2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T4ae,Of 196 approached participants, 146 met eligibility criteria and were included in the study. Mean (SD) participant age was 40 (12) years, and epilepsy was diagnosed at a mean (SD) age of 19.8 (13.6) years. The cohort had 84 (57.5%) female participants. A total of 35 participants had implantable devices; 1 had epilepsy surgery during the study. Of 146 participants, 128 provided sufficient seizure data for analysis, and 2 were excluded as outliers. Seizure frequency was reduced in 86 participants (68.3%) during the second half of study participation compared to the first half. In the overall cohort, mean modeled monthly seizure frequency percentage reduction was 68.73% (95% CI, 52.92%-84.54%). From 0 to 12 months (cohort 1), mean modeled percentage reduction was 67.76% (95% CI, 19.42%-116.09%); for 12 to 24 months (cohort 2), 36.00% (95% CI, 9.27%-53.46%); and for longer than 24 months (cohort 3), 66.03% (95% CI, 48.25%-83.80%) (all P < .001). An ASM was added in 69 participants (54.7%), of whom 46 (66.7%) experienced seizure frequency reduction, including seizure freedom. Seizure trajectories in participants with devices did not significantly differ from those without devices.31:Tbbc,Open-label trials of antiseizure medications (ASMs) and devices suggest seizure reduction in focal treatment-resistant epilepsy (FTRE) may demonstrate treatment-related disease-modifying effects. Understanding FTRE trends can provide insight into treatment responses. To determine whether seizure frequency in FTRE improves over time. The Human Epilepsy Project 2 was a prospective, observational, multicenter study of patients with FTRE from May 2018 to September 2021 who were followed up for 18 to 36 months at 10 US-based comprehensive epilepsy centers. Analysis was performed from 2021 to 2024. Study data included seizure frequency, medication use, device use, surgeries tracked using daily electronic diaries, monthly check-ins, medical record review, and case report forms. Eligibility criteria included focal epilepsy diagnosis, age between 16 and 65 years, and failure of 4 or more ASMs (≥2 due to seizure control failure). Participants were recruited as a volunteer sample. Participants were treated with multiple interventions at their physicians' discretion. The primary outcome was seizure frequency trends, evaluated by quantifying seizure freedom rates and frequency reductions. Medication and device treatment responses were assessed by tracking ASM and device changes. Of 196 approached participants, 146 met eligibility criteria and were included in the study. Mean (SD) participant age was 40 (12) years, and epilepsy was diagnosed at a mean (SD) age of 19.8 (13.6) years. The cohort had 84 (57.5%) female participants. A total of 35 participants had implantable devices; 1 had epilepsy surgery during the study. Of 146 participants, 128 provided sufficient seizure data for analysis, and 2 were excluded as outliers. Seizure frequency was reduced in 86 participants (68.3%) during the second half of study participation compared to the first half. In the overall cohort, mean modeled monthly seizure frequency percentage reduction was 68.73% (95% CI, 52.92%-84.54%). From 0 to 12 months (cohort 1), mean modeled percentage reduction was 67.76% (95% CI, 19.42%-116.09%); for 12 to 24 months (cohort 2), 36.00% (95% CI, 9.27%-53.46%); and for longer than 24 months (cohort 3), 66.03% (95% CI, 48.25%-83.80%) (all P < .001). An ASM was added in 69 participants (54.7%), of whom 46 (66.7%) experienced seizure frequency reduction, including seizure freedom. Seizure trajectories in participants with devices did not significantly differ from those without devices. Findings from the HEP2 study imply that FTRE improves over time, ASM additions had low probability of achieving seizure freedom but contributed to seizure reduction, and device-treated participants exhibited similar seizure trajectories to those without devices. Whether improvements reflected the natural history of FTRE or active management remains unclear, but our findings suggest cautious interpretation of open-label studies positing disease-modifying effects and further research into FTRE treatment response.32:T111e, Importance Open-label trials of antiseizure medications (ASMs) and devices suggest seizure reduction in focal treatment-resistant epilepsy (FTRE) may demonstrate treatment-related disease-modifying effects. Understanding FTRE trends can provide insight into treatment responses. Objective To determine whether seizure frequency in FTRE improves over time. Design, Setting, and Participants The Human Epilepsy Project 2 was a prospective, observational, multicenter study of patients with FTRE from May 2018 