TOUCH MEDICAL MEDIA 85 Commentary Epilepsy Journal Publication Date: December 23, 2020 Cenobamate—The New Kid on the Block, Teaching More About Epilepsy Than Just Offering a New Treatment for Seizures Roy G Beran 1–3 1. University of New South Wales, Sydney, New South Wales, Australia; 2. School of Medicine, Griffith University, Queensland, Australia; 3. Sechenov First Moscow State Medical University, Moscow, Russia T he treatment of epilepsy is evolving, and with it, so should our approach to treatment. A recent article by Klein et al. (published in this issue of US Neurology) confronted my own attitude towards anti-epileptic medication, and ultimately changed the way I view this therapy and the nomenclature I use. Their empathetic approach to the topic of new anti-seizure medication compelled me to write something that is normally outside of my usual remit. I hope this first-person perspective reflects the impact this article had on me and encourages others to consider their own philosophy in this field. Keywords Epilepsy, anti-seizure medication, placebo effect, cenobamate Disclosure: Roy G Beran has no fnancial or non-fnancial relationships or activities to declare in relation to this article. Review Process: Double-blind peer review. Compliance with Ethics: This article is an opinion piece and does not report on new clinical data, or any studies with human or animal subjects performed by the author. Authorship: The named author meets the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, takes responsibility for the integrity of the work as a whole, and has given fnal approval for the version to be published. Access: This article is freely accessible at touchNEUROLOGY.com © Touch Medical Media 2020. Received: July 6, 2020 Accepted: September 23, 2020 Published Online: December 12, 2020 Citation: US Neurology. 2020;16(2):85–6 Corresponding Author: Roy G Beran, Suite 5, Level 6, 12 Thomas Street, Chatswood, NSW 2067, Australia. E: roy@royberan.com Support: No funding was received in the publication of this article. Dogma dictates that scientific literature should be couched in the third person, past tense. The idea is to obviate the potential to introduce personal bias that may accompany first person, present tense, which is creeping into modern scientific writing. This use of the first person, I am reliably told, followed wide adoption of blogging, in which the authors assume the authority to share personal views without the prerequisite for literature support to underpin that which the blogger may espouse. As a pedant of scientific writing, it has been a personal approach to retain third person, past tense; but to every rule, there is an exception. The article entitled, "Cenobamate for the Treatment of Focal Seizures", by Klein et al., which appears in this issue of US Neurology, evoked a feeling of empathy and dealt with issues that transcend a simple review of yet another new medication, namely cenobamate, in the management of people with epilepsy. 1 It led me to offer the provision of an editorial that is more akin to a blog, and will allow the introduction of personal bias, including first-person syntax. Over the years, I have chosen to avoid the acronym, AED, to denote "anti-epileptic drug", and preferred AEM to reflect “anti-epileptic medication”. This removed the negative connotation attached to drugs and the current overt battle against drugs. Accepting that the concept of drugs produces negative implications, it seemed inappropriate to expand the stigma that is attached to epilepsy to include the potential concept of drug dependence; acknowledging that people with epilepsy are dependent on medication(s) to control their seizures. In their abstract, Klein et al. have taken this one step further. They have acknowledged that the medications used in the treatment of epilepsy are not anti-epileptic (a concept incorporated into the acronym, AED, and further incorporated in the name of the professional body—the International League Against Epilepsy), but are used to treat epilepsy and are designed to stop seizures. Klein et al. introduced a more appropriate and acceptable term, “anti-seizure medication” (ASM). This fosters a further move away from the concept of drugs and the associated negative implications. I fully endorse Klein et al’s use of the acronym, ASM, in preference to my own use of AEM, as it better reflects that which the medications are designed to achieve. I sincerely hope that ASM becomes the chosen, and accepted, acronym to denote these medications. It is appropriate that the introduction of this acronym is attached to this review of the latest arrival in the treatment against seizures. A second feature that permeates the paper by Klein et al., is the acknowledgment of a new classification of seizures. 2,3 It has been shown that many clinicians are unaware of these classifications, be it the older classification or the newer terminology. 4 In their paper, Klein et al. have transcended the gulf between old and new classifications and have adopted both terminologies within the text, such as focal aware (simple partial onset), focal impaired awareness (complex partial onset), and focal to bilateral tonic-clonic (secondarily generalized tonic-clonic) seizures. This allows those who are less