Audio Epilepsy Digest (AED) is a colleague-level podcast briefing on epilepsy research, controversies, and practice-shaping signals for epileptologists, epilepsy fellows, and surgical epilepsy teams.
Episode 22: The Epilepsy Follow-Up: Continue, Adjust, Switch—or Refer?
NOTE: This podcast is an evolving collaboration between human and AI. While we strive for accuracy, AI hosts may misinterpret or oversimplify source material. Always refer to the original published articles for clinical decision-making. If you find any claims made by the AI hosts to be inaccurate, please let us know. Your feedback directly improves future episodes.
Episode 22: The Epilepsy Follow-Up: Continue, Adjust, Switch—or Refer?
An adult outpatient special prompted by a nurse practitioner's request: three everyday visits, from breakthrough seizures to treatment burden and repeated medication trials. The August 2025 Xcopri liver-label update provides a concrete example of checking medication-specific safety requirements.
In this episode:
- Reassessing events, actual medication use and barriers before automatic escalation.
- Asking how a patient feels and functions, even when seizures have stopped.
- Reviewing adequacy of previous treatments and explaining comprehensive epilepsy referral.
Clinical context:
- Liver-warning symptoms include unexplained nausea, vomiting, right upper quadrant pain, fatigue, anorexia, jaundice or dark urine. Seek prompt clinical assessment. Early DRESS may occur without an evident rash.
- Xcopri labeling specifies baseline ALT, AST and total bilirubin unless available within three months. Follow-up testing is clinically indicated; no universal monthly schedule or liver-failure incidence is supplied.
- SANAD II studied newly diagnosed focal epilepsy, not switching stable patients or comparing cenobamate.
- Individualize emergency plans within local protocols and prescribing standards. NICE is UK guidance, not US regulation.
- Jehi’s surgical-referral consensus recommends offering evaluation up to age 70 and considering older patients without surgical contraindications. Comprehensive care remains individualized. Referral evaluates options and does not commit a patient to surgery.
- The label specifies ALT, AST and total bilirubin; other urgent tests are clinician-directed, not universal label requirements. Clinically indicated follow-up is broader than symptoms alone.
21 Sept 2026
Episode 21: FCD: What Does the Diagnosis Actually Tell Us?
NOTE: This podcast is an evolving collaboration between human and AI. While we strive for accuracy, AI hosts may misinterpret or oversimplify source material. Always refer to the original published articles for clinical decision-making. If you find any claims made by the AI hosts to be inaccurate, please let us know. Your feedback directly improves future episodes.
Episode 21: FCD: What Does the Diagnosis Actually Tell Us?
A monthly special on focal cortical dysplasia: what an integrated diagnosis explains, what anatomy and electrophysiology add, and where AI detection and targeted treatment remain uncertain.
14 Sept 2026
Episode 20: Who Decides on Epilepsy Surgery?
NOTE: This podcast is an evolving collaboration between human and AI. While we strive for accuracy, AI hosts may misinterpret or oversimplify source material. Always refer to the original published articles for clinical decision-making. If you find any claims made by the AI hosts to be inaccurate, please let us know. Your feedback directly improves future episodes.
Episode 20: Who Decides on Epilepsy Surgery?
From identifying people who have not reached evaluation to center-level recommendations and estimates of seizure benefit and visual harm, five papers examine how the path to epilepsy surgery is shaped—and what these studies cannot decide for an individual.
The opening welcomes Timon, the editor’s new Sheltie puppy, before the research discussion.
AED Quiz for this episode:
https://audioepilepsydigest.com/episode-020-aed-quiz.html
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