The 2012 American Epilepsy Society annual meeting brings a multitude of original research and important reports that set the stage for the future of care for people with epilepsy. In the coming days, look for coverage of the meeting from Clinical Neurology News.
Here are some highlights of presentations we will report on:
Dr. Joseph Drazkowski
• The Institute of Medicine’s 2012 report. The Presidential Symposium’s focus on the IOM report, "Epilepsy Across the Spectrum: Promoting Health and Understanding," should help to give neurologists a better understanding of where the public health emphasis for epilepsy needs to be. Dr. Joseph Drazkowski, a Clinical Neurology News editorial advisory board member and an epilepsy specialist at the Mayo Clinic in Phoenix, says the symposium should help neurologists to understand the implications of the report.
"In the new world of the Affordable Care Act, there has been much speculation and uncertainty on how our patients’ lives will be affected and what the corresponding impact will be to the practice of caring for the person with epilepsy. Included in the program will be discussion from an expert with a perspective from the leadership of the Department of Health and Human Services. Additionally, there will be a presentation from an IOM panelist, hopefully providing insight about why epilepsy was chosen as a focus, how the report was crafted, and what implications it has for the future. How this mix of patients, providers, advocacy groups, insurers and government regulators plays out over the next several years has potentially far-reaching implications for epilepsy care, neurology, and medicine in general."
Another editorial advisory board member, Dr. Jeffrey Buchhalter of Alberta Children's Hospital, Calgary, commented that "the impact of the Institute of Medicine report on epilepsy is yet to be fully realized. It could put epilepsy on center stage and have profound implications for future research resources."
• Merritt-Putnam Symposium. The discussion at this year's symposium will focus on advances in the understanding of the genetics of epilepsy. "Epilepsy genetics continues to be a very hot topic due to the expansion in testing available. The symposium will explore a number of the key areas including the meaning of a particular type of mutation, how these are discovered, and the functional implications," Dr. Buchhalter said.
• Transitioning from adolescent to adult epilepsy care. In the Professionals in Epilepsy Care Symposium, experts discuss transition models and their personal experience in handling the tradeoff, as well as the challenges of doing so for adolescents with intellectual disabilities and epilepsy.
• Barriers to optimal care. Several poster abstracts focus on the factors associated with patients not having access to specialized epilepsy care that they need, such as video EEG monitoring, surgery, or psychiatric, psychological, neuropsychological, or speech and language evaluations. The most important factors predicting access to such care are age, race, insurance status, and proximity to a comprehensive epilepsy center.
• Predicting epilepsy after childhood status epilepticus. Preliminary results from the first prospective pediatric population-based study in childhood status epilepticus, the Status Epilepticus Outcomes Study (STEPSOUT), indicate that children with prolonged febrile seizures have good neurologic and cognitive outcomes within 10 years of the status epilepticus episode, but in some cases, those with prior known neurologic problems do not.
• Long-term results of deep brain stimulation. The 5-year results of deep brain bilateral stimulation of the anterior nuclei of the thalamus for drug refractory epilepsy in the SANTE trial (Stimulation of the Anterior Nucleus of the Thalamus for Epilepsy) indicate a sustained efficacy and continuous improvement with a median reduction in seizure frequency of 69%. The intervention is still considered investigational in the United States.
• Discussing sudden, unexplained death. A new survey indicates that few neurologists always bring up the issue of sudden, unexplained death in epilepsy with patients and their parents, contrary to what many parents say they want.
• Impact of antidepressants on epilepsy outcomes. Selective serotonin and serotonin-norepinephrine reuptake inhibitors do not worsen seizure frequency and may have a slight antiepileptic effect in patients with frequent seizures.