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Is the End of Epilepsy in Sight? 

Is the End of Epilepsy in Sight?
Chapter:
Is the End of Epilepsy in Sight?
Author(s):

Dieter Schmidt

and Simon Shorvon

DOI:
10.1093/med/9780198725909.003.0008
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date: 29 March 2020

The best proxy for the end of epilepsy is the complete cessation of seizures and the permanent ending of the need for further treatment. This marks the end of the biology of epilepsy, but not necessarily of all its societal consequences. The good news is that today over 80% of people developing epilepsy will reach this goal after a few years of treatment. Unfortunately, though, not all patients can reach this point, and it is for these patients that we seek improvements in the future. The end of epilepsy is not always easy to predict at the beginning. The taking of drugs is an issue, as always, of risk versus benefit, and although there are some benefits to discontinuation, this has to be balanced against the risk of seizure recurrence. Even if drugs alone don’t work, additional surgery may end epilepsy in as many as one in four people with amenable epilepsy. New thinking and new strategies for drug treatment, which not only control seizures but also address the underlying processes resulting in epilepsy, offer new horizons. The bottom line is that a revolution in discovery and development is needed. Epilepsy is, as pointed out throughout this book, more than having seizures, and so thus the scope of its treatment should be broader than simple seizure suppression. The end of epilepsy is, like the end of the rainbow, on the horizon, but equally tantalisingly difficult to reach.

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