to September 2021 who were followed up for 18 to 36 months at 10 US-based comprehensive epilepsy centers. Analysis was performed from 2021 to 2024. Study data included seizure frequency, medication use, device use, surgeries tracked using daily electronic diaries, monthly check-ins, medical record review, and case report forms. Eligibility criteria included focal epilepsy diagnosis, age between 16 and 65 years, and failure of 4 or more ASMs (≥2 due to seizure control failure). Participants were recruited as a volunteer sample. Exposures Participants were treated with multiple interventions at their physicians’ discretion. Main Outcomes and Measures The primary outcome was seizure frequency trends, evaluated by quantifying seizure freedom rates and frequency reductions. Medication and device treatment responses were assessed by tracking ASM and device changes. Results Of 196 approached participants, 146 met eligibility criteria and were included in the study. Mean (SD) participant age was 40 (12) years, and epilepsy was diagnosed at a mean (SD) age of 19.8 (13.6) years. The cohort had 84 (57.5%) female participants. A total of 35 participants had implantable devices; 1 had epilepsy surgery during the study. Of 146 participants, 128 provided sufficient seizure data for analysis, and 2 were excluded as outliers. Seizure frequency was reduced in 86 participants (68.3%) during the second half of study participation compared to the first half. In the overall cohort, mean modeled monthly seizure frequency percentage reduction was 68.73% (95% CI, 52.92%-84.54%). From 0 to 12 months (cohort 1), mean modeled percentage reduction was 67.76% (95% CI, 19.42%-116.09%); for 12 to 24 months (cohort 2), 36.00% (95% CI, 9.27%-53.46%); and for longer than 24 months (cohort 3), 66.03% (95% CI, 48.25%-83.80%) (all P &lt; .001). An ASM was added in 69 participants (54.7%), of whom 46 (66.7%) experienced seizure frequency reduction, including seizure freedom. Seizure trajectories in participants with devices did not significantly differ from those without devices. Conclusions and Relevance Findings from the HEP2 study imply that FTRE improves over time, ASM additions had low probability of achieving seizure freedom but contributed to seizure reduction, and device-treated participants exhibited similar seizure trajectories to those without devices. Whether improvements reflected the natural history of FTRE or active management remains unclear, but our findings suggest cautious interpretation of open-label studies positing disease-modifying effects and further research into FTRE treatment response. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Focal Treatment-Resistant Epilepsy: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Focal Treatment-Resistant Epilepsy (condition). Clinician-written summaries and actionable practice insights. Updated daily.\",\"url\":\"https://www.reachrx.ai/hub/tag/condition/Focal%20Treatment-Resistant%20Epilepsy\",\"breadcrumb\":{\"@type\":\"BreadcrumbList\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https://www.reachrx.ai\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Research Hub\",\"item\":\"https://www.reachrx.ai/hub\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Conditions\",\"item\":\"https://www.reachrx.ai/hub/tag/condition\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Focal Treatment-Resistant Epilepsy\",\"item\":\"https://www.reachrx.ai/hub/tag/condition/Focal%20Treatment-Resistant%20Epilepsy\"}]}}"}}]],["$","$L2f",null,{"title":"Focal Treatment-Resistant Epilepsy: Research & Clinical Takeaways","description":"Discover peer-reviewed research on Focal Treatment-Resistant Epilepsy with concise clinician summaries and next-step guidance.","papers":[{"doi":"10.1001/jamaneurol.2025.4085","pmid":"41114972","title":"Seizure Frequency Trends Over Time in Treatment-Resistant Focal Epilepsy","journal_title":"JAMA Neurology","journal_issn":"2168-6149","published_at":"2025-10-20T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12687094/","source_score":316,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-12-14","doi":"10.1001/jamaneurol.2025.4085","days":"30","issn":"2168-6149","rank":"4","field":"Clinical Medicine","score":"316","category":"Clinical Neurology","categories":["Clinical Neurology"],"_categories":["Clinical Neurology"]},"pubmed":{"doi":"10.1001/jamaneurol.2025.4085","title":"Seizure Frequency Trends Over Time in Treatment-Resistant Focal Epilepsy.","journal":"JAMA neurology","methods":"","results":"$30","abstract":"$31","keywords":[],"pubmed_id":"41114972","conclusions":"","publication_date":"2025-10-20T00:00:00"},"crossref":{"DOI":"10.1001/jamaneurol.2025.4085","URL":"https://doi.org/10.1001/jamaneurol.2025.4085","ISSN":["2168-6149"],"link":[{"URL":"https://jamanetwork.com/journals/jamaneurology/articlepdf/2840155/jamaneurology_potnis_2025_oi_250072_1764183367.6093.