2024 Clinical Preview for Epilepsy and Seizure Disorders: Claude Steriade, MD, CM

WATCH TIME: 5 minutes

“We're understanding more and more on mechanisms of autoimmunity in patients with epilepsies that have an autoimmune cause. There's been a lot of work, particularly coming out of Europe, on neuropathological findings in patients with autoimmune associated epilepsies. We're now starting to understand a little bit better why it is that these patients have poor response to immunotherapies.”

In 2024, those in epilepsy medicine are hopeful for new research updates and approval of therapies for epilepsy and seizure disorders, including those with various epilepsy types and rare syndromes such as Dravet syndrome and Lennox-Gastaut syndrome, and others. The field is currently still challenged by issues with drug-resistant epilepsy, adverse reactions, therapy interactions, earlier identification of epileptic syndromes, and limited prevention therapies for epilepsy as well as its comorbidities.¹ Despite these challenges, investigators are continuing their pursuit in 2024 to understand more of the determinants, interactions, and the biological mechanisms of seizures to discover better management options for patients.

Currently, there are many treatment options for seizures that center on the condition's symptoms rather than the cause, meaning there are still several patients with difficult epilepsy to treat that need effective therapies. This is the case especially for patients who live with autoimmune epilepsy, which presents specific clinical manifestations. According to a review published in the Journal of Clinical Neurology, research shows that the type of autoimmune epilepsy is a critical factor to consider when selecting from among various immunotherapy options for patients. In addition, researchers suggest that clinicians should additionally take the characteristics of antiepileptic treatment into account when using them as an adjuvant therapy for those with autoimmune epilepsy.²

Claude Steriade, MD, CM, an epileptologist at NYU Langone Health and associate professor in the department of neurology at NYU Grossman School of Medicine, recently sat down in an interview with NeurologyLive® to share her clinical perspective on potential therapies in epilepsy and seizure disorders for 2024. She talked about the unique mechanisms of action of potential upcoming epilepsy medications, and how they differ from currently available antiseizure treatments. Steriade also spoke about how the epilepsy community is leveraging international registries to gain insights into the long-term outcomes and functional aspects of autoimmune-associated epilepsies. In addition, she discussed preliminary findings suggesting stem cell therapy could be a promising and safe approach for treating mesial temporal lobe epilepsy.

REFERENCES
1. Ventola CL. Epilepsy management: newer agents, unmet needs, and future treatment strategies. P T. 2014;39(11):776-792.
2. Jang Y, Kim DW, Yang KI, et al. Clinical Approach to Autoimmune Epilepsy. J Clin Neurol. 2020;16(4):519-529. doi:10.3988/jcn.2020.16.4.519