The burden of epilepsy and unmet need in people with focal seizures

Abstract

Background

Epilepsy is one of the most common neurological conditions worldwide. As a chronic condition, epilepsy imposes a significant burden on people with epilepsy and society. We aimed to assess the burden and unmet need of individuals with epilepsy and their caregivers, focusing on focal seizures, the main type of seizure in adults and children.

Methods

A targeted evidence review of the burden of epilepsy, focusing on focal seizures, was conducted to identify articles reporting: epidemiology, mortality, morbidity, quality of life (QoL), and costs.

Results

Focal seizures affect up to ∼61% of people with epilepsy. They are associated with an increased risk of injury and premature death than the general population. People with epilepsy also have high comorbidity, particularly depression, anxiety, and cognitive impairments. Higher seizure frequency, adverse treatment events, and employment concerns reduce QoL. A reduction in caregivers' QoL is also often reported. Epilepsy requires long‐term treatment accounting for high individual costs. Hospitalizations and antiseizure medications (ASMs) are the leading cost drivers of inpatient management and indirect costs with high unemployment rates, particularly in drug‐resistant populations. Despite the advent of new treatments, a high unmet need remains unaddressed; approximately 40% of people with epilepsy are drug‐resistant, further increasing the risks associated with epilepsy.

Conclusions

Our findings highlight a substantial burden of illness and unmet needs in individuals with focal seizures, especially those with drug‐resistant epilepsy. Suboptimal treatment options negatively impact QoL and, consequently, a sizeable economic burden indicating the need for new treatments and prioritizing this condition

Abstract

Seizure freedom is the ultimate goal for the treatment of focal epilepsy. A 30‐year study found that the probability of achieving seizure freedom decreases substantially with each additional antiseizure medication regimen attempted. If the first ASM is ineffective, the second ASM results in an 11.6% chance of seizure freedom, decreasing to 4.4% if a third drug is required. After this, only 2.1% achieved seizure control on subsequent ASM regimens.