EpilepsiaPub Date : 2025-08-25DOI: 10.1111/epi.18618
Bernadette Macrohon, Medine I Gulcebi, Sanjay M Sisodiya
{"title":"Climate change and melting medications.","authors":"Bernadette Macrohon, Medine I Gulcebi, Sanjay M Sisodiya","doi":"10.1111/epi.18618","DOIUrl":"https://doi.org/10.1111/epi.18618","url":null,"abstract":"","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EpilepsiaPub Date : 2025-08-23DOI: 10.1111/epi.18601
Julie Lévi-Strauss, Vi-Huong Nguyen-Michel, Espártaco Moraes Ribeiro, Virginie Lambrecq, Aurélie Hanin, Sophie Demeret, Vincent Navarro
{"title":"An extreme type of new onset refractory status epilepticus with stimulus-induced seizures in pharmacological isoelectric states.","authors":"Julie Lévi-Strauss, Vi-Huong Nguyen-Michel, Espártaco Moraes Ribeiro, Virginie Lambrecq, Aurélie Hanin, Sophie Demeret, Vincent Navarro","doi":"10.1111/epi.18601","DOIUrl":"https://doi.org/10.1111/epi.18601","url":null,"abstract":"<p><strong>Objective: </strong>Status epilepticus (SE) is a common neurological emergency associated with high morbidity and mortality. SE is classified as refractory when it persists despite benzodiazepine and second-line antiseizure medication. Managing refractory SE in the intensive care setting often requires high doses of sedative drugs, which can induce burst suppression or complete electrical suppression (amplitude < 10 μV). We aimed to investigate the characteristics of persistent epileptic seizures in patients undergoing pharmacologically induced electrical suppression for treatment of refractory SE.</p><p><strong>Methods: </strong>We retrospectively screened our hospital electroencephalographic (EEG) database for patients admitted to the neurointensive care unit with SE and a new onset refractory status epilepticus (NORSE) diagnosis from 2006 to 2024 (N = 65). Patients with persistent seizures despite a suppressed EEG were included. EEG, biological, and clinical data and outcomes were collected.</p><p><strong>Results: </strong>We identified seven patients with persistent electrical seizures despite pharmacologically induced electrical suppression lasting >1 min. All had cryptogenic NORSE (c-NORSE), preceded by a febrile event, and showed cerebrospinal fluid inflammation. Electrical suppression was achieved using three to four sedative drugs, including a barbiturate. A specific seizure onset EEG pattern was identified in all, characterized by periodic and/or rhythmic generalized discharges (GDs), followed by faster, lower amplitude rhythmic activity. In two patients, increased sedation revealed a second seizure onset pattern, characterized by abrupt rhythmic activity over isoelectric EEG background, independent of GDs. In six patients, multimodal stimuli (auditory, visual, or tactile) triggered either seizures, interictal high-amplitude GDs, or both. Repeated stimuli were associated with small-amplitude evoked potentials. All patients died in the intensive care unit.</p><p><strong>Significance: </strong>We report a series of seven c-NORSE patients with a rare and extremely severe presentation: persistent and stimulus-induced seizures occurring over an electrically suppressed EEG background. This hyperexcitability state may result from cellular and network alterations induced by phenobarbital in patients with central nervous system inflammation.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EpilepsiaPub Date : 2025-08-23DOI: 10.1111/epi.18526
{"title":"15th Asian & Oceanian Epilepsy Congress Author Index","authors":"","doi":"10.1111/epi.18526","DOIUrl":"https://doi.org/10.1111/epi.18526","url":null,"abstract":"","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":"66 S2","pages":"1-6"},"PeriodicalIF":6.6,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EpilepsiaPub Date : 2025-08-22DOI: 10.1111/epi.18599
Johann Philipp Zöllner, Catrin Mann, Laurent Willems, Felix von Podewils, Lisa Langenbruch, Laura Bierhansl, Susanne Knake, Katja Menzler, Juliane Schulz, Bernadette Gaida, Felix Rosenow, Adam Strzelczyk
{"title":"Sleep quality and its correlates in people with epilepsy: A multicenter cross-sectional study in Germany.","authors":"Johann Philipp Zöllner, Catrin Mann, Laurent Willems, Felix von Podewils, Lisa Langenbruch, Laura Bierhansl, Susanne Knake, Katja Menzler, Juliane Schulz, Bernadette Gaida, Felix Rosenow, Adam Strzelczyk","doi":"10.1111/epi.18599","DOIUrl":"https://doi.org/10.1111/epi.18599","url":null,"abstract":"<p><strong>Objective: </strong>Sleep disturbances and epilepsy are closely interrelated. This study aimed to examine associations between sleep quality, affective symptoms, and quality of life (QoL) in people with epilepsy (PWE), and to identify clinical and sociodemographic factors linked to impaired sleep.</p><p><strong>Methods: </strong>We conducted a multicenter cross-sectional study of adult PWE across four tertiary epilepsy centers in Germany. We assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI), affective symptoms with the Hospital Anxiety and Depression Scale (HADS), and epilepsy-specific QoL with the 31-item Quality of Life in Epilepsy (QOLIE-31) inventory. We evaluated sociodemographic and clinical predictors of sleep quality and QoL using univariable and multivariable analyses. Comparisons were made with normative data from the general German population and individuals with chronic migraine.