Which terms should be used to describe medications used in the treatment of seizure disorders? An ILAE position paper

Author:

Perucca Emilio12ORCID,French Jacqueline A.3ORCID,Aljandeel Ghaieb4ORCID,Balestrini Simona567ORCID,Braga Patricia8ORCID,Burneo Jorge G.91011ORCID,Felli Augustina Charway12ORCID,Cross J. Helen131415ORCID,Galanopoulou Aristea S.16ORCID,Jain Satish17ORCID,Jiang Yuwu1819202122ORCID,Kälviäinen Reetta2324ORCID,Lim Shih Hui2526ORCID,Meador Kimford J.27ORCID,Mogal Zarine28ORCID,Nabbout Rima29303132ORCID,Sofia Francesca33ORCID,Somerville Ernest34ORCID,Sperling Michael R.35ORCID,Triki Chahnez36ORCID,Trinka Eugen3738ORCID,Walker Matthew C.7ORCID,Wiebe Samuel39ORCID,Wilmshurst Jo M.40ORCID,Wirrell Elaine41ORCID,Yacubian Elza Márcia42ORCID,Kapur Jaideep4344ORCID

Affiliation:

1. Department of Medicine The University of Melbourne (Austin Health) Heidelberg Victoria Australia

2. Department of Neuroscience Monash University Melbourne Victoria Australia

3. NYU Grossman School of Medicine and NYU Langone Health New York New York USA

4. Faculty of Epileptology Iraqi Council for Medical Specializations, Medical City Baghdad Iraq

5. Neuroscience Department Meyer Children's Hospital Florence Italy

6. University of Florence Florence Italy

7. Department of Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology London UK

8. Institute of Neurology, Facultad de Medicina Universidad de la República Montevideo Uruguay

9. Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry Western University London Ontario Canada

10. Department of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry Western University London Ontario Canada

11. Neuroepidemiology Unit, Schulich School of Medicine and Dentistry Western University London Ontario Canada

12. 37 Military Hospital Accra Ghana

13. Developmental Neurosciences Research and Teaching Department UCL NIHR BRC Great Ormond Street Institute of Child Health London UK

14. Department of Neurology Great Ormond Street Hospital London UK

15. Young Epilepsy Lingfield UK

16. Isabelle Rapin Division of Child Neurology, Saul R. Korey Department of Neurology, Dominick P Purpura Department of Neuroscience Albert Einstein College of Medicine New York New York USA

17. Indian Epilepsy Centre New Delhi India

18. Department of Pediatrics and Pediatric Epilepsy Center Peking University First Hospital Beijing China

19. Pediatric Epilepsy Center Peking University First Hospital Beijing China

20. Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases Beijing China

21. Key Laboratory for Neuroscience Ministry of Education/National Health and Family Planning Commission, Peking University Beijing China

22. Center of Epilepsy Beijing Institute for Brain Disorders Beijing China

23. Kuopio Epilepsy Center Kuopio University Hospital Kuopio Finland

24. Institute of Clinical Medicine University of Eastern Finland Kuopio Finland

25. National Neuroscience Institute Singapore Singapore

26. Duke‐National University of Singapore Medical School Singapore Singapore

27. Department of Neurology and Neurological Sciences Stanford University School of Medicine Palo Alto California USA

28. National Epilepsy Center Jinnah Postgraduate Medical Center Karachi Pakistan

29. Reference Centre for Rare Epilepsies, Department of Pediatric Neurology Necker–Enfants Malades Hospital Paris France

30. Assistance Publique – Hôpitaux de Paris, member of the European Reference Network EpiCARE Paris France

31. Institut Imagine – INSERM UMR 1163 Paris France

32. Université Paris Cité Paris France

33. International Bureau for Epilepsy Dublin Ireland

34. Prince of Wales Hospital, University of New South Wales Sydney New South Wales Australia

35. Department of Neurology Thomas Jefferson University Philadelphia Pennsylvania USA

36. Child Neurology Department Hedi Chaker University Hospital, LR19ES15, Sfax Medical School, University of Sfax Sfax Tunisia

37. Department of Neurology, Neurocritical Care, and Neurorehabilitation, Centre for Cognitive Neuroscience Christian Doppler University Hospital, Paracelsus Medical University Salzburg Austria

38. Department of Public Health, Health Services Research and Health Technology Assessment UMIT – University for Health Sciences, Medical Informatics and Technology Hall in Tirol Austria

39. Department of Clinical Neurosciences University of Calgary Calgary Alberta Canada

40. Department of Pediatric Neurology, Red Cross War Memorial Children's Hospital, Neuroscience Institute University of Cape Town Cape Town South Africa

41. Divisions of Child and Adolescent Neurology and Epilepsy, Department of Neurology Mayo Clinic Rochester Minnesota USA

42. Department of Neurology and Neurosurgery Universidade Federal de São Paulo São Paulo Brazil

43. Department of Neurology University of Virginia Charlottesville Virginia USA

44. UVA Brain Institute University of Virginia Charlottesville Virginia USA

Abstract

AbstractA variety of terms, such as “antiepileptic,” “anticonvulsant,” and “antiseizure” have been historically applied to medications for the treatment of seizure disorders. Terminology is important because using terms that do not accurately reflect the action of specific treatments may result in a misunderstanding of their effects and inappropriate use. The present International League Against Epilepsy (ILAE) position paper used a Delphi approach to develop recommendations on English‐language terminology applicable to pharmacological agents currently approved for treating seizure disorders. There was consensus that these medications should be collectively named “antiseizure medications”. This term accurately reflects their primarily symptomatic effect against seizures and reduces the possibility of health care practitioners, patients, or caregivers having undue expectations or an incorrect understanding of the real action of these medications. The term “antiseizure” to describe these agents does not exclude the possibility of beneficial effects on the course of the disease and comorbidities that result from the downstream effects of seizures, whenever these beneficial effects can be explained solely by the suppression of seizure activity. It is acknowledged that other treatments, mostly under development, can exert direct favorable actions on the underlying disease or its progression, by having “antiepileptogenic” or “disease‐modifying” effects. A more‐refined terminology to describe precisely these actions needs to be developed.

Publisher

Wiley

Subject

Neurology (clinical),Neurology

Reference21 articles.

1. Antiepileptic drug therapy the story so far;Brodie MJ;Seizure,2010

2. Antiepileptic drugs: evolution of our knowledge and changes in drug trials;Perucca E;Epileptic Disord,2019

3. Comments on Dhevender Bhalla et al. “Anti‐epileptic drugs: is terminology appropriate: a change might be needed”;Somerville E;Neurol Asia,2015

4. Anti‐epileptic drugs: is terminology appropriate? A change might be needed;Bhalla D;Neurol Asia,2015

5. Time to start calling things by their own names? The case for antiseizure medicines;French JA;Epilepsy Curr,2020

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