Tyvaert L
Department of Neurology, Hôpital central CHU Nancy, UMR 7365 IMOPA, Université de Lorraine, Nancy, France.
Rev Neurol (Paris). 2025 May;181(5):445-449. doi: 10.1016/j.neurol.2025.03.009. Epub 2025 Apr 8.
The International League Against Epilepsy (ILAE) is proposing a new nomenclature, replacing the confusing term antiepileptic drugs (AEDs) with antiseizure medications (ASMs). This approach has been partly motivated by the emergence of new treatments with antiepileptogenic or, more precisely, disease-modifying effects. This implies an effect on the temporal course of the disease, even when treatment is discontinued. However, the terms ASM and disease-modifying are not mutually exclusive. In some cases, ASMs can have this property. however, demonstrating this disease-modifying effect, and hence the development of these molecules, remains complex and difficult. The disease-modifying effect of ASM seems to depend on its etiological or pathophysiological effect on the developing epileptic disease, but also on other characteristics: target on etiological or pathophysiological mechanisms of the disease, level of cerebral maturation, time after onset of an epileptogenic event, dosage and duration of treatment. The development of this new type of treatment requires a better definition of the target populations, a better understanding of the cascade of epileptogenic phenomena, and the definition of new diagnostic and prognostic markers for epilepsy.
国际抗癫痫联盟（ILAE）正在提议采用一种新的命名法，用抗癫痫发作药物（ASMs）取代令人困惑的术语抗癫痫药物（AEDs）。这种做法部分是由于出现了具有抗癫痫发生作用，或者更确切地说具有疾病修饰作用的新疗法。这意味着即使在停药后，对疾病的病程也有影响。然而，ASM和疾病修饰这两个术语并非相互排斥。在某些情况下，抗癫痫发作药物可以具有这种特性。然而，证明这种疾病修饰作用以及这些分子的研发仍然复杂且困难。抗癫痫发作药物的疾病修饰作用似乎取决于其对正在发展的癫痫疾病的病因学或病理生理学作用，也取决于其他特征：针对疾病病因学或病理生理学机制的靶点、大脑成熟程度、致痫事件发作后的时间、治疗剂量和持续时间。开发这种新型治疗方法需要更好地定义目标人群，更好地理解致痫现象的级联反应，以及定义癫痫新的诊断和预后标志物。
