Medically refractory epilepsy remains a significant clinical challenge, affecting approximately 30 percent of the 3.4 million Americans living with epilepsy. These patients experience persistent seizures, despite appropriate and adequate trials of anti-seizure medications, necessitating a comprehensive evaluation and consideration of alternative therapeutic modalities.
A landmark study by Kwan and Brodie (2000) established that achieving seizure freedom diminishes substantially with each failed medication trial: 47 percent of epilepsy patients became seizure-free on their first drug, 13 percent with their second medication and only 4 percent with their third drug or a combination of two drugs.
The data underscores the critical importance of referral to specialized epilepsy centers for patients who have failed two anti-seizure medications, says neurologist Pooja Patel, M.D., director of the Epilepsy Program and the Epilepsy Monitoring Unit at Marcus Neuroscience Institute at Boca Raton Regional Hospital, part of Baptist Health.
“If the patient has epilepsy and has failed two anti-seizure medications, one after the other or in combination, then we need to consider alternatives to medication,” says Dr. Patel, who shared her expertise recently at the Marcus Neuroscience Institute’s Brain & Spine Symposium, an educational meeting to bring the latest advances to physicians and other healthcare providers…