Reviewing Updated Epilepsy Guidelines to Prioritize Outpatient Focus and Patient-Centric Approach: Fred Lado, MD, PhD

WATCH TIME: 5 minutes

"The guidelines were conceived with the idea of giving patients the data they need to participate fully in their care, providing them the loudest voice in decision-making and ensuring sound communication—a crucial part of good patient care."

In 1990, the National Association of Epilepsy Centers (NAEC) issued its first epilepsy center guidelines and since then has developed new guidelines every decade. Recently, the NAEC published new recommendations in Neurology regarding the essential services needed for a comprehensive epilepsy center and the optimal manner for their delivery to advance the quality of care.¹ These latest guidelines by NAEC are the first to be established on an evidence-informed, consensus-based process, and will provide ongoing support for epilepsy centers to obtain adequate resources for their programs.

Among 5937 studies, 197 articles were assessed by a panel of 41 stakeholders in a literature review. The multidisciplinary panel reached a consensus on 52 recommendations covering services from specialized epilepsy centers in both the inpatient and outpatient settings in key areas including epilepsy monitoring unit care, surgery, neuroimaging, neuropsychology, genetics, and outpatient care. As more research comes out to set practice standards and expand clinical knowledge, NAEC noted that they will consistently update the guidelines which will standardize care for epilepsy centers over time.

Lead author Fred Lado, MD, PhD, a professor of neurology at the Zucker School of Medicine at Hofstra-Northwell and director of the Epilepsy Division for the Central and Eastern Regions of Northwell Health, sat down with NeurologyLive® to discuss how the updated epilepsy care guidelines has evolved from the previous version, particularly in addressing outpatient care. He also talked about key elements in patient care, such as communication, shared decision-making, and addressing specific populations, that are emphasized in the new guidelines. Additionally, Lado spoke about how guidelines aim to influence epilepsy centers, payors, and clinicians to provide comprehensive support for patients beyond controlling seizures.

REFERENCES
1. Lado FA, Ahrens SM, Riker E, et al. Guidelines for Specialized Epilepsy Centers: Executive Summary of the Report of the National Association of Epilepsy Centers Guideline Panel. Neurology. 2024;102(4):e208087. doi:10.1212/WNL.0000000000208087