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"1257","type":"journal-article","issue":"12","score":1,"title":["Seizure Frequency Trends Over Time in Treatment-Resistant Focal Epilepsy"],"author":[{"given":"Ojas","family":"Potnis","sequence":"first","affiliation":[{"name":"Department of Neurology, NYU Langone Health, New York, New York"}]},{"given":"Gabriel","family":"Biondo","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana"}]},{"given":"Rachel","family":"Sukonik","sequence":"additional","affiliation":[{"name":"Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland"}]},{"given":"Caitlin","family":"Grzeskowiak","sequence":"additional","affiliation":[{"name":"Research and Innovation, Epilepsy Foundation, Bowie, Maryland"}]},{"given":"Gary","family":"Cutter","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Alabama at Birmingham"}]},{"given":"Hamada","family":"Altalib","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yale University, New Haven, Connecticut"}]},{"given":"Ruben","family":"Kuzniecky","sequence":"additional","affiliation":[{"name":"Department of Neurology, Northwell Health, New York, New York"}]},{"given":"Daniel","family":"Lowenstein","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of California, San Francisco"}]},{"given":"Jacqueline","family":"French","sequence":"additional","affiliation":[{"name":"Comprehensive Epilepsy Center, NYU Langone Health, New York, New York"}]},{"given":null,"family":null,"sequence":"additional","affiliation":[]},{"given":"Gregory","family":"Cascino","sequence":"additional","affiliation":[{"name":"for the HEP2 Investigators"}]},{"given":"Paul","family":"Atkinson","sequence":"additional","affiliation":[{"name":"for the HEP2 Investigators"}]},{"given":"Manisha","family":"Holmes","sequence":"additional","affiliation":[{"name":"for the HEP2 Investigators"}]},{"given":"Chris","family":"Morrison","sequence":"additional","affiliation":[{"name":"for the HEP2 Investigators"}]},{"given":"Manu","family":"Hegde","sequence":"additional","affiliation":[{"name":"for the HEP2 Investigators"}]},{"given":"Michael","family":"Gelfand","sequence":"additional","affiliation":[{"name":"for the HEP2 Investigators"}]},{"given":"Andres","family":"Kanner","sequence":"additional","affiliation":[{"name":"for the HEP2 Investigators"}]},{"given":"Kamil","family":"Detyniecki","sequence":"additional","affiliation":[{"name":"for the HEP2 Investigators"}]},{"given":"Bassel","family":"Abou-Khalil","sequence":"additional","affiliation":[{"name":"for the HEP2 Investigators"}]},{"given":"Robert","family":"Wechsler","sequence":"additional","affiliation":[{"name":"for the HEP2 Investigators"}]},{"given":"Brandy","family":"Fureman","sequence":"additional","affiliation":[{"name":"for the HEP2 Investigators"}]},{"given":"Heath","family":"Pardoe","sequence":"additional","affiliation":[{"name":"for the HEP2 Investigators"}]},{"given":"Barry","family":"Gidal","sequence":"additional","affiliation":[{"name":"for the HEP2 Investigators"}]},{"given":"Dennis","family":"Dlugos","sequence":"additional","affiliation":[{"name":"for the HEP2 Investigators"}]},{"given":"Kim","family":"Meador","sequence":"additional","affiliation":[{"name":"for the HEP2 Investigators"}]},{"given":"John","family":"Hixon","sequence":"additional","affiliation":[{"name":"for the HEP2 Investigators"}]}],"issued":{"date-parts":[[2025,12,1]]},"member":"10","prefix":"10.1001","source":"Crossref","volume":"82","created":{"date-time":"2025-10-20T15:31:07Z","timestamp":1760974267000,"date-parts":[[2025,10,20]]},"indexed":{"date-time":"2025-12-08T16:06:46Z","timestamp":1765210006539,"date-parts":[[2025,12,8]]},"subject":[],"abstract":"$32","language":"en","relation":{},"resource":{"primary":{"URL":"https://jamanetwork.com/journals/jamaneurology/fullarticle/2840155"}},"subtitle":[],"deposited":{"date-time":"2025-12-08T16:01:08Z","timestamp":1765209668000,"date-parts":[[2025,12,8]]},"issn-type":[{"type":"print","value":"2168-6149"}],"published":{"date-parts":[[2025,12,1]]},"publisher":"American Medical Association (AMA)","reference":[{"DOI":"10.1001/jamaneurol.2017.3949","key":"noi250072r2","year":"2018","issue":"3","author":"Chen","volume":"75","first-page":"279","unstructured":null,"article-title":"Treatment outcomes in patients with newly diagnosed epilepsy treated with established and new antiepileptic drugs: a 30-year longitudinal cohort study.","journal-title":"JAMA Neurol","doi-asserted-by":"publisher"},{"DOI":"10.1111/epi.17585","key":"noi250072r3","year":"2023","issue":"5","author":"Kverneland","volume":"64","first-page":"e69","unstructured":null,"article-title":"Health-related