A recent study led by researchers at NYU Langone Health as part of the international Human Epilepsy Project has found that most people with focal epilepsy experience seizures for at least a year after starting antiseizure medication. The study, which involved nearly 450 newly diagnosed patients, revealed that while more than half eventually achieved seizure control with medication, significant improvement typically took an average of 12 months.
Focal epilepsy accounts for about 60 percent of all epilepsy cases and is characterized by sudden bursts of electrical activity in specific regions of the brain. These episodes can lead to abnormal emotions, behaviors, or sensations. While previous research has often focused on patients who do not respond to treatment, this study examined those who may find relief after trying different medications or dosages.
“Our findings suggest that those with focal epilepsy should expect a long adjustment period as their healthcare provider determines the best treatment regimen for them,” said Jacqueline A. French, MD, senior author and neurologist at NYU Langone Health.
Dr. French noted that one reason for the delay in achieving seizure control could be that physicians are not selecting the optimal therapy on their first attempt. She explained that although levetiracetam is commonly prescribed due to its broad applicability and limited drug interactions—57 percent of participants started on it—only a quarter became seizure-free on their initial regimen.
The study was conducted across 34 epilepsy centers in the United States, Europe, and Australia from 2012 to 2019. Participants tracked their seizures using electronic diaries over three to six years and provided detailed information about their medication use.
Results showed that 63 percent of participants continued to have frequent or worsening seizures during the first year of therapy regardless of eventual outcomes. Those who had less frequent seizures before starting treatment were more likely to respond positively to medication compared to those with weekly episodes. Additionally, individuals with a history of psychological disorders such as anxiety or depression were almost twice as likely not to respond well to antiseizure drugs.
“Our results show that the best way to a new treatment plan is sometimes through making better use of the tools we already have instead of always searching for the next breakthrough drug,” Dr. French said.
The research team plans further analysis focusing on patients who did not become seizure-free during the study period. Dr. French cautioned that factors such as choice and dosage of regimen or side effects were not directly assessed in this investigation.
The Human Epilepsy Project involves hundreds of professionals working together internationally to better understand how patients respond to therapies and achieve seizure freedom.
Funding for this research came from several sources including pharmaceutical companies UCB, Eisai Co., Pfizer, Lundbeck, Sunovion Pharmaceuticals Inc., nonprofit organizations like Finding a Cure for Epilepsy and Seizures (FACES), and private foundations such as the Andrews Foundation and John and Barbara Vogelstein Foundation.
Dr. French disclosed receiving support from various organizations related to her work in epilepsy research; these relationships are managed by NYU Langone Health according to institutional policies.
Other co-senior authors include Ruben Kuzniecky, MD (Northwell Health) and Daniel Lowenstein, MD (University of California San Francisco). Additional co-investigators contributed from institutions in Australia, New York State, Florida, and California.
NYU Langone Health operates an integrated health system recognized nationally for quality patient outcomes and low mortality rates; it has been ranked No. 1 among comprehensive academic medical centers by Vizient Inc., with several clinical specialties also ranked highest nationwide by U.S. News & World Report (https://nyulangone.org/news/nyu-langone-health-ranked-no-1-vizient-quality-academic-medical-centers-third-year-row). The system encompasses multiple inpatient locations—including two tuition-free medical schools—and extensive outpatient services throughout New York and Florida.
