Child Neurology Society's Brainstorm CNS Brainstorm Episode 44 "Antiseizure Medications" with guest Howard Goodkin, MD, PhD
Jun 4, 2025
In this discussion, Dr. Howard Goodkin, a leading child neurologist and epileptologist, dives into the world of anti-seizure medications. He explains how these treatments work and emphasizes the difference between anti-seizure and anti-epileptic drugs. The podcast also highlights the critical impact of these medications on bone health and the necessity of folate monitoring for pregnant patients. Goodkin discusses long-term cognitive risks and advocates for precision medicine, showcasing cutting-edge strategies for rare epilepsy types like Dravet syndrome.
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Anti-Seizure vs Anti-Epileptic
- Anti-seizure medications work by reducing seizure probability through varied mechanisms but do not cure epilepsy itself.
- These drugs influence seizure threshold, not the underlying disease causing seizures.
Terminology Matters for Medicine
- The term 'anti-epileptic' is misleading as it implies curing epilepsy, which current drugs cannot do.
- 'Anti-seizure medication' is preferred since these drugs only affect seizure occurrence, not epilepsy itself.
Generations of Anti-Seizure Drugs
- About 30 to 40 anti-seizure medications are FDA-approved, spanning several generations.
- Early drugs like phenobarbital and phenytoin were followed by better tolerated newer medications like levetiracetam and lamotrigine.