Clinical Neurology and Neurosurgery最新文献

{"title":"Antimicrobial management of unresectable embolisation agent infection: A case report","authors":"Timothy D. Shaw ,&nbsp;Suhani Bansal ,&nbsp;Jun Lau ,&nbsp;Carly Culbert ,&nbsp;Ashraf Abouharb ,&nbsp;Ian Rennie ,&nbsp;Louise McCorry","doi":"10.1016/j.clineuro.2025.108894","DOIUrl":"10.1016/j.clineuro.2025.108894","url":null,"abstract":"<div><div>Liquid embolisation agents represent an uncommon but serious site of intracranial infection. Surgical excision of the infected material is typically required to eradicate infection and outcomes are poor in inoperable cases due to recurrent, treatment-refractory ventriculitis. We present our case in whom retained E. coli-infected embolisation glue was managed with antimicrobial therapy only. Following multiple failed courses of antibiotics, we found an aggressive induction phase (12 weeks intravenous therapy) followed by lifelong suppressive oral therapy resulted in sustained clinical recovery at one year’s follow-up.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108894"},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting hospital outcomes in concussion and TBI: A mixed-effects analysis utilizing the nationwide readmissions database","authors":"Anubhav Chandla ,&nbsp;Shane Shahrestani ,&nbsp;Gabrielle E.A. Hovis ,&nbsp;Mahlet Mekonnen ,&nbsp;Andre E. Boyke ,&nbsp;Anna Furton ,&nbsp;Diya Dhawan ,&nbsp;Chirag Patil ,&nbsp;Isaac Yang","doi":"10.1016/j.clineuro.2025.108893","DOIUrl":"10.1016/j.clineuro.2025.108893","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Traumatic brain injury (TBI) is characterized by a wide range in severity. This variation presents a challenge for predicting outcomes and making management decisions, particularly for patients sustaining less severe injury. We present a novel statistical model for the prediction of hospital outcomes in two propensity-matched cohorts to optimize TBI patient management and counseling.</div></div><div><h3>Methods</h3><div>Hospitalized patients diagnosed with TBI were selected from the Nationwide Readmissions Database (NRD) from 2010 to 2019 using ICD-9 and ICD-10 codes. Using propensity score matching for baseline characteristics, patients were sorted by GCS score into two cohorts: 1188 patients with mild to moderate TBI (mTBI, GCS &gt; 8) and 1219 patients with severe TBI (sTBI, GCS ≤ 8). Mixed-effects modeling was implemented, and model performance was evaluated using the Area Under the Curve (AUC). Any variance in ROC model prediction between cohorts was compared using DeLong’s test.</div></div><div><h3>Results</h3><div>After bivariate analysis, the mean length of stay (LOS), hospital cost, and mortality were significantly lower in the mTBI cohort relative to sTBI. GCS scores within the range of 9–15 were predictive of LOS (p &lt; 0.01), with a trend towards significance in the prediction of non-routine discharge (p = 0.06).</div></div><div><h3>Conclusion</h3><div>Using an advanced mixed-effects model, our study found that GCS is an accurate predictor of hospital outcomes after a TBI diagnosis. These results provide insight that may aid in the development of preventative strategies, management decisions, and patient counseling to ensure a safe return to daily life for patients diagnosed with concussion.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108893"},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral blood flow velocities measured by transcranial doppler are associated with magnetic resonance imaging biomarkers in moyamoya arteriopathy","authors":"Lisa R. Sun ,&nbsp;Melike Guryildirim ,&nbsp;John R. Gatti ,&nbsp;Syed Ameen Ahmad ,&nbsp;Wendy Ziai ,&nbsp;Rebecca F. Gottesman ,&nbsp;Lori C. Jordan ,&nbsp;Risheng Xu ,&nbsp;Aylin Tekes ,&nbsp;Vivek Yedavalli","doi":"10.1016/j.clineuro.2025.108889","DOIUrl":"10.1016/j.clineuro.2025.108889","url":null,"abstract":"<div><h3>Purpose</h3><div>In individuals with moyamoya arteriopathy, transcranial Doppler (TCD) may be a useful complement to MRI because of its safety, cost effectiveness, and ability to be performed without anesthesia in children. We evaluated associations between various MR-based moyamoya biomarkers and cerebral blood flow velocity (CBFV) as measured by TCD in individuals with moyamoya.