Dec 4-8, 2015, Philadelphia, PA
This year’s Annual Course will focus on the complex relationship between patients with epilepsy, their treating neurologists and other care providers, and the media. This topic is very timely in light of the growth and impact of the Internet and social media. The Annual Course will delve into detail about the way information is portrayed and communicated about epilepsy through the media. Rather than the usual case vignettes, vignettes will focus on the common interactions over the course of a working day between an epileptologist and patients, families and caregivers focused on media-provided information. Didactic lectures and debates will be combined with illustrative examples, interspersed before breaks. Topics will include seizure detection (dogs and devices), driving rules, cannabadiols and SUDEP.
This program will provide education regarding design, implementation and use of video-EEG. It will review how to utilize modern technology, safety protocols and nursing and physician practice to provide optimal care for patients with uncontrolled seizures. Effective use of video, interictal EEG, ictal EEG and intracranial EEG will be reviewed, and participants will learn how to integrate data obtained using these modalities. Sample cases will be used to further illustrate use of this method.
This symposium will present an update on MRI functions of cortical development and epilepsy. The classification scheme, imaging findings, clinical phenotypes will be presented. Medical and surgical paradigms will be addressed. As a result of attending this symposium, the attendee will recognize clinical and imaging features and classify MCD patients, ordering genetic testing, treatment and counseling.
This symposium will guide the attendee in managing epilepsy patients from initial diagnosis to consideration of respective epilepsy surgery. Guidelines will be presented providing best practice for initiating anti-seizure drug therapy. Attendees will learn ways to recognize and manage drug “failures” that are not due to lack of drug efficacy. Updated information on best practices for rational polypharmacy to obtain the best patient outcomes will be presented. Newer nonpharmacologic treatments for patients who continue to have seizures despite adequate trials of anti-seizure medications will also be presented. The concept of anti-epileptic versus antiepileptogenic therapy for seizures will be discussed in a practical, clinically-based approach.
Uncontrolled studies suggested lack of efficacy or increased adverse events when people with epilepsy switched from brand to generic AEDs. Some neurologists, patients and patient advocacy groups questioned the FDA whether product bioequivalence established in healthy volunteers can ensure AED bioequivalence in people with epilepsy receiving concomitant medications. To address the epilepsy community’s concern, the FDA Office of Generic Drugs (OGD) has funded a series of prospective brand-to-generic AED switching studies in epilepsy patients starting in 2010, including the bioequivalence in Epilepsy Patients (BEEP) study and Equivalence in Generic Drugs (EQUIGEN) study. The research findings from BEEP and EQUGEN studies will be presented. Some other factors which may affect AED clinical outcomes, including pill appearance, patient adherence and patient/physician perception about generic drugs, will be discussed. FDA OGD’s continued efforts on generic AEDs including narrow therapeutic index (NTI) drug classification and modified release products will be updated.
This program will provide information to enable physicians and other health care providers to improve diagnostic and patient management skills. The topics include practical approach to ordering and interpreting genetic testing for epilepsy, a practical approach to diagnosing and treating autoimmune epilepsy, a review of indications and use of valproate for women with epilepsy and an update on cannabis and cannabinoid use in epilepsy.
Network science is a multidisciplinary field based on fundamental discoveries in mathematics and physics that has had significant impact on a wide range of disciplines spanning engineering, medicine, biology, social and information technology. Advances in the science of networks have led to a deeper understanding of the role of the cellular constituents, assemblies and large-scale brain networks underlying normal and pathological brain activity, and has important implications for epileptogenesis, seizures and epilepsy. In this Merritt-Putman symposium we review the science and technology driving the rapidly evolving, interdisciplinary field of networks, and address some of the key opportunities and challenges. This will include discussion of the role of networks in clinical epilepsy, including evaluation of cognition and planning epilepsy surgery.
This symposium will present a detailed review of mortality in children with epilepsy with emphasis on what is currently fact. A discussion of SUDEP will outline why this catastrophe is different in children than adults and the quality of evidence for prevention. There will be a careful discussion of what to tell patients and families about the risk of death and how to assist families should their child die.
Epilepsy care has focused on symptomatic treatment, that is, control of seizures. Modification of disease progression, underway in other clinical areas, has not been a focus of epilepsy research until recent years. Translation from the bench to the clinic requires collaboration among scientists, clinical researchers and clinicians. This symposium will address the development of clinical trials for diseasemodifying therapies including issues which can adversely impact successful outcomes.
Recent research and practice recommendations include that health professionals must work collaboratively to improve the delivery of care and outcomes for patients and families (RWJ, 2011). Interprofessional competency domains that all health care providers must address, including values/ethics for interprofessional practice, roles/responsibilities, interprofessional communication and teams and teamwork (IPEC, 2011). The IOM Report on epilepsy includes the recommendation to research and develop a quality framework for epilepsy care to increase access to care, quality of life and health outcomes (England et al., 2012). This symposium will present recent research and practice evidence regarding how providing interprofessional care assists health care teams to provide comprehensive lifespan care for persons with epilepsy and their families. Examples of existing interprofessional models of care will be reviewed in populations such as children, adolescents, adults and veterans. In addition, possible interventions to accommodate lack of resources and funding for interprofessional care models will also be addressed.
Tremendous advances in our understanding of the genetic mutations that underlie different types of epilepsy have left the epilepsy research and clinical world reeling. How to take this knowledge to the next level so that treatments can be identified for these patients in, some of whom exist in only small numbers, is being wrestled with at many levels. At the same time President Obama’s recent Precision Medicine Initiative represents a bold new research effort to revolutionize how we improve health and treat disease. This symposium will address these issues, from mutation to bedside in a precision medicine fashion.
The symposium will provide an overview of frontal lobe epilepsy, especially the clinical semiology of seizures and the comorbidities associated to intractable cases, with special reference to neuropsychological aspects which affect quality of life including social and psychological development. It will also provide an overview of current practices in Spanish speaking countries to identify intractable cases and refer to surgical management especially in the setting of limited resources.
Clinicians are knowledgeable about interpretation of clinical trials but have limited knowledge of pre- clinical discovery and development of therapeutic agents and devices. This symposium will address critical issues identified by AES and ILAE working groups that require solutions in order to facilitate and promote translational research in therapeutic development for epilepsy and related co-morbidities. Problems in reproducing pre-clinical research have increased the risk of embarking on programs for development of new therapies for venture and industrial sponsors. Multiple academic studies have documented the high rate of failure to reproduce critical preclinical studies. Criteria to increase the rigor, and therefore the reproducibility of preclinical work have been identified; initial efforts to implement these strategies have identified challenges and opportunities, as well as critical resources required to achieve the goal of increasing rigor. Finally, effective communication of positive and negative results, as well as reproducibility and validation studies requires novel publication models. This symposium states the problem, examines the components required to achieve rigor, reviews recent experience in designing and conducting studies designed to meet proposed criteria, and concludes with a discussion of the effects of publication bias and a description of a novel publication platform designed to serve the needs of the translational research community. In addition to addressing issues in research methodology for researchers, the information presented at this symposium will allow clinicians to better assess new therapeutic options.
For aging people with epilepsy to maintain independence
Sudden Unexpected Death in Epilepsy