Cornelia Drees, MD, Mayo Clinic, Phoenix, AZ, discusses the future of therapeutics in drug-resistant epilepsy. There are ongoing trials for multiple pharmaceuticals, most of which have some likelihood of reducing seizures at the cost of increased tiredness and other emotional or cognitive side effects. Neurostimulation devices show potential for epilepsy treatment and could be combined with each other or medication due to their different mechanisms of action. Surgery to prevent seizures is also considered, raising the possibility of removing parts of the brain responsible for seizures. However, this comes with many risks and will likely fail to prevent seizures due to the large size of neuronal networks. The latest development in drug resistant-epilepsy research is genetic alteration, which aims to alter the network and cells that participate in seizures. For this to be possible, we must first identify vectors implicated in the disease process and those that cannot be ‘turned off’ due to important physiological functions. This interview took place at the American Academy of Neurology Annual Meeting 2023 in Boston, MA.
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