</div></div><div><h3>Methods</h3><div>Participants ≤ 26-years-old with moyamoya who had not had surgical revascularization underwent TCDs within 14 days of surveillance brain MRIs. Associations between MRI parameters (Suzuki scores, cerebrovascular stenosis score, ivy sign, brush sign) and CBFV of the MCA and ICA were assessed.</div></div><div><h3>Results</h3><div>Twenty-six TCD-MRI pairs from 16 participants were analyzed. Median participant age was 7.3 (IQR 5.9–8.9) years. No associations between CBFV and Suzuki score or cerebrovascular stenosis score were identified. There was a significant positive association between MCA CBFV and degree of MCA stenosis between 0 % and 99 % stenosis (p = 0.02). Hemispheres without ivy sign had higher MCA CBFV compared with hemispheres with ivy sign (144 cm/s v. 105 cm/s, p = 0.02). Hemispheres with brush sign had higher CBFV compared with hemispheres without brush sign in both the MCA (232 cm/s v. 122 cm/s, p = 0.009) and ICA (213 cm/s v. 131 cm/s, p = 0.03).</div></div><div><h3>Conclusion</h3><div>In this cohort of children and young adults with moyamoya, higher MCA CBFV were associated with higher degrees of stenosis (but not complete occlusion), the presence of a brush sign, and the absence of the ivy sign. TCD may have an important role as an adjunct to traditional neuroimaging in moyamoya arteriopathy.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108889"},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative indocyanine green videoangiography versus postoperative catheter angiography to confirm microsurgical occlusion of cranial dural arteriovenous fistulas","authors":"Katherine Karahalios ,&nbsp;Lea Scherschinski ,&nbsp;Visish M. Srinivasan ,&nbsp;Joseph H. Garcia ,&nbsp;Rohin Singh ,&nbsp;Adam T. Eberle ,&nbsp;Joelle N. Hartke ,&nbsp;Joshua S. Catapano ,&nbsp;Redi Rahmani ,&nbsp;Christopher S. Graffeo ,&nbsp;Michael T. Lawton","doi":"10.1016/j.clineuro.2025.108896","DOIUrl":"10.1016/j.clineuro.2025.108896","url":null,"abstract":"<div><h3>Objective</h3><div>Intracranial dural arteriovenous fistulas (DAVFs) are diagnosed with catheter digital subtraction angiography (DSA) and confirmed intraoperatively with indocyanine green videoangiography (ICG-VA). Stand-alone ICG-VA has been demonstrated to successfully predict complete obliteration of spinal DAVFs with an associated cost reduction. The predictive value of standalone ICG-VA has not been assessed; this study sought to assess the diagnostic value of intraoperative ICG-VA versus postoperative DSA for obliteration of cranial DAVFs.</div></div><div><h3>Methods</h3><div>A multi-institutional cerebrovascular database was queried for all surgically managed DAVFs. Patients who underwent both intraoperative ICG-VA and postoperative DSA were included. Demographic and radiologic data, intraoperative findings, and surgical outcome data were analyzed retrospectively.</div></div><div><h3>Results</h3><div>Thirty-five patients with 39 DAVFs were identified (mean [SD] age: 60.3 [10.4] years; 26 [74 %] men, 9 [26 %] women). All DAVFs were treated with interruption of the fistula with clip occlusion of the draining vein. Intraoperative ICG-VA showed complete obliteration in all patients. Postoperative DSA was performed after 28 procedures and confirmed complete obliteration in all cases. The negative predictive value of ICG-VA confirming complete occlusion of cranial DAVFs was 100 %.</div></div><div><h3>Conclusion</h3><div>Complete microsurgical occlusion of DAVFs can be confirmed using intraoperative ICG-VA. The diagnostic power of ICG-VA is underscored by its direct correlation with postoperative DSA results. The 100 % negative predictive value of ICG-VA suggests that postoperative DSA may not be necessary when intraoperative ICG-VA confirms complete occlusion of the DAVF. Forgoing postoperative DSA has the potential to save patients the procedural risk and cost associated with an additional procedure.