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Objective: Cenobamate is an antiseizure medication (ASM) with a dual mechanism of action that was recently approved for the treatment of focal seizures in adults. This analysis aimed to describe the outcomes at 12 and 24 weeks after starting cenobamate therapy in a real-world setting.
Methods: BLESS [NCT05859854] is an ongoing, observational, retrospective and prospective cohort study to evaluate the real-world effectiveness and safety of adjunctive cenobamate in adults with uncontrolled focal epilepsy. Subgroup analysis was performed in subjects with 2 to 3 previous ASMs (early users) and those with >3 previous ASMs (late users).
Results: The second interim analysis of the BLESS study included 388 participants with a median (interquartile range) age of 43.0 (31.0-54.0) years. They had a median of 6.0 (4.0-9.0) prior ASMs and a median of 7.2 (3.0-20.6) monthly seizures at baseline. The median monthly seizure frequency was reduced by 59.9% (19.2%-87.3%) from baseline to 24 weeks; 229 (59.0%) subjects had a ≥50% seizure frequency reduction, and 44 (11.3%) showed sustained seizure freedom. The proportion of participants taking ≤2 concomitant ASMs increased from 217 (56.5%) at baseline to 239 (65.7%) at 24 weeks. Among the early users (n = 76, 19.6%), the median reduction in monthly seizure frequency at 24 weeks was 78.0% (50.0-97.1%), and 76.3% of subjects had a ≥50% response rate. The frequency of adverse drug reactions (ADRs) was 5.3% and 23.4% in early and late users. The most frequent ADRs were somnolence, dizziness, and balance disorder; after the occurrence of ADRs, 63.5% of participants maintained the prescribed dose, and 5.2% permanently discontinued treatment.
Significance: Cenobamate was effective in reducing seizure frequency in a real-world setting and showed a manageable safety profile. The treatment with cenobamate also reduced the burden of concomitant ASMs in both early and late users.
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http://dx.doi.org/10.1111/epi.18357 | DOI Listing |
Neural Netw
September 2025
School of Automation, Northwestern Polytechnical University, Xi'an, 710072, Shaanxi, China. Electronic address:
Epilepsy with its complex seizure mechanisms and diverse clinical manifestations, presents numerous challenges for clinical diagnosis and treatment, while electroencephalography (EEG) plays a crucial and irreplaceable role in its diagnosis. Although general-purpose foundation models have demonstrated some capability in knowledge processing, they still face challenges in capturing specific disease features and dealing with data scarcity in highly specialized domains such as epilepsy. To address these issues, we propose a domain-specific foundation model for epilepsy-EpilepsyFM, designed to learn generalized representations of epilepsy to support various downstream tasks.
View Article and Find Full Text PDFNeurology
October 2025
Department of Neurology, Children's National Hospital, Washington, DC.
Background And Objectives: Posthypoxic myoclonus (PHM) is associated with a poor prognosis in adults. Studies on this topic are limited in pediatrics. We aim to describe the incidence, EEG features, and outcomes of PHM after pediatric cardiac arrest (CA).
View Article and Find Full Text PDFIEEE J Biomed Health Inform
September 2025
Accurate early prediction of epileptic seizures is crucial for improving patients' quality of life. However, existing seizure prediction methods often rely on large-scale labeled datasets and face challenges in generalization and real-time performance. To address these issues, this study proposes an efficient seizure prediction framework that achieves high performance even with limited labeled data, significantly reducing dependence on extensive annotations.
View Article and Find Full Text PDFClin Drug Investig
September 2025
Department of Epidemiology, Biostatistics, Occupational Health, McGill University, Montreal, QC, Canada.
Background And Objectives: Benzodiazepines are commonly prescribed medications approved for and used in the treatment of anxiolytic and sleep disorders, as well as for seizures, and alcohol withdrawal. However, benzodiazepines are also controlled substances because of their potential for abuse and personal harm, which are especially prevalent among older people. It is therefore important to understand how benzodiazepines are being prescribed, and the prevalence of off-label benzodiazepine prescribing, of which very little is known because of challenges in documenting treatment indication.
View Article and Find Full Text PDFEpileptic Disord
September 2025
Division of Child Neurology, Department of Pediatrics, Cohen Children's Medical Center, New Hyde Park, New York, USA.
Introduction: Neurologic complications, including seizures, are common in pediatric patients undergoing heart surgery, especially those requiring postoperative extracorporeal membrane oxygenation (ECMO), requiring prompt, vigilant postoperative monitoring. Prolonged EEG monitoring in critically ill children presents a risk of scalp/pressure injuries. The skin's sensitivity to microcirculatory changes can also provide valuable insights into the patient's overall tissue perfusion, making it a critical component in the management of these vulnerable patients.
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