Epilepsy Currents最新文献

{"title":"American Epilepsy Society Clinical Practice Guideline: Infantile Epilepsy.","authors":"Daniel Freedman, Ifeoluwa Babatunde, Rebecca L Morgan, Renad Abu-Sawwa, Dara Albert, Mandana Behbahani, Kevin Chapman, Erin Fecske, William Davis Gaillard, Monika Jones, Mary Anne Meskis, Leah Schust Myers, Kim Nye, Chima Oluigbo, Heidi H Pfeifer, Reneé A Shellhaas, Lindsey Thompson, Howard L Weiner, Courtney J Wusthoff, Elissa Yozawitz","doi":"10.1177/15357597261433266","DOIUrl":"10.1177/15357597261433266","url":null,"abstract":"<p><p>This practice guideline from the American Epilepsy Society provides evidence-based recommendations for pharmacological, dietary, and surgical therapies for epilepsy for infants and children from 1 month of age to <36 months. The multidisciplinary panel updated an existing systematic review, which was funded by the Patient-Centered Outcomes Research Institute and conducted by ECRI (formerly the Emergency Care Research Institute) on behalf of the Agency for Healthcare Research and Quality. The updated review used the same search strategy, inclusion/exclusion criteria, and Grading of Recommendations Assessment, Development and Education methodology, and added studies from August 2021 through September 2025 that were not in the original systematic review. As with the previous review, West syndrome and infantile spasms were excluded from this guideline, as existing treatment guidance is already available for infantile epileptic spasms. While many of the recommendations are conditional due to low certainty of evidence, the panel made two strong recommendations: (1) hemispherectomy/hemispherotomy surgery is recommended for infants and children <36 months of age with drug resistant epilepsy secondary to select underlying lesional pathologies, including but not limited to hemimegaloencephaly, Rasmussen's encephalitis, Sturge-Weber syndrome, perinatal stroke, and hemispheric cortical dysplasia; and (2) intralobar, multilobar, or focal resections or posterior disconnections for drug-resistant focal or lesional epilepsy in this same age range. A treatment algorithm was developed based on evidence and expert opinion as part of the guideline to help place pharmacological, dietary, and surgical recommendations in a clinical context. The limited number of studies and low certainty of evidence in this population underscores the need for higher-quality data and etiology-specific treatments. More research is needed to evaluate effective therapies for infants with epilepsy, as well as the impact these therapies have on long-term developmental and mortality outcomes.</p>","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"174-202"},"PeriodicalIF":4.6,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Turning Up the Heat on Temporal Lobe Epilepsy: LAANTERN Helps Illuminate the Role of Laser Ablation.","authors":"John D Rolston","doi":"10.1177/15357597261438916","DOIUrl":"10.1177/15357597261438916","url":null,"abstract":"","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"298-300"},"PeriodicalIF":4.6,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking Bone: Vulnerability, Assessment, and Prevention.","authors":"Danielle A Becker","doi":"10.1177/15357597261440734","DOIUrl":"10.1177/15357597261440734","url":null,"abstract":"","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"295-297"},"PeriodicalIF":4.6,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Stroke of Insight? Possible Bidirectional Relationship Between Stroke and Epilepsy.","authors":"Samuel W Terman","doi":"10.1177/15357597261432025","DOIUrl":"10.1177/15357597261432025","url":null,"abstract":"","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"292-294"},"PeriodicalIF":4.6,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13031133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On Time Saves Lives: Survey Insights and Position Statement from the American Epilepsy Society on Barriers to Antiseizure Medication Access.","authors":"Marjorie E Bunch, Jessica Falco-Walter, Sasha Alick-Lindstrom, Abrar O Al-Faraj, Brandy E Fureman, James Herbst, Lisa C Garrity, Shilpa Klocke, Alain Lekoubou, Lara V Marcuse, Lauren Orciuoli","doi":"10.1177/15357597261435471","DOIUrl":"10.1177/15357597261435471","url":null,"abstract":"<p><strong>Rationale: </strong>Seizure medication must be taken regularly to be effective; seizures often result from missed doses. Numerous barriers can delay people with epilepsy (PWE) from obtaining medication on time.</p><p><strong>Methods: </strong>Two surveys were designed, one for PWE and their caregivers and one for healthcare providers (HCPs). Surveys were delivered electronically and data analysis was descriptive.</p><p><strong>Results: </strong>Medication unavailability was the most common barrier reported. Additional barriers in order of decreasing frequency included: the message \"too soon to refill,\" insurance coverage, prescription delay, and cost. For non-active drivers, transportation was a barrier. Sequelae of delayed medication access included: stress, emergency medication utilization, and hospitalization. Access to seizure medications was recognized as a problem by 95% of HCP surveyed, most frequently attributed to insurance barriers and cost. Over 10% of HCP reported a patient death from a medication access issue.</p><p><strong>Conclusion: </strong>The American Epilepsy Society's Position Statement on medication access supports reducing obstacles that delay obtaining medication through a multifaceted approach. It recommends elimination of unnecessary regulatory barriers, cost containment and insurance reform, supply chain transparency, practice management guidance, and ongoing research.</p>","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"15357597261435471"},"PeriodicalIF":4.6,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"American Epilepsy Society/International League Against Epilepsy-North America Joint Task Force for Epilepsy Health Care Disparities in the United States.\"","authors":"","doi":"10.1177/15357597261436214","DOIUrl":"10.1177/15357597261436214","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/15357597251342227.].