JAMA Neurol
Seizure freedom may take more than a year for many patients with focal epilepsy
September 3, 2025

Study details: The Human Epilepsy Project was a multicenter, prospective cohort study conducted across 34 tertiary epilepsy centers in the U.S., Europe, and Australia that followed 448 individuals aged 12 to 60 years with newly diagnosed focal epilepsy for up to 6 years. Participants were enrolled within 4 months of initiating antiseizure medication (ASM), and treatment response was classified using International League Against Epilepsy definitions.
Results: Seizure freedom was achieved by 59.6% of participants, with 83.5% of those maintaining remission. Among treatment-sensitive individuals (54.7%), nearly 90% responded to monotherapy, but only 27% of the total cohort became seizure free on their first ASM. Median time to seizure freedom was 12.1 months, occurring earlier in those who never relapsed (2.2 months) vs. those who did (7.4 months). Infrequent pretreatment seizures were associated with higher drug resistance (relative risk [RR], 0.41; P=.03), while psychiatric comorbidities increased resistance risk (RR, 1.78; P=.001).
Clinical impact: These findings emphasize the need for early identification of patients at risk for drug resistance. Psychiatric history and seizure frequency may guide prognosis and inform timely referral to specialized care or alternative treatment strategies.
Source:
Barnard SN, et al; Human Epilepsy Project (1) Investigators. (2025, August 25). JAMA Neurol. Treatment Response to Antiseizure Medications in People With Newly Diagnosed Focal Epilepsy. https://pubmed.ncbi.nlm.nih.gov/40853673/
TRENDING THIS WEEK