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108896"},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143858853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the triglyceride-glucose index and cognitive function in stroke free patients with atrial fibrillation: A cross-sectional study","authors":"Juncun Wu ,&nbsp;Zhetao Wang ,&nbsp;Chen Ye ,&nbsp;Junfeng Liu ,&nbsp;Shi Chen ,&nbsp;Wendan Tao ,&nbsp;Fabao Gao ,&nbsp;Zilong Hao","doi":"10.1016/j.clineuro.2025.108890","DOIUrl":"10.1016/j.clineuro.2025.108890","url":null,"abstract":"<div><h3>Objectives</h3><div>No existing research has documented the correlation between the triglyceride-glucose (TyG) index and cognitive function in patients suffering from atrial fibrillation (AF). The objective of this study is to examine this potential association.</div></div><div><h3>Methods</h3><div>Patients diagnosed with AF were enrolled in this study from March 2021 to May 2022 at the cardiology department of West China Hospital, Sichuan University. TyG index was calculated. Cognitive function was evaluated using the Mini-Mental State Examination (MMSE) scale and Montreal Cognitive Assessment (MoCA), Verbal Fluency Test (VFT), Shape Trail Test (STT), Digit Symbol Substitution Test (DSST), and Stroop C scores and seconds. Logistic regression analyses were conducted to examine the association between the TyG index (continuous and quartiles) and cognitive function.</div></div><div><h3>Results</h3><div>A total of 142 patients were included. The median value of the TyG index was 1.28 (1.01, 1.71). After adjusted potential confounding factors, participants in the 4th quartile of the TyG index were not found to be associated with cognitive function (all P &gt; 0.05). The findings for TyG as a continuous variable were consistent with these results.</div></div><div><h3>Conclusion</h3><div>In patients with AF, the TyG index was found to be unrelated to low cognitive function as assessed by a comprehensive battery of tests. These findings should be validated in further studies.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108890"},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of type 2 diabetes mellitus and cognitive function with the resumption of oral intake during stroke rehabilitation","authors":"Shinya Fukuda ,&nbsp;Hitoshi Fukuda ,&nbsp;Yusuke Ueba ,&nbsp;Norio Yamamoto ,&nbsp;Isami Kumakura ,&nbsp;Suguru Shirakawa ,&nbsp;Kei Kawada ,&nbsp;Tetsuya Ueba","doi":"10.1016/j.clineuro.2025.108891","DOIUrl":"10.1016/j.clineuro.2025.108891","url":null,"abstract":"<div><h3>Background</h3><div>Physical factors including motor and balance functions are associated with resumption of oral intake of the stroke patients receiving nasogastric tube feeding. However, association of non-physical factors remains unclear. The aims of this study are to explore non-physical factors associated with resumption of oral intake after stroke and to clarify how they affect the time course of the resumption.</div></div><div><h3>Methods</h3><div>A total of 116 patients receiving nasogastric tube feeding after stroke were retrospectively analyzed from a single center observational cohort database. Associations of physical and non-physical factors with resumption of oral intake at discharge from the stroke rehabilitation facility were investigated. We also evaluated how the specific combination of non-physical prognostic factors affected the time course of resumption using survival analyses.</div></div><div><h3>Results</h3><div>Among 116 patients, 59 (50.4 %) resumed oral intake. History of diabetes mellitus (DM) (P &lt; 0.001) and higher cognitive functional independence scores (C-FIM) (P = 0.03) were significantly associated with the resumption of oral intake at discharge. These non-physical factors had an additive value on conventional risk factors to predict resumption of oral intake. Patients with a history of DM were significantly associated with improved resumption of oral intake than with non-DM patients with lower C-FIM scores (&lt; 18) by survival analysis (P = 0.001), and this difference became prominent after 90 days post-stroke.