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Neuroscience and Pain Learning Zone

Epilepsy

Read time: 170 mins
Last updated:22th Oct 2020
Recognise the symptoms of epilepsy and consider some ways in which healthcare professionals can improve outcomes for patients and carers.

With onset commonly occurring in childhood and adolescence, epilepsy is a chronic, heterogenous condition in which patients experience recurrent and seemingly unprovoked seizures1,2. About 46 million people worldwide have active epilepsy3. Despite being common, classifying, diagnosing and treating epilepsy in adults and children can be difficult. Only about half of adults became seizure free with their first anti-epileptic drug (AED), for example4 and treatment resistance remains a major challenge. Paradoxically, some AEDs can even exacerbate seizures. Advances in AEDs reduce the risk of certain adverse events that proved problematical with some older drugs, such as neuropsychological side effects.

Meet the Experts

  • Professor Lieven Lagae from the University of Leuven, Belgium (KUL) is Head of the Paediatric Neurology Department of the KUL University Hospitals and Director of the Childhood Epilepsy Program at the KUL University Hospitals
  • Professor Yuwu Jiang is Director of the Department of Paediatrics and the Centre for Children with Epilepsy, Peking University First Hospital
  • Professor Patrick Kwan is Professor of Neurology at the Department of Neuroscience at Monash University and Head of Epilepsy at the Alfred Hospital in Melbourne, Australia
  • Dr Andrew Neal is a consultant neurologist and epileptologist based in Melbourne, Australia. He is also a research fellow at Monash University with a special interest in epilepsy surgery and intracranial-EEG
  • Professor Terence O’Brien is a neurologist specialising in the treatment of epilepsy. He is Head of the Department of Neuroscience at Monash Central Clinical School
  • Professor Piero Perucca is an Associate Professor from the Department of Neuroscience at the Monash Central Clinical School. He is also a consultant neurologist and epileptologist at the Royal Melbourne Hospital, and at Alfred Health

The incidence of paediatric epilepsy is up to 187 cases per 100,000 of the population5 and healthcare professionals need to consider a number of differential diagnoses. 

Treatment of paediatric epilepsy, tailored to their seizure type6, currently focuses on managing clinical seizures. However, advances in molecular biology may lead to individualised treatments.

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Which anti-epileptic drugs are used to treat paediatric patients with epilepsy?

 

Professors Lagae and Jiang discuss how to optimise treatment of paediatric epilepsy, which currently focuses on managing clinical seizures.

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Epilepsy in adults

About 46 million people worldwide have active epilepsy3, which can have a devastating impact on an adult’s quality of life, health and occupational prospects and ability to participate in other activities of daily living13.

Is epilepsy a major public health burden?

In this introductory video, Professor Patrick Kwan discusses the epidemiology of epilepsy and reviews the International League Against Epilepsy (ILAE) 2017 classification of seizure types (Figure 3)14.

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Treatment options

What pharmacological and non-pharmacological therapies are available for epilepsy?

Prescribers can choose from a large number of anti-epileptic drugs (AEDs; Figure 4). In this presentation, Professor Kwan discusses the appropriate use of AEDs, which differ in their spectrum of activity.

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