The International Human Epilepsy Project finds seizure control is possible for most, but often takes time and persistence
VALHALLA, N.Y. (September 8, 2025) – The results of a large-scale study of people with epilepsy were just published in a paper titled “Treatment Response to Antiseizure Medications in People With Newly Diagnosed Focal Epilepsy” in JAMA Neurology, offering new hope and clearer expectations for people newly diagnosed with epilepsy. The study was authored by Sarah N. Barnard, MD, MIPH; Zhibin Chen, PhD; and Manisha Holmes, MD, Epilepsy Section Chief at Westchester Medical Center, et al, on behalf of the HEP1 study investigators. The study’s findings were recently highlighted on the global stage at the International League Against Epilepsy meeting in Lisbon, held from August 30 to September 3.
The Human Epilepsy Project (HEP), which followed 448 people with newly diagnosed focal epilepsy across 34 epilepsy centers between 2012 and 2020, found that while seizure freedom is possible for most patients, achieving it often requires patience, persistence, and more than one treatment.
Key findings include:
- Most patients (60%) became seizure-free, but only 27% achieved this with their first anti-seizure medication (ASM).
- Seizure control usually takes more than one year—the median time to seizure freedom was 12 months.
- One in four patients developed treatment-resistant epilepsy, continuing to have seizures despite multiple adequate medications.
- The first year after diagnosis is the most challenging—63% still had seizures during that time, including subtle episodes that may be overlooked.
“This study helps set realistic expectations for patients,” said Dr. Holmes. “For many people, seizure freedom is possible, but it may take patience, persistence, and different approaches over time. These findings provide reassurance that while seizure freedom doesn’t always come right away, most people do get there. Working with an epilepsy specialist can help patients find the right treatment path more quickly and safely.”
The research also shows that patients who continue to have frequent seizures or who also have mental health conditions may need closer monitoring and earlier access to advanced therapies. Options for those with treatment-resistant epilepsy include surgery, laser ablation, or implantable devices such as the vagus nerve stimulator, responsive neurostimulator, and deep brain stimulator.
Epilepsy affects more than 3.4 million Americans. Seizures can impact safety, independence, and quality of life. In New York, for example, individuals must be seizure-free for one year before they can legally drive—making seizure control a crucial step toward regaining independence.
“HEP provides a roadmap not just for physicians, but for patients and families,” said Dr. Holmes. “It shows why ongoing follow-up and specialized care matter, and why we must continue developing new treatments. Every seizure carries risks—from falls to car accidents—and detecting and treating them early is critical.”
The study also highlights the future potential of precision medicine, including the role of genetic markers and neurocognitive data in predicting which patients may respond best to certain treatments.
Westchester Medical Center is recognized as a Level 4 Epilepsy Center by the National Association of Epilepsy Centers, providing the highest level of comprehensive care for complex epilepsy cases.