Dyslipidemia

map
westmidwestnortheastsoutheast
Please review and answer questions before proceeding to the activity.
   
Program Description

Epilepsy affects approximately 2 million people in the United States. About 40% to 60% of patients with newly diagnosed epilepsy have focal seizures. Epilepsy with focal seizures is an acquired epilepsy that can begin in childhood or adulthood. The primary goal of treatment is to restore each patient’s functional capacity to its maximal potential by achieving freedom from seizures. Despite the development of new antiepileptic drugs (AEDs) in recent years and the availability of practice guidelines, more than 30% of patients continue to experience seizures, even after receiving appropriate therapy. Complicating the management of patients with refractory focal seizures has been a lack of understanding about what constitutes treatment resistance. In 2010, the International League Against Epilepsy (ILAE) published a consensus-based definition of treatment resistance. In addition, emerging AEDs with novel mechanisms of action may provide opportunities for combining agents to achieve synergistic effects. This activity reviews guidelines for diagnosing and treating focal seizures in adults, ILAE recommendations for defining treatment resistance, and current strategies for managing patients with refractory focal seizures.
  
Since this activity was released in August 2012, perampanel was approved by the FDA as adjunctive therapy for partial-onset seizures in patients 12 years of age or older.
  
Activity Overview
This educational activity consists of a CME-accredited e-Course, narrated by Dr Steven Schachter, which offers 1 hour of AMA PRA Category 1 Credits™. The Regional Neurology Insights are not CME accredited.
  
Target Audience
Neurologists
  
Goal
To familiarize neurologists with the new consensus-based definition of treatment resistance in epilepsy and to update them on the current and emerging strategies for managing focal seizures in adults.
  
Learning Objectives
After completing this activity, participants should be better able to:
  • Explain the concept of treatment resistance in patients with focal seizures
  • Discuss issues related to treatment strategies for focal seizures
  • Describe the mechanisms of action of emerging therapies for treatment-resistant focal seizures
  • Evaluate potential roles for emerging therapies in the care of patients with treatment-resistant focal seizures

  
Faculty
Program Chair
Steven C. Schachter, MD
Professor of Neurology
Harvard Medical School
Chief Academic Officer
Center for Integration of Medicine and Innovative Technology
Boston, Massachusetts
   
Course Director
William A. DeBassio, PhD, MD
Associate Professor of Pediatrics and Neurology
Boston University School of Medicine
Director, Pediatric Sleep Services
Associate Director, Pediatric Epilepsy and EEG
Boston Medical Center
Boston, Massachusetts

Regional Faculty
West
Robert S. Fisher, MD, PhD, Professor of Neurology, Stanford University School of Medicine, Stanford, California
Peter Glusker, MD, PhD, Adjunct Clinical Assistant Professor, Stanford University Medical Center, Stanford, California
John D. Hixson, MD, Assistant Professor of Clinical Neurology, The University of California, San Francisco, San Francisco, California
   
Midwest
Thomas R. Henry, MD, Professor of Neurology, University of Minnesota Medical School, Minneapolis, Minnesota
Andres M. Kanner, MD, Professor, Neurological Sciences, Psychiatry, Rush University Medical Center, Chicago, Illinois
Angela Mark, MD, Attending Neurologist, NorthShore University HealthSystem, Evanston, Illinois
   
Northeast
Carl W. Bazil, MD, PhD, Professor of Clinical Neurology, College of Physicians and Surgeons, Columbia University, New York, New York
Alan B. Ettinger, MD, MBA, Director of Epilepsy, Neurological Surgery, P.C., Lake Success, New York
Eric B. Geller, MD, Director, Adult Comprehensive Epilepsy Center, Saint Barnabas Medical Center, Livingston, New Jersey
   
Southeast
Hayden C. Long, MD, Neurology Child and Adult, P.C., Mobile, Alabama
Charles Scott Markle, MD, Diagnostic and Medical Clinic, Mobile, Alabama
Juan G. Ochoa, MD, Associate Professor of Neurology, University of South Alabama College of Medicine, Mobile, Alabama
  
Brought to you by
Continuing Education Alliance
  
Accreditation Information
Boston University logoThis activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Boston University School of Medicine and Continuing Education Alliance. Boston University School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
  
Boston University School of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
   
Release date: August 17, 2012
Expiration date: August 16, 2013
   
For continuing medical education questions, please contact: cme@bu.edu.
For information on Boston University School of Medicine Privacy Policy, please visit:
www.bu.edu/cme/policies/privacy_policy.html.
  
