CME Credit

Selected Reports from the 69th Annual Meeting
of the American Epilepsy Society

Gregory K. Bergey, MD, Guest Editor

Activity release date: February 25, 2016  |  Expiration date: February 26, 2017

University of CincinnatiThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the University of Cincinnati and Direct One Communications, Inc. The University of Cincinnati is accredited by the ACCME to provide continuing medical education for physicians. The University of Cincinnati designates this Enduring Material Activity for a maximum of 3.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

You will need to answer 8 of the 10 post-test questions (80%) correctly and complete the evaluation form to receive credit for participating in this activity.

RATIONALE AND PURPOSE
Over the past 150 years, the definitions, understanding, diagnosis, and treatment of epilepsy have been influenced by clinical and scientific discoveries involving genetic research and the clever use of novel, pharmacologically active compounds, as well as surgery, dietary therapy, and neurostimulation. This edition of The Neurology Report, a summary and discussion of some of the more important research presented this past December at the 69th Annual Meeting of the American Epilepsy Society in Philadelphia, reviews the results of important clinical trials that have transformed the management of epilepsy and that have led to new investigational directions.

In this issue we take a close look at the clinical management of epilepsy, from diagnosis through treatment of recalcitrant cases. Proposed solutions for overcoming drug resistance and pseudoresistance are examined, and the value of combining different antiepileptic drug (AED) combinations for maximum therapeutic effectiveness is discussed. One of the newest AEDs—perampanel—is looked at in depth from the viewpoint of recent clinical trials. The consequences of using psychoactive medications in patients with epilepsy are discussed, along with the effects of using various AEDs in patients with preexisting psychiatric symptoms. The issue closes with a discussion of certain current controversies, including the appropriate use of genetic testing, the role of autoimmune-mediated inflammation in seizure disorders, the risks and benefits of using valproate in women of childbearing age, and the potential of cannabis and cannabinoid derivatives for treating epilepsy in children and other patients.

The articles in this issue, written from the academic perspective of physicians-in-training at leading medical institutions, summarize the import of these new findings and place them into clinical context. This activity has been developed and approved by a planning committee of nationally recognized thought leaders to meet a perceived educational need to provide neurologists, neurosurgeons, and other physicians with diagnostic and therapeutic strategies to help them perform their medical roles.

LEARNING OBJECTIVES
After studying this issue of The Neurology Report, participants in this educational activity should be able to:

  • Describe the obstacles to diagnosing epilepsy and how to overcome them.
  • Review the advantages and disadvantages of using AEDs alone and in combination, along with novel nonpharmacologic interventions, to treat patients with refractory epilepsy.
  • Summarize the results of pivotal clinical trials and newer studies evaluating the efficacy and safety of perampanel in different patient populations.
  • Identify the problems associated with using psychoactive medications in patients with epilepsy and practical approaches to managing psychiatric comorbidities.
  • Discuss the efficacy, cost-effectiveness, and outcomes associated with psychobehavioral interventions in patients with epilepsy.

TARGET AUDIENCE
Neurologists, neurosurgeons, and other physicians significantly involved in the diagnosis and management of epilepsy should find participating in this educational activity valuable.

ACCREDITATION AND CREDIT DESIGNATION
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the University of Cincinnati and Direct One Communications, Inc. The University of Cincinnati is accredited by the ACCME to provide continuing medical education for physicians.

The University of Cincinnati designates this Enduring Material Activity for a maximum of 3.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

CREDIT AVAILABILITY
Activity release date: February 25, 2016
Expiration date: February 26, 2017

METHOD OF PARTICIPATION
This Enduring Material Activity is available in print and online at www.NeurologyReport.com and consists of an introduction, six articles, a postactivity assessment, and an evaluation. Estimated time to complete the activity is 3.0 hours.

To receive credit, participants must read the CME information on this page, including the learning objectives and disclosure statements, as well as the full content of this monograph, and then complete the post test and evaluation form online at www.NeurologyReport.com. Upon successful completion of the post test (80% correct) and evaluation form, a CME certificate of participation will be awarded automatically. The certificate may be printed directly from the Web site or e-mailed and printed later.

