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Leah Blank, MD, an assistant professor of neurology, population health, science, and policy at the Icahn School of Medicine provided commentary on some of the experience and positive movement from the 2024 American Epilepsy Society Annual Meeting.
The 2024 American Epilepsy Society (AES) Annual Meeting, held December 6-10 in Los Angeles, California, brought together healthcare providers, scientists, advocates, industry, and other professionals who are dedicated to better outcomes for people with epilepsy. In total, the conference comprised of more than 120 sessions, offering up 39.25 CME credits. Some of the main areas of focus included genetics, neurostimulation, rare epileptic syndromes, developmental epileptic encephalopathies, pregnancy with epilepsy, and entering a new era of artificial intelligence, among others.
To gain greater insights from the meeting, NeurologyLive® sat down with Leah Blank, MD, MPH, a board certified epileptologist who serves as an assistant professor of neurology, population health, science, and policy at the Icahn School of Medicine at Mount Sinai. Blank, who joined the institution in 2019, has expertise in managing patients with epilepsy, including women’s issues in epilepsy, and the evaluation of those who may be candidates for epilepsy surgery. In the interview, she provided commentary on the lasting thoughts from the recently concluded meeting, including perspectives on some of the emerging women-related research, advances in neurostimulation, and the importance of aging on epilepsy management.
Leah Blank, MD, MPH: I think AES is every epileptologist's favorite meeting, right? It really brings together people, not just from all over the country but also from around the world. It’s a place where you get the newest updates on clinical care and the latest research developments. It’s a chance to update your knowledge, and at the same time, see friendly and familiar faces. It’s exciting because it’s all about epilepsy, which I love.
The Women’s Lunch is an annual event at AES, and I think it’s really important. It focuses on women in epilepsy practice and research and how to support the growing community of women in the field. As a woman, I think this is crucial—not just from the clinician, researcher, and care provider perspective, but from the patient side as well.
We talk a lot about representation in medicine, and having providers who understand your life experiences and challenges can help build strong therapeutic alliances with patients. It also shapes how we provide care and decide which areas to focus on in research. For years, women were excluded from clinical trials, and while the NIH and other institutions have made strides to change that, we still have a long way to go. The lunch provides a forum to discuss these issues and ensure we continue to represent everyone in epilepsy.
Oh, absolutely. There’s a lot of work to be done in women’s medicine and epilepsy across the lifespan. For example, we’re gaining awareness of the interplay between hormones and epilepsy, and there’s a lot of effort to better understand that relationship.
Pregnancy is another critical area—understanding how medications and other treatments affect pregnancy is something we still don’t have enough data on. And as the population ages, we’re starting to explore how hormonal changes during menopause might impact epilepsy. There’s so much to learn about how epilepsy evolves with different phases of life, and it’s an exciting, necessary area of focus.
Neurostimulation is a huge topic right now. Everyone in medicine is working towards making treatments more personalized and minimally invasive, and neurostimulation offers a way to do both in epilepsy.
We currently have several devices—like vagus nerve stimulators, deep brain stimulators, and responsive neurostimulators. These are mainly used for drug-resistant epilepsy, meaning patients who have failed at least two appropriately chosen and dosed medications. These devices have been game-changers, especially for patients who weren’t candidates for resective surgery in the past.
Now, a lot of research is focused on improving these devices—figuring out the best placement in the brain and optimizing their use. There’s even talk about whether one day we might not need resections at all. Another area of exploration is whether neurostimulation can do more than just reduce seizure burden. For example, could it help patients stay more aware during their seizures? There’s exciting work happening in this space.
I’m not on the main board of the ILAE, but I sit on several task forces. The ILAE’s mission is to improve epilepsy care worldwide, and one of their biggest recent achievements is the Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders (IGAP).
This plan, which was ratified by the World Health Assembly, aims to advance understanding and care for epilepsy globally. The ILAE is using the momentum from this initiative to make significant strides in the coming years. It’s an exciting time for global epilepsy care.
We know that new-onset epilepsy becomes more common as people age. This isn’t surprising because, as you get older, you accumulate damage throughout your body, including the brain, which can trigger epilepsy.
Epilepsy and neurodegenerative disorders are also closely linked. For instance, people with late-onset seizures that don’t have a clear cause seem to be at higher risk of developing neurodegenerative diseases. Conversely, those with neurodegenerative conditions are more likely to develop seizures.
Older adults metabolize drugs differently, so the “start low and go slow” principle definitely applies here. There’s also evidence that certain medications, like lamotrigine and levetiracetam, are better tolerated in older adults. Interestingly, levetiracetam is being studied for its potential cognitive benefits in people with neurodegenerative diseases, even at lower doses. It’s unclear whether this effect is due to treating subclinical seizures or other mechanisms, but it’s an area of growing interest.