</div></div><div><h3>Conclusion</h3><div>A history of DM and better cognitive function as non-physical factors were significantly associated with the resumption of oral intake in patients receiving nasogastric tube feeding after stroke.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108891"},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Modified Five-item Frailty Index (mFI-5) versus Grip Strength as predictors of length of stay, discharge to home, and early surgical complications in patients undergoing long segment fusion” [Clin. Neurol. Neurosurg. 252 (2025) 108864]","authors":"Yamenah Ambreen ,&nbsp;Cole Veliky ,&nbsp;Joshua H. Weinberg ,&nbsp;Joshua Wang ,&nbsp;Stephanus Viljoen ,&nbsp;David S. Xu ,&nbsp;Vikram Chakravarthy ,&nbsp;Siri Sahib Khalsa ,&nbsp;Bryan Ladd ,&nbsp;Andrew J. Grossbach","doi":"10.1016/j.clineuro.2025.108885","DOIUrl":"10.1016/j.clineuro.2025.108885","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"252 ","pages":"Article 108885"},"PeriodicalIF":1.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143854903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revision surgery for proximal junctional failure: A single-center analysis","authors":"Samuel Adida ,&nbsp;Joseph S. Hudson ,&nbsp;Andrew D. Legarreta ,&nbsp;Suchet Taori ,&nbsp;Regan M. Shanahan ,&nbsp;Mohamed-Ali H. Jawad-Makki ,&nbsp;Jhair A. Colan ,&nbsp;Rida Mitha ,&nbsp;Nitin Agarwal ,&nbsp;David O. Okonkwo ,&nbsp;D. Kojo Hamilton ,&nbsp;Thomas J. Buell","doi":"10.1016/j.clineuro.2025.108880","DOIUrl":"10.1016/j.clineuro.2025.108880","url":null,"abstract":"<div><h3>Background</h3><div>Proximal junctional kyphosis (PJK) is a radiographic complication following adult spinal deformity (ASD) surgery due to degeneration of mobile segments adjacent to fused spine. Proximal junctional failure (PJF) represents PJK with structural failure, neurologic deficit, or mechanical instability warranting revision with extension of fusion above the uppermost instrumented vertebra (UIV). This study investigates the clinical presentation, mechanisms of failure, revision strategies, and outcomes for ASD patients who develop PJF after instrumented fusion to the pelvis.</div></div><div><h3>Methods</h3><div>Fifty-four ASD patients who developed PJF after a posterior instrumented fusion to the pelvis at a single institution from 2009 to 2021 were analyzed. PJF was defined by radiographic PJK with (1) UIV or UIV+1 fracture, UIV screw pullout, or soft-tissue posterior ligamentous disruption, and (2) neurological deficit at presentation.</div></div><div><h3>Results</h3><div>The cohort was stratified into upper thoracic (UT, 10 patients, T2-T6), lower thoracic (LT, 35 patients, T8-T11), and lumbar (L, 9 patients, L1-L3) spine UIV groups based on index surgery. Patients developed PJF at a median of 14 months (mean 18 ± 16, range: 1–78) after their index surgery. Neurological deficits at presentation included radiculopathy (61 %), myelopathy (48 %), motor deficits (33 %), and bowel or bladder incontinence (9 %). Mechanisms of PJF were vertebral fracture and screw pullout (UT: 50 %, LT: 80 %, L: 89 %, <em>P</em> &lt; 0.001) or soft-tissue disruption (UT: 50 %, LT: 20 %, L: 11 %, <em>P</em> = 0.089) at the UIV. Revision surgery commonly involved posterior column osteotomies (63 %) rather than three-column osteotomies (9 %). Of patients in the UT group, 40 % were extended above the cervicothoracic junction. In the LT and L groups, 91 % and 89 % of patients were extended to the UT and LT spine, respectively. Median follow-up for the cohort after revision for PJF was 24 months (range: 2–89). A total of 26 patients (48 %) required a second revision surgery (median 14 months, range: 1–50), 16 of whom (28 %) were revised for recurrent PJF. Patient-specific and radiographic risk factors for recurrent PJF could not be elucidated.