NeurologyLive® Year in Review 2022: Top Stories in Epilepsy

In 2022, the NeurologyLive^® staff was a busy bunch, covering clinical news and data readouts from around the world across a number of key neurology subspecialty areas. From major study publications and FDA decisions to societal conference sessions and expert interviews, the team spent all year bringing the latest information to the website's front page.

Among our key focus areas is epilepsy and seizure disorders, a field that saw a number of therapeutic hopefuls move through the pipeline in the past 12 months, among other progress. Although major news items often appear among the top pieces our team produces, sometimes smaller stories reach those heights for other reasons—clinical impact and interest, or concerns about the small- or big-picture parts of care, for example. Whatever the reason for the attention these stories got, their place here helps provide an understanding of the themes in this field over the course of 2022.

Here, we'll highlight some of the most-read content on NeurologyLive^® this year. Click the buttons to read further into these stories.

1. Ganaxolone Now Available After Winning Landmark Approval for CDKL5 Deficiency Disorder

After its approval in March, Marinus Pharmaceuticals announced the commercial launch of ganaxolone (Ztalmy; Marinus Pharmaceuticals) oral suspension in the US for the treatment of seizures associated with CDKL5 deficiency disorder in patients 2 years of age and older, noting in its announcement that information about the new treatment option can be found at the treatment website, ztalmyhcp.com, and by inquiring with independent specialty pharmacy Orsini Specialty Pharmacy.

2. FDA Approves Midazolam Autoinjector for Status Epilepticus

The FDA gave the green light to Rafa Laboratories for its 10-mg midazolam autoinjector for the treatment of status epilepticus in adults, making it the first autoinjectable product to be approved by the FDA, joining other rescue treatments with different routes of administration. The Rafa autoinjector was developed in partnership with the US Department of Defense’s Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense, with additional support from the Chemical and Biological Defense Program.

3. Long-Term Use of Diazepam Nasal Spray Improves Time Between Seizure Clusters

Newly published data from Jurriaan Peters, MD, PhD, and colleagues showed that treatment with diazepam nasal spray (Valtoco; Neurelis), an FDA-approved antiseizure medication, resulted in significant prolongation of time intervals between seizure clusters in patients with epilepsy. The full findings, published in Epilepsia, followed exploratory analysis presented at the Second North American Epilepsy Congress, held virtually on May 5-8, 2022.

4. Updates in Dravet Syndrome: Entering a New Era

Joseph Sullivan, MD, writes about the past decade's incredible advances in the diagnosis and treatment of Dravet syndrome, once considered a rare epilepsy syndrome with limited treatment options, that is now being increasingly diagnosed, with diagnoses occurring at an earlier age.

5. Zonisamide Oral Suspension FDA-Approved for Partial Seizures in Epilepsy

After being originally approved in the US in 2000, this summer, the FDA cleared a new oral suspension of zonisamide (Azurity Pharmaceuticals), marketed as Zonisade, for the treatment of partial seizures in adults and pediatrics aged 16 years and older with epilepsy.

6. The Application of Neurostimulation Devices in Detecting Seizures in Generalized Epilepsy

Mark Richardson, MD, PhD, spoke about the successes of thalamic neuromodulation for patients with generalized epilepsy in his presentation at the 2022 Congress of Neurological Surgeons, what it could mean for patients with epilepsy, and a new clinical trial to test the ability of the treatment to work in patients with generalized epilepsy.

7. EEG Changes in Acute Phase of Autoimmune Encephalitis May Predict Risk of Drug-Resistant Epilepsy

In a new retrospective analysis published in Epilepsy and Behavior by Robb Wesselingh, MBBS, et al, drug-resistant epilepsy was found to be uncommon in patients with autoimmune encephalitis at 12-month follow-up but was associated with several risk factors, including the presence of status epilepticus during acute admission and multiple biomarkers of neuronal dysfunction on electroencephalography.

8. Long-Term Cenobamate Data Show Sustained Seizure Reductions, Including Total Seizure Freedom

Newly published data in Neurology from Pavel Klein, MD, and colleagues from the long-term, open-label extension of the randomized, placebo-controlled C017 study (NCT01866111) of cenobamate (Xcopri; SK Life Sciences) showed that the antiseizure medication sustained efficacy after 48 months, with more than 15% of patients achieving 100% seizure freedom.

9. Cell Therapy NRTX-1001 Shows Significant Effect on Drug-Resistant Epilepsy in Early Data

Late this year, Neurona Therapeutics announced findings from the first-in-human study (NCT05135091) of NRTX-1001 (Neurona Therapeutics), a regenerative neural cell therapy derived from human pluripotent stem cells, showed encouraging signs of seizure reduction in 2 patients with drug-resistant focal epilepsy treated with the agent.

10. Following ASM Discontinuation, Age at Epilepsy Diagnosis and Abnormal EEG Predict Future Pediatric Seizure Relapse

Findings published in Epilepsy and Behavior by Mirac Yildirim, MD, and colleagues from a study of seizure-free children who discontinued their antiseizure medication indicated that being an adolescent age at diagnosis, having abnormal EEG findings following withdrawal, and having a high number of seizures while on ASMs were associated with a higher risk of seizure relapse.