Epilepsy Currents最新文献

Numerous factors including social determinants of health, knowledge gaps, economic challenges, workforce limitations, and health system deficiencies are associated with significant disparities in access to health care services and health outcomes for people with epilepsy (PWE). The American Epilepsy Society (AES) and the International League Against Epilepsy-North America (ILAE-NA) established a joint task force to explore and develop recommendations to address health care disparities experienced by PWE. The task force gathered foundational knowledge through meetings, public and patient organization comments and discussions to develop consensus recommendations. We enumerate the recommendations and discuss the rationale behind them to reduce disparities in epilepsy care through comprehensive research, inclusive clinical practices, robust advocacy, and targeted educational initiatives. While our recommendations are focused on the United States, we acknowledge that similar barriers and limitations exist for PWE globally and that these also need to be addressed within their local domains and with attention to unique factors therewithin.

High frequency oscillations (HFOs) are being incorporated into the presurgical evaluation of patients with epilepsy and also represent a rapidly evolving field in basic epilepsy research. Animal models have been pivotal in uncovering the mechanisms underlying HFOs and their role in epilepsy. In this review, we provide an overview of HFOs recorded in animal models, highlighting their relevance not only to epilepsy but also to neuropsychiatric and Alzheimer's diseases, suggesting a broader role in brain disorders. Then we explore recent advances, including innovative computational methods for the automated detection and analysis of HFOs. Building on this analysis, we propose guidelines for HFO identification and reporting with translational potential from animal models to humans. Finally, we discuss existing knowledge gaps and outline future directions for research in this rapidly evolving field.

Drug-resistant epilepsy (DRE) disproportionately affects individuals in low- and middle-income countries (LMIC), where access to affordable and effective care remains a significant challenge. Patients with DRE face high healthcare costs, inadequate access to epilepsy surgery, and limited availability of trained professionals. This review explores a multifaceted approach to managing DRE in resource-constrained settings. Key strategies include rational polypharmacy with cost-effective antiseizure medications (ASM), implementation of dietary therapies like the ketogenic diet, and cost-conscious presurgical evaluations. Enhancing emergency care systems, particularly for conditions like status epilepticus, is critical, as is the development of standardized diagnostic and treatment protocols and training programs for healthcare providers. By addressing these gaps, LMIC can improve outcomes for individuals with DRE and reduce the burden of untreated seizures on patients and healthcare systems.

This brief review summarizes presentations and discussion from the Health Disparities Special Interest Group held in December 2024 at the American Epilepsy Society Annual Meeting. The session addressed known health disparities in pediatric and adult epilepsy at a national and global level. The goal of the session was not just to present the known inequities, but to also propose ideas and work together toward improving healthcare for all. Invited speakers work directly with at-risk communities in the United States and abroad and shared their experiences on how we can do better. This piece is intended to provide a brief overview of the talks given by the invited speakers and to put it all together with the goal of achieving better epilepsy care for all by working together.