</div></div><div><h3>Conclusion</h3><div>In this series of ASD patients, after revision for PJF, recurrent PJF was the most common complication requiring another revision. Junctional failures tended to be vertebral body fracture and screw pullout in the LT and L spine and soft tissue disruption in the UT spine. Most revisions involved posterior column osteotomies with proximal extension across the thoracolumbar junction or apex of thoracic kyphosis (e.g., L to LT, LT to UT); notably, nearly half of UT failures were not extended to the cervical spine. Future research is warranted to elucidate risk factors for recurrent PJF and potential preventative strategies.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108880"},"PeriodicalIF":1.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Augmented reality in cranial surgery: Surgical planning and maximal safety in resection of brain tumors via head-mounted fiber tractography” [Clin. Neurol. Neurosurg. 251 (2025), 108820]","authors":"Muhammet Enes Gurses ,&nbsp;Adham M. Khalafallah ,&nbsp;Elif Gökalp ,&nbsp;Jordan Spatz ,&nbsp;Siyar Bahadir ,&nbsp;Vratko Himic ,&nbsp;Ricardo J. Komotar ,&nbsp;Michael E. Ivan","doi":"10.1016/j.clineuro.2025.108886","DOIUrl":"10.1016/j.clineuro.2025.108886","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"252 ","pages":"Article 108886"},"PeriodicalIF":1.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143854904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and treatment responses of epilepsy in the elderly in northwestern China","authors":"Bofei Tan ,&nbsp;Qiang Liu ,&nbsp;Mengyun Li ,&nbsp;Jianming Wu ,&nbsp;Feng Rao ,&nbsp;Qing Zhang","doi":"10.1016/j.clineuro.2025.108887","DOIUrl":"10.1016/j.clineuro.2025.108887","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the clinical characteristics and treatment responses of epilepsy in the elderly.</div></div><div><h3>Methods</h3><div>Consecutive epilepsy patients (age≥65) who were admitted to the tertiary medical center in northwestern China from 2019 to 2022 and were</div><div>divided into the early-onset epilepsy (EOE) group and the late-onset epilepsy (LOE) group. Clinical data were analyzed retrospectively, and all patients were followed for one year.</div></div><div><h3>Results</h3><div>A total of 239 elderly PWE (100 in the EOE group) were enrolled, with ischemic stroke being the primary cause (27.2 %). The proportion of epilepsy due to ischemic stroke was higher in the LOE group compared to the EOE group (33.8 % vs. 27.0 %, p = 0.007). Generalized tonic-clonic seizures (GTCS) were the most common seizure type in elderly PWE (34.7 %) and EOE group (46.0 %). Complex partial seizures (CPS) were the most common seizure type in the LOE group (30.2 %). Hypertension (49.8 %) was the most prevalent comorbidity, and it was more common in the LOE group than in the EOE group (56.8 % vs. 40.0 %, p &lt; 0.05). Of the 207 patients who completed follow-up, 184 were on anti-seizure medications (ASMs) including125 being prescribed a single type of ASM and 59 two or more types. Among patients receiving one type of ASM, more EOE group received traditional ASM (55.6 % vs. 31.0 %), while more LOE group received novel ASM (69.0 % vs. 44.4 %, p = 0.006). More patients receiving two or more type of ASMs were included in the EOE group than in the LOE group (35.9 % vs. 22.6 %, p = 0.036). Seizure freedom was achieved in 61.8 % of the elderly PWE,and the seizure freedom rate was higher in the LOE group than in the EOE group(67.0 % vs51.7 %, p = 0.035).</div></div><div><h3>Conclusion</h3><div>In elderly PWE, there are differences between EOE and LOE across several aspects, including etiology, semiology, and ASMs selection, etc. Furthermore, patients with LOE having a higher likelihood of achieving seizure freedom. Conversely, more patients with EOE need two or more type of ASMs to control their seizures.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108887"},"PeriodicalIF":1.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}