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PubMed · 10255037

Why comprehensive epilepsy programs?

J J Gereghino
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Abstract

Epilepsy is a common disorder, affecting more than two million people in the United States. For the majority of these people, medications control seizures and permit them to lead nearly normal lives. But the Commission for the Control of Epilepsy and its Consequences estimates that at least 200,000 Americans suffer seizures more than once a month. The National Institute of Neurological and Communicative Disorders and Stroke has established comprehensive Epilepsy Programs to stimulate clinical research on all aspects of epilepsy, including prevention, diagnosis, and more effective management.

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EpilepsyHealth Services Needs and DemandHealth Services ResearchHumansNational Health ProgramsUnited StatesJournal Article

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J J Gereghino. Why comprehensive epilepsy programs?. https://pubmed.ncbi.nlm.nih.gov/10255037/

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Long-term seizure outcomes and factors associated with response to adjunctive everolimus in TSC-associated epilepsy.

BACKGROUND: Everolimus, a mechanistic target of rapamycin (mTOR) inhibitor, is increasingly used in tuberous sclerosis complex (TSC)-associated epilepsy; however, long-term real-world outcomes and factors associated with favorable response remain unclear. This study aimed to evaluate the long-term seizure outcomes of adjunctive everolimus and explore clinical factors associated with treatment response. METHODS: We retrospectively recruited 21 patients with active TSC-associated epilepsy receiving adjunctive everolimus and assessed seizure outcomes during follow-up. Clinical characteristics were compared between responders and non-responders at 1 year after treatment initiation. RESULTS: Over a median treatment duration of 72 months, responder rates ranged from 53.8% to 64.7%, and seizure-free rates ranged from 33.3% to 41.2%. Responders had fewer involved organ systems at baseline (median 3 vs. 4, p = 0.020) and lower anti-seizure medication burden (median 2 vs. 4, p = 0.045). Younger age at treatment initiation showed a trend toward improved response. CONCLUSION: Adjunctive everolimus was associated with sustained long-term seizure reduction in this real-world cohort. In exploratory analyses, fewer involved organ systems and fewer baseline ASMs were associated with favorable treatment response. These findings require validation in larger prospective cohorts.

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