When Epilepsy Medication Fails: Where Neuromodulation Fits - Prof. John Duncan, National Hospital for Neurology and Neurosurgery, UK

What happens when epilepsy medication doesn’t work, and how are the next steps decided? Prof. John Duncan explains how treatment pathways move beyond medication, including surgery and neuromodulation, and how patients and clinicians weigh options together. The conversation explores how outcomes, risk, cognition, and quality of life are balanced in real-world decisions.

 

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This episode is sponsored by EASEE® by Precisis who’s had no influence over the editorial content or discussion. Learn more about EASEE® here.

 

Episode Highlights

  • Why many people still have seizures despite medication

  • Why further medications rarely work after 2–3 appropriate options

  • Why many patients are not suitable for epilepsy surgery

  • What neuromodulation can realistically achieve (and what it cannot)

  • How treatment decisions balance risk, cognition, and daily life

  • Why seizure reduction, not cure, is often the goal


About John Duncan

Professor John Duncan is a consultant neurologist specialising in epilepsy and epilepsy surgery at the National Hospital for Neurology and Neurosurgery (NHNN) and Professor of Neurology at University College London Institute of Neurology. His research is focused on neuroimaging applied to epilepsy.

Full profile: John-Duncan

Topics mentioned

  • drug-resistant epilepsy

  • neuromodulation

  • easee

  • focal epilepsy

  • resective surgery

  • video eeg telemetry

  • functional mri

  • vns

  • dbs

  • rns

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