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Management of patients with epilepsy
Could you please summarize the key advice for neurologists treating patients with drug-resistant epilepsy?
2023-05-17
Could you please summarize the key advice for neurologists treating patients with drug-resistant epilepsy?
What is the current place of cannabidiol and other cannabinoids in the treatment of epilepsy? How often are OTC cannabinoid preparations used by patients with epilepsy in North America? How does it affect the clinical management of epilepsy?
Novel antiseizure drugs are typically approved as adjunctive therapy, to be used as an add-on. It might take years until their registration is expanded to include initial monotherapy. Do you think that cenobamate and other novel drugs could reduce the rates of drug resistance when introduced earlier, even as first-line medications in selected patients?
What is more likely to bring a breakthrough in the management of drug-resistant epilepsy: the development of new drugs with novel mechanisms of action or wider use of nonpharmacologic interventions, such as epilepsy surgery or, possibly, DBS?
When using antiseizure treatment, why do we continue to rely on seizure morphology rather than use biologic, metabolic, or genetic markers in an attempt to individualize therapy (possibly with the exception of vigabatrin in infantile spasms associated with tuberous sclerosis)?
We have a broad and still growing selection of antiseizure medications available, and yet drug resistance remains a challenge in roughly a third of patients with epilepsy. Why is this rate so high and how can we improve chronic seizure management in these patients?
If you were to name the 3 most important recent advances in neurology that are relevant for everyday practice, what would they be?
What is the “Chain of Survival” in patients with stroke in Canada?
What should the emergency medical services focus on when approaching a patient with suspected transient ischemic attack (TIA)?
When should we refer a patient with chronic headache treated in a pain clinic for repeated imaging studies? When should neurologic consultation be repeated?
