Overview

• The JAMA Neurology paper from the Human Epilepsy Project tracked nearly 450 newly diagnosed patients at 34 centers from 2012 to 2019 using electronic seizure diaries with multi-year follow-up.
• About 60% ultimately became seizure-free, typically after a median 12 months, while 63% continued to have ongoing or worsening seizures during the first year of therapy.
• Once seizure-free, 84% did not relapse, yet 23% of the cohort had treatment-resistant epilepsy that did not respond well to medications.
• Outcomes varied by baseline factors, with infrequent pre-treatment seizures predicting better response and a history of anxiety or depression nearly doubling the likelihood of drug resistance.
• Levetiracetam was the initial choice for 57% of patients, but only about one quarter achieved seizure freedom on the first regimen, and authors flagged study limitations and planned deeper analyses of persistent non-responders.