quality of life in adults with drug-resistant focal epilepsy treated with modified Atkins diet in a randomized clinical trial.","journal-title":"Epilepsia","doi-asserted-by":"publisher"},{"DOI":"10.1007/s40263-021-00827-8","key":"noi250072r4","year":"2021","issue":"9","author":"Löscher","volume":"35","first-page":"935","unstructured":null,"article-title":"The pharmacology and clinical efficacy of antiseizure medications: from bromide salts to cenobamate and beyond.","journal-title":"CNS Drugs","doi-asserted-by":"publisher"},{"DOI":"10.1056/NEJMra1004418","key":"noi250072r5","year":"2011","issue":"10","author":"Kwan","volume":"365","first-page":"919","unstructured":null,"article-title":"Drug-resistant epilepsy.","journal-title":"N Engl J Med","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.yebeh.2023.109182","key":"noi250072r6","year":"2023","issue":null,"author":"Skrehot","volume":"142","first-page":null,"unstructured":null,"article-title":"Neuro-stimulation in focal epilepsy: a systematic review and meta-analysis.","journal-title":"Epilepsy Behav","doi-asserted-by":"publisher"},{"DOI":"10.1111/j.1528-1167.2011.03024.x","key":"noi250072r7","year":"2011","issue":"4","author":"Löscher","volume":"52","first-page":"657","unstructured":null,"article-title":"Modern antiepileptic drug development has failed to deliver: ways out of the current dilemma.","journal-title":"Epilepsia","doi-asserted-by":"publisher"},{"DOI":"10.1016/S1474-4422(23)00151-5","key":"noi250072r8","year":"2023","issue":"8","author":"Perucca","volume":"22","first-page":"723","unstructured":null,"article-title":"Drug resistance in epilepsy.","journal-title":"Lancet Neurol","doi-asserted-by":"publisher"},{"DOI":"10.1002/ana.21166","key":"noi250072r9","year":"2007","issue":"4","author":"Callaghan","volume":"62","first-page":"382","unstructured":null,"article-title":"Likelihood of seizure remission in an adult population with refractory epilepsy.","journal-title":"Ann Neurol","doi-asserted-by":"publisher"},{"DOI":"10.2147/NDT.S256699","key":"noi250072r10","year":"2021","issue":"17","author":"Guery","volume":"17","first-page":"2229","unstructured":null,"article-title":"Clinical management of drug resistant epilepsy: a review on current strategies.","journal-title":"Neuropsychiatr Dis Treat","doi-asserted-by":"publisher"},{"DOI":"10.1111/epi.17875","key":"noi250072r11","year":"2024","issue":"4","author":"Terman","volume":"65","first-page":"846","unstructured":null,"article-title":"Challenges and directions in epilepsy diagnostics and therapeutics: proceedings of the 17th Epilepsy Therapies and Diagnostics Development conference.","journal-title":"Epilepsia","doi-asserted-by":"publisher"},{"DOI":"10.1111/j.1528-1167.2009.02397.x","key":"noi250072r12","year":"2010","issue":"6","author":"Kwan","volume":"51","first-page":"1069","unstructured":null,"article-title":"Definition of drug resistant epilepsy: consensus proposal by the ad hoc task force of the ILAE Commission on Therapeutic Strategies.","journal-title":"Epilepsia","doi-asserted-by":"publisher"},{"DOI":"10.1111/j.1528-1167.2007.00992.x","key":"noi250072r13","year":"2007","issue":null,"author":"French","volume":"48","first-page":"3","unstructured":null,"article-title":"Refractory epilepsy: clinical overview.","journal-title":"Epilepsia","doi-asserted-by":"publisher"},{"DOI":"10.1002/ana.21064","key":"noi250072r14","year":"2007","issue":"4","author":"Luciano","volume":"62","first-page":"375","unstructured":null,"article-title":"Results of treatment changes in patients with apparently drug-resistant chronic epilepsy.","journal-title":"Ann Neurol","doi-asserted-by":"publisher"},{"DOI":"10.1212/01.wnl.0000286959.22040.6e","key":"noi250072r15","year":"2008","issue":"1","author":"Schiller","volume":"70","first-page":"54","unstructured":null,"article-title":"Quantifying the response to antiepileptic drugs: effect of past treatment history.","journal-title":"Neurology","doi-asserted-by":"publisher"},{"DOI":"10.1111/j.1528-1167.2011.03024.x","key":"noi250072r16","year":"2011","issue":"4","author":"Löscher","volume":"52","first-page":"657","unstructured":null,"article-title":"Modern antiepileptic drug development has failed to deliver: ways out of the current dilemma.","journal-title":"Epilepsia","doi-asserted-by":"publisher"},{"DOI":"10.1007/s10072-024-07513-9","key":"noi250072r17","year":"2024","issue":"9","author":"Salama","volume":"45","first-page":"4243","unstructured":null,"article-title":"The role of neuromodulation in the management of drug-resistant epilepsy.","journal-title":"Neurol Sci","doi-asserted-by":"publisher"},{"DOI":"10.3389/fnhum.2024.1429223","key":"noi250072r18","year":"2024","issue":null,"author":"Li","volume":"18","first-page":null,"unstructured":null,"article-title":"The