[Health Information] From drugs to robots and AI…the evolution of epilepsy treatment

 For the roughly 360,000 people with epilepsy in Korea, the treatment paradigm is evolving rapidly beyond simple seizure suppression towards a cure and a better quality of life.

To mark ‘World Brain Day’, St. Peter's Hospital introduced on 23 July the latest treatment trends that are overcoming the limits of epilepsy management.

Epilepsy, one of the three major neurological disorders, has often been confined to conservative, drug-centered management because of a lack of infrastructure, but it is now at a turning point with the introduction of new drugs, precision diagnosis and surgical techniques.

Epilepsy treatment has recently been shifting towards an active strategy that reduces drug side effects and improves long-term prognosis through patient-tailored care.

First, third-generation drugs with mechanisms that set them apart from existing second-generation agents are appearing one after another.

Leading examples are cenobamate, developed by a Korean company and under health insurance reimbursement review, and brivaracetam formulations, which reduce side effects such as depression.

Advances in surgical technique are also notable.

Detailed evaluation has become possible with stereo-EEG electrode implantation (SEEG) using the Kymero surgical robot, and where a cure is difficult, tailored surgery that takes the individual patient's lesion into account, such as deep brain stimulation (DBS) and vagus nerve stimulation (VNS), is expanding.

Hong Seung-bong, Director of the Epilepsy & Sleep Center at St. Peter's Hospital, explained, "Major epilepsy centers in the United States and Europe are actively performing epilepsy treatment using radiofrequency or lasers."

For drug-resistant epilepsy, surgery is highly effective, yet a lack of infrastructure once meant a wait of one to two years before an operation.

Recently, however, new specialist institutions have greatly improved access to treatment, and the switch of magnetoencephalography (MEG) to essential insurance coverage has also improved the diagnostic environment.

St. Peter's Hospital opened its Epilepsy & Sleep Center last year and, with state-of-the-art equipment, has built and now operates a fast track running from diagnosis through to surgery.

Research to find new treatment strategies is also active.

Seoul National University Hospital has in fact published a model that uses artificial intelligence (AI) to predict in advance how individual patients will respond to more than 20 different anticonvulsants, while SoVarGen, a KAIST faculty startup, developed an RNA drug (ASO) for intractable epilepsy and signed a large-scale technology transfer agreement with a global pharmaceutical company.

Center Director Hong Seung-bong said, "With new drugs, precision diagnosis and surgical techniques all advancing at the same time, epilepsy care is at a turning point," adding, "As Korea's epilepsy diagnosis and treatment infrastructure continues to expand, the range of treatment options should widen further in the years ahead."

Director Hong went on to say, “In the past a lack of treatment infrastructure made it difficult to provide active treatment suited to each patient’s condition, but with new treatments emerging and specialized epilepsy centers being established, the diagnostic and treatment environment is changing rapidly.” He added, “If, through research into and development of a variety of strategies that combine various drugs and surgical techniques, we go on to achieve outcomes such as long-term seizure suppression and cure, we will be able to offer ‘a life without seizures’ to many more patients.”

Source: Hospital News (http://www.khanews.com)