Topiramate injection has received orphan-drug designation from the Food and Drug Administration (FDA) for the treatment of focal seizures or generalized tonic-clonic seizures in hospitalized epilepsy patients, or epilepsy patients being treated in an emergency care setting who are unable to take oral topiramate.[162]US Food and Drug Administration. Orphan drug designations and approvals: topiramate injection. Jul 2013 [internet publication].
https://www.accessdata.fda.gov/scripts/opdlisting/oopd/detailedIndex.cfm?cfgridkey=283909
Cannabidiol
Cannabidiol oral solution has been approved by the FDA and the European Medicines Agency for the treatment of seizures associated with Lennox-Gastaut syndrome or Dravet syndrome. Multicenter, randomized, placebo-controlled trials are required to demonstrate efficacy in patients with generalized seizures.[163]American Epilepsy Society. AES Position statement on cannabis as a treatment for patients with epileptic seizures updated. Sep 2022 [internet publication].
https://www.aesnet.org/about/about-aes/position-statements/aes-position-statement-on-cannabis-as-a-treatment-for-patients-with-epileptic-seizures
[164]Lattanzi S, Trinka E, Striano P, et al. Highly purified cannabidiol for epilepsy treatment: a systematic review of epileptic conditions beyond dravet syndrome and lennox-gastaut syndrome. CNS Drugs. 2021 Mar;35(3):265-81.
https://link.springer.com/article/10.1007/s40263-021-00807-y
http://www.ncbi.nlm.nih.gov/pubmed/33754312?tool=bestpractice.com
[165]Appendino JP, Boelman C, Brna PM, et al. Position statement on the use of medical cannabis for the treatment of epilepsy in Canada. Can J Neurol Sci. 2019 Nov;46(6):645-52.
https://www.cambridge.org/core/journals/canadian-journal-of-neurological-sciences/article/position-statement-on-the-use-of-medical-cannabis-for-the-treatment-of-epilepsy-in-canada/13C57EE11502474BB0F71089C1AB0D77
http://www.ncbi.nlm.nih.gov/pubmed/31466531?tool=bestpractice.com
Seizure detection devices
Although still in developmental stages, there is evidence that implantable devices will be able to detect and prevent seizures before they occur. Use of such devices currently focuses on the recording of non-electroencephalography signals associated with tonic-clonic seizures in carefully selected patients.[166]Beniczky S, Wiebe S, Jeppesen J, et al. Automated seizure detection using wearable devices: a clinical practice guideline of the International League Against Epilepsy and the International Federation of Clinical Neurophysiology. Clin Neurophysiol. 2021 May;132(5):1173-84.
https://www.doi.org/10.1016/j.clinph.2020.12.009
http://www.ncbi.nlm.nih.gov/pubmed/33678577?tool=bestpractice.com
[167]Shum J, Friedman D. Commercially available seizure detection devices: a systematic review. J Neurol Sci. 2021 Sep 15;428:117611.
http://www.ncbi.nlm.nih.gov/pubmed/34419933?tool=bestpractice.com