comparison of DBS and RNS for adult drug-resistant epilepsy: a systematic review and meta-analysis.","journal-title":"Front Hum Neurosci","doi-asserted-by":"publisher"},{"DOI":null,"key":"noi250072r1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"World Health Organization. Epilepsy: a public health imperative. Accessed January 24, 2024. https://www.who.int/publications/i/item/epilepsy-a-public-health-imperative","article-title":null,"journal-title":null,"doi-asserted-by":null}],"short-title":[],"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12,1]]}},"content-domain":{"domain":[],"crossmark-restriction":false},"original-title":[],"container-title":["JAMA Neurology"],"published-print":{"date-parts":[[2025,12,1]]},"reference-count":18,"published-online":null,"references-count":18,"short-container-title":["JAMA Neurol"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1001/jamaneurol.2025.4085","is_oa":true,"title":"Seizure Frequency Trends Over Time in Treatment-Resistant Focal Epilepsy","updated":"2025-12-13T00:32:06+00:00","published_date":"2025-10-20","best_oa_location":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12687094/","pmh_id":"oai:pubmedcentral.nih.gov:12687094","url_for_pdf":null,"url_for_landing_page":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12687094/"}}},"created_at":"2026-01-08T08:12:02.165Z","updated_at":"2026-01-11T11:19:33.869Z","tags":[{"paper_doi":"10.1001/jamaneurol.2025.4085","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4085","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4085","tag_type":"condition","value":"Focal Treatment-Resistant Epilepsy","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4085","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4085","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4085","tag_type":"modality","value":"Antiseizure Medication","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4085","tag_type":"modality","value":"Neuromodulation Device","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4085","tag_type":"sample_size","value":"n=146","value_numeric":146},{"paper_doi":"10.1001/jamaneurol.2025.4085","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4085","tag_type":"study_design","value":"Prospective Cohort","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4085","tag_type":"warning","value":"Design is an observational prospective cohort without a control arm, limiting causal attribution.","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4085","tag_type":"warning","value":"The denominator for the 68.3% reduction figure is not explicitly stated; 128 provided data and 2 were excluded as outliers.","value_numeric":null}],"summaries":{"what_studied":"A prospective, observational, multicenter cohort (Human Epilepsy Project 2) followed patients aged 16–65 years with focal treatment‑resistant epilepsy for 18–36 months to assess seizure frequency trends and responses to antiseizure medications and implantable devices under physician‑directed care. A total of 146 participants were enrolled; 128 provided analyzable seizure data, and 2 were excluded as outliers.","key_result":"Seizure frequency declined over time: 86 participants (68.3%) had fewer seizures in the second half of participation versus the first, and the modeled monthly seizure frequency decreased by 68.73% (95% CI, 52.92%–84.54%) overall, with reductions of 67.76% (0–12 mo), 36.00% (12–24 mo), and 66.03% (>24 mo) (all P<.001). An antiseizure medication was added in 69 participants (54.7%), of whom 46 (66.7%) had seizure reductions (including seizure freedom), and seizure trajectories with implantable devices did not differ from those without devices.","limitations":"Nonrandomized, physician‑directed, multi‑intervention management with a volunteer sample limits causal inference; only 128/146 contributed seizure data and 2 outliers were excluded. Whether observed improvements reflect natural history versus active management remains unresolved.","practice_takeaway":"In focal treatment‑resistant epilepsy, seizure counts often decline over time under routine care; adding an antiseizure medication frequently reduces seizures but has a low likelihood of seizure freedom, and device‑treated patients showed similar trajectories to those without devices in this cohort. Interpret open‑label claims of disease‑modifying effects with caution and seek corroboration in controlled studies."}}],"initialOffset":1,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Focal Treatment-Resistant Epilepsy"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Focal Treatment-Resistant Epilepsy"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Focal Treatment-Resistant Epilepsy"}}}]]

Papers