Acknowledgment
This activity is supported by an educational grant from Eisai Inc.
  
Disclaimers
THESE MATERIALS AND ALL OTHER MATERIALS PROVIDED IN CONJUNCTION WITH CONTINUING MEDICAL EDUCATION ACTIVITIES ARE INTENDED SOLELY FOR PURPOSES OF SUPPLEMENTING CONTINUING MEDICAL EDUCATION PROGRAMS FOR QUALIFIED HEALTHCARE PROFESSIONALS. ANYONE USING THE MATERIALS ASSUMES FULL RESPONSIBILITY AND ALL RISK FOR THEIR APPROPRIATE USE. TRUSTEES OF BOSTON UNIVERSITY MAKES NO WARRANTIES OR REPRESENTATIONS WHATSOEVER REGARDING THE ACCURACY, COMPLETENESS, CURRENTNESS, NONINFRINGEMENT, MERCHANTABILITY, OR FITNESS FOR A PARTICULAR PURPOSE OF THE MATERIALS. IN NO EVENT WILL TRUSTEES OF BOSTON UNIVERSITY BE LIABLE TO ANYONE FOR ANY DECISION MADE OR ACTION TAKEN IN RELIANCE ON THE MATERIALS. IN NO EVENT SHOULD THE INFORMATION IN THE MATERIALS BE USED AS A SUBSTITUTE FOR PROFESSIONAL CARE.
  
Faculty Disclosures
Boston University School of Medicine asks all individuals involved in the development and presentation of Continuing Medical Education (CME) activities to disclose all relationships with commercial interests. This information is disclosed to CME activity participants. Boston University School of Medicine has procedures to resolve any apparent conflicts of interest. In addition, faculty members are asked to disclose when any discussion of unapproved use of pharmaceuticals and devices is being discussed. This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration.
   
CME Activity Faculty
Dr DeBassio has nothing to disclose with regard to commercial interests.
Dr Schachter: consultant: BrainScope, Cyberonics, Inc., Insero Health, Sage Therapeutics; stockholder/patent royalties:
Insero Health.
   
Regional Faculty
Dr Bazil: consultant: Pfizer Inc., UCB.
Dr Ettinger has nothing to disclose with regard to commercial interests.
Dr Fisher: consultant: Jazz Pharmaceuticals; stockholder: Cyberonics, Inc., ICVRx, NeuroVista, SmartWatch.
Dr Geller: grant/research support: National Institute of Neurological Disorders and Stroke, NeuroScience, Inc.
Dr Glusker has nothing to disclose with regard to commercial interests.
Dr Henry has nothing to disclose with regard to commercial interests.
Dr Hixson: consultant: Lumetra Healthcare Solutions Inc.; grant/research support: UCB.
Dr Kanner: grant/research support: Pfizer, Inc.
Dr Long has nothing to disclose with regard to commercial interests.
Dr Mark has nothing to disclose with regard to commercial interests.
Dr Markle has nothing to disclose with regard to commercial interests.
Dr Ochoa has nothing to disclose with regard to commercial interests.
  
The Planning Committee for this activity included Mike Burke and Ilana Hardesty of Boston University School of Medicine; and Ruth Cohen, Christie Avraamides, PhD, and Christine M. Olsen, PhD, of Continuing Education Alliance. The members of the Planning Committee have no significant relationships to disclose.
  
System Requirements
Flash Player 6.0.79 or later (http://www.adobe.com/go/getflash), and one of the following browsers:

  • • Windows: Internet Explorer 6 and later, Firefox 1.x and later, Safari 3 and later, Google Chrome, Opera 9.5 and later
  • • Mac: Safari 3 and later, Firefox 1.x and later, Google Chrome
  • • Linux: Firefox 1.x and later
  
   
© 2012 Continuing Education Alliance. All Rights Reserved. CEE78312

 
Please answer the following questions before you access the program.
1.
Treatment resistance is defined as:

2.
If 2 monotherapy trials with first-line AEDs fail to control focal seizures, another AED option would be:

3.
The agent for treatment-resistant focal seizures that antagonizes AMPA-type glutamate receptors is:

4.
How often do you currently add or switch to second-line AEDs to control treatment-resistant focal seizures?

5.
How often do you currently add or switch to third-line AEDs to control treatment-resistant focal seizures?

6.
How often do you currently recommend surgery or other nonpharmacologic therapies to manage patients with treatment-resistant focal seizures?