</p>","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"163"},"PeriodicalIF":6.3,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13008787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Best Practices in Clinical Epilepsy Symposium | Mortality in Epilepsy: Challenges and Interventions.","authors":"Yinchen Song, Angela Wabulya, Jessica Sabino, Megan Keeler, Sara Preisendanz, Avani C Modi, Meghann Kelly","doi":"10.1177/15357597261432005","DOIUrl":"10.1177/15357597261432005","url":null,"abstract":"<p><p>Epilepsy-related mortality, including Sudden Unexpected Death in Epilepsy and suicide, is a crucial topic within the interdisciplinary scope of caring for people with epilepsy (PWE). This review highlights best practices that emphasize proactive education for patients, caregivers, and communities, as well as evidence-based strategies and interventions for seizure management aimed at reducing mortality risk. It further underscores the essential contribution of the multidisciplinary care team in managing epilepsy-related mortality, highlighting considerations such as comorbid behavioral health conditions, challenges with treatment adherence, the use of the ketogenic diet, and the impact of social determinants of health and health disparities on historically marginalized populations. The authors provide actionable insights to address these challenges and barriers and enhance the outcomes and quality of life for PWE and their loved ones.</p>","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"15357597261432005"},"PeriodicalIF":4.6,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13008791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Biomarkers: Empiric Immunotherapy in Refractory Epilepsy and the Search for Responders.","authors":"Samuel Lapalme-Remis","doi":"10.1177/15357597261435133","DOIUrl":"10.1177/15357597261435133","url":null,"abstract":"","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"289-291"},"PeriodicalIF":4.6,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13008788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is It Policy And Not Treatment That Actually Determines Epilepsy Outcomes?","authors":"Amza Ali, Heather Ravvin McKee, Sanjay M Sisodiya","doi":"10.1177/15357597261434565","DOIUrl":"10.1177/15357597261434565","url":null,"abstract":"<p><p>Epilepsy is among the most prevalent and treatable neurological disorders worldwide, yet it remains associated with persistent and preventable inequities in morbidity and mortality. Despite major advances in diagnostics, pharmacotherapy, and surgery, substantial treatment gaps and excess mortality persist globally across all income segments of society. These outcomes frequently reflect failures of access, continuity, and health-system design, rather than limitations of existing therapies. Using epilepsy specifically as a tracer neurological condition, this analysis examines how health systems respond to chronic neurological disease under stress. In many low- and middle-income countries and other underserved settings, health systems have evolved passively, shaped by fragmented financing, short-term priorities, and misaligned incentives rather than by intentional, outcome-oriented policy. Evidence from global neurology and health economics shows that such passive system development produces reactive care models, inefficient resource use, and high indirect costs due to productivity loss, caregiver burden, injury, disability, and premature mortality. Environmental and climate-related stressors further expose these structural weaknesses in vulnerable regions. Extreme weather events, environmental instability, and displacement disrupt medication supply, infrastructure, and continuity of neurological care. In epilepsy, even brief interruptions in treatment can precipitate breakthrough seizures, injury, or death, transforming environmental exposure into avoidable neurological harm. This article contends that policy is the primary determinant of whether health systems remain reactive or become resilient. Secondly, we propose that artificial intelligence (AI) may play a critical enabling role by supporting the development of context-appropriate policy and system design. When aligned with local realities, AI-facilitated policy could enable earlier diagnosis, sustained treatment, and more efficient resource allocation. Proactive epilepsy care is therefore not only an ethical imperative but an economically rational strategy. Aligning policy, technology, and health system design is essential to deliver durable, equitable, and cost-effective epilepsy care in an era of accelerating environmental and geopolitical change where external funding is diminishing globally.</p>","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"15357597261434565"},"PeriodicalIF":4.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147498052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Mental Health Equity in Epilepsy: Social Determinants of Health Across the Lifespan.","authors":"Margaret Gopaul, Jonah Fox, Aimee W Smith, Sarita Maturu, Robert McInnis, Palak S Patel, Shannon Brothers, Susan Duberstein, Jared Woodward, Kelly Conner, Nick Beimer, Laura Strom, Mary Wojnaroski, Heidi Munger-Clary","doi":"10.1177/15357597251406119","DOIUrl":"10.1177/15357597251406119","url":null,"abstract":"<p><p>Mental health equity is a critical issue for people with epilepsy (PWE), who bear a disproportionate burden of psychiatric and cognitive comorbidities. Conditions such as depression, anxiety, attention-deficit/hyperactivity disorder, autism spectrum disorder, functional/dissociative seizures, and cognitive impairment occur more frequently in PWE, contributing to elevated morbidity, mortality, and reduced quality of life. Many of these disorders have bidirectional relationships with epilepsy, reflecting overlapping biological, psychological, and social mechanisms. Social Determinants of Health (SDoH), including educational opportunities, access to health care, neighborhood and environmental exposures, social and community context, and economic stability, further shape risk, presentation, and outcomes across the lifespan. Children with epilepsy and neurodevelopmental disorders face academic and service inequities, while adults encounter barriers in mental health access and stigma that may worsen depression and anxiety. Older adults with epilepsy and dementia experience additional disparities driven by socioeconomic status and minority status. This narrative review synthesizes current evidence on the epidemiology, risk factors, and mechanisms linking epilepsy with psychiatric, neurodevelopmental, and neurodegenerative conditions, with an emphasis on how SDoH exacerbates inequities. We identify gaps in mechanistic research and highlight the underrepresentation of vulnerable populations. To advance equity, strategies must include routine SDoH screening, integration of psychosocial and neurologic care, stigma-reduction efforts, and development of culturally competent, patient-centered interventions. Policy initiatives that address structural barriers to care are also essential. Together, these approaches can improve outcomes and promote health equity for PWE.</p>","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"15357597251406119"},"PeriodicalIF":4.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147498048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}