There are no fees for participating in or receiving credit for this activity.

CME REVIEWER
Rick Ricer, MD
Adjunct Professor of Family Medicine
University of Cincinnati
Cincinnati, Ohio

CME ACCREDITATION
Susan P. Tyler, MEd, CMP, CHCP
Director, Continuing Medical Education
University of Cincinnati
Cincinnati, Ohio

FACULTY DISCLOSURES
All faculty members (or anyone else in a position to control content, such as activity planners) are required to complete a Disclosure of Commercial Interest and Resolution form and to cooperate with identified methods for resolving conflict of interest prior to participating in the activity. The University of Cincinnati requires disclosure to the learners of all relevant financial relationships and adheres strictly to the ACCME Standards for Commercial Support.

Gregory K. Bergey, MD, Professor of Neurology, Director of the Johns Hopkins Epilepsy Center, and Co-Director of the Epilepsy Research Laboratory, Johns Hopkins University School of Medicine and Hospital, Baltimore, Maryland, has nothing to disclose.

Pawan V. Rawal, MD, MHA, Assistant Professor of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, has nothing to disclose.

James Thomas Houston, MD, a Clinical Neurophysiology Fellow at the University of Alabama at Birmingham, Birmingham, Alabama, has nothing to disclose.

Christian M. Cabrera Kang, MD, a Clinical Neurophysiology Fellow at Emory University School of Medicine, Atlanta, Georgia, has nothing to disclose.

Deepti Anbarasan, MD, a Clinical Neurophysiology Fellow at The Neurological Institute of New York, Columbia University Medical Center, New York, New York, has nothing to disclose.

Emily L. Johnson, MD, an Epilepsy Fellow in the Department of Neurology at Johns Hopkins School of Medicine, Baltimore, Maryland, has nothing to disclose.

Rick Ricer, MD, has nothing to disclose.

Susan P. Tyler, MEd, CMP, CHCP, has nothing to disclose.

Jacqueline Keenan and Edwin Geffner of Direct One Communications, Inc., have nothing to disclose.

DISCLAIMER
This activity is an independent educational activity under the direction of the University of Cincinnati. The activity was planned and implemented in accordance with the accreditation requirements and policies of the ACCME, the Ethical Opinions/Guidelines of the American Medical Association, the US Food and Drug Administration (FDA), the Office of Inspector General of the US Department of Health and Human Services, and the Pharmaceutical Research and Manufacturers of America Code on Interactions With Healthcare Professionals, thus assuring the highest degree of independence, fair balance, scientific rigor, and objectivity.

However, the planning committee, faculty, University of Cincinnati, Eisai Inc., and Direct One Communications, Inc. shall in no way be liable for the currency of information or for any errors, omissions, or inaccuracies in this activity. The opinions and recommendations presented herein are those of the faculty and do not necessarily reflect the views of the provider, producer, or grantor.

Participants in this activity are encouraged to refer to primary references or full prescribing information resources.

DISCLOSURE OF UNAPPROVED / OFF-LABEL USE
Discussions concerning drugs, dosages, devices, and procedures may reflect the clinical experience of the planning committee or faculty, may be derived from the professional literature or other sources, or may suggest uses that are investigational and not approved labeling or indications.

In this issue of The Neurology Report, Dr. Houston discusses the use of stiripentol, which has not been approved by the FDA, in severe myoclonic epilepsy of infancy, and Dr. Johnson presents an algorithm for managing autoantibodies in patients with epilepsy using several FDA-approved drugs off-label.

CONTACT INFORMATION
We would like to hear your comments regarding this or other educational activities produced by Direct One Communications, Inc. In addition, suggestions for future activities are welcome. Contact us at:

Direct One Communications, Inc.
1424 Ridge Road
Syosset, NY 11791
Phone: 516-364-1020
Fax: 516-364-4217
Website: www.CMEdirect.net

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