are better medications for seizures. However, cost remains a problem, especially in the Global South.

While the average price of epilepsy medicine in the developed world is less than $1 per month, the financial landscape for this kind of medication is completely different elsewhere.

WHO reports have often described the difficulties in offering epilepsy care to developing nations due to the limitation in resources and physicians. One solution is telemedicine, which holds great potential for the future of access to various treatments.

Surgery and neuromodulatory devices represent some of the most cutting-edge interventions offered for the achievement of seizure control in patients deemed refractory, after failure of achievement of seizure control using two or more appropriately chosen anti-seizure medications.

But what are the definitions of successful epilepsy treatment? And why are they so important to patients with epilepsy?

To find out more about this ongoing issue, look no further.


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