Patient-Clinician Conversations Regarding Drug-Resistant Epilepsy, Surgical Options: Alex Whiting, MD

WATCH TIME: 3 minutes

"For individuals with epilepsy who have already attempted various medications without success, this can be a daunting and distressing period. They might feel like they've run out of options and are in a hopeless situation. During our discussions, I emphasize that seeking my expertise is a positive step."

Over the years, the toolbox of antiseizure medications to treat patients with epilepsy has expanded; however, a small portion of patients’ condition remains uncontrollable. AEDs are available in different forms, including tablets, capsules, liquids, and syrups, offering patients a wide variety of options. Brain surgery is considered a potential method if the efficacy of AEDs remains insufficient or the seizures are caused by a problem in the small part of the brain that can be removed without causing serious effects.

Clinicians have begun to feel more comfortable with epilepsy surgery in part to technological innovations in the preoperative evaluation, surgical techniques, and outcome prediction. In addition, high-resolution structural imaging has opened opportunities to detect previously unrecognizable subtle abnormalities.

For patients who continue to fair several medications, it can feel like they’re out of options and in a hopeless situation, said Alex Whiting, MD. Whiting, director of epilepsy surgery at Allegheny Health Network, recently sat down with NeurologyLive^® to discuss the challenges with drug-resistant epilepsy, and the potential options patients may have. He provided perspective on the conversations between patients and clinicians, as well as the earliest signs and symptoms a patient might be drug-resistant. Finally, he spoke on the phenomenon about this condition, and the mechanistic questions that continue to puzzle the field.