</p><p><strong>Results: </strong>Of 449 individuals (mean age 39.9 years, 58.1% women), 221 (49.2%) were identified as \"poor sleepers,\" significantly exceeding rates in the general population (35.9%, p < .001). In multivariable analysis, poor sleep quality was independently associated with female sex (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.36-3.01, p = .001), unemployment (OR 1.74, 95% CI = 1.10-2.73, p = .017), anxiety (OR = 3.79, 95% CI = 2.39-6.04, p < .001), and depression (OR = 2.19, 95% CI = 1.36-3.54, p = .001). In addition, daily seizures were linked to worse sleep quality (OR = 2.55, 95% CI = 1.03-6.30, p = .042). Poor sleep was independently associated with lower epilepsy-related QoL after adjusting for affective symptoms and seizure frequency (OR = 1.79, 95% CI = 1.20-2.68, p = .005).</p><p><strong>Significance: </strong>Sleep quality in PWE is significantly impaired and strongly associated with anxiety, depression, and sociodemographic variables in addition to epilepsy-specific factors. Poor sleep independently correlates with diminished QoL, supporting the value of routine screening for affective symptoms and sleep disturbances in epilepsy care.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EpilepsiaPub Date : 2025-08-22DOI: 10.1111/epi.18605
Martin Guillemaud, Aurélie Hanin, James J Riviello, Mario Chavez, Ayush Batra, Megan Berry, Francesca Bisulli, Carlos Castillo-Pinto, Carla Cobos-Hernandez, Sophie Demeret, Krista Eschbach, Raquel Farias-Moeller, Madeline Fields, Nicolas Gaspard, Elizabeth E Gerard, Teneille E Gofton, Margaret T Gopaul, Matthew D Gruen, Anthony D Jimenez, Karnig Kazazian, Minjee Kim, Marwa Mansour, Lara Marcuse, Clémence Marois, Mikaela Morales, Lorenzo Muccioli, Elena Pasini, Michelle M Pham, Santiago Philibert Rosas, Aaron F Struck, Nathan Torcida, Mark S Wainwright, Ji Yeoun Yoo, Eyal Muscal, Vincent Navarro, Lawrence J Hirsch, Yichen Lai
{"title":"Standard complete blood count to predict long-term outcomes in febrile infection-related epilepsy syndrome (FIRES): A multicenter study.","authors":"Martin Guillemaud, Aurélie Hanin, James J Riviello, Mario Chavez, Ayush Batra, Megan Berry, Francesca Bisulli, Carlos Castillo-Pinto, Carla Cobos-Hernandez, Sophie Demeret, Krista Eschbach, Raquel Farias-Moeller, Madeline Fields, Nicolas Gaspard, Elizabeth E Gerard, Teneille E Gofton, Margaret T Gopaul, Matthew D Gruen, Anthony D Jimenez, Karnig Kazazian, Minjee Kim, Marwa Mansour, Lara Marcuse, Clémence Marois, Mikaela Morales, Lorenzo Muccioli, Elena Pasini, Michelle M Pham, Santiago Philibert Rosas, Aaron F Struck, Nathan Torcida, Mark S Wainwright, Ji Yeoun Yoo, Eyal Muscal, Vincent Navarro, Lawrence J Hirsch, Yichen Lai","doi":"10.1111/epi.18605","DOIUrl":"https://doi.org/10.1111/epi.18605","url":null,"abstract":"<p><strong>Objective: </strong>We investigated whether complete blood count (CBC) analyses during intensive care unit stay could predict 12-month outcomes in patients with cryptogenic febrile infection-related epilepsy syndrome (FIRES), a subset of new-onset refractory status epilepticus (NORSE).</p><p><strong>Methods: </strong>Outcomes at 12 months were classified as \"unfavorable\" (Glasgow Outcome Score [GOS] 1-3) or \"favorable\" (GOS 4-5). Demographic, clinical, and serial CBC data were collected across treatment phases: (1) no immunotherapy (before initiation or no treatment), (2) first-line immunotherapy, and (3) second-line immunotherapy. For each treatment phase, predictive models stratified outcomes based on CBC features using decision tree regression, with separate models for adults and children. Model performance was tested using a leave-one-patient-out approach.</p><p><strong>Results: </strong>We studied 63 patients (34 adults, 29 children) from 12 centers. Unfavorable outcomes occurred in 18 adults and 12 children. Children were more likely to receive second-line immunotherapy. We analyzed 1530 CBCs (adults: 997 CBCs, including 539 for unfavorable outcomes; children: 533 CBCs, including 415 for unfavorable outcomes). Subgroup analyses revealed differences in CBC levels according to the outcomes and the treatment received. Adults with unfavorable outcomes notably had higher neutrophil-to-lymphocyte ratios (NLRs) and monocyte-to-lymphocyte ratios (MLRs), whereas children with unfavorable outcomes had higher red cell distribution width. NLRs and MLRs increased when CBCs were collected after the initiation of immunotherapy for both adults and children. The variables of interest differed in the different predictive models but always included the proportion of at least one subtype of leukocyte. Prediction accuracy with our models was higher in children (87% overall, with the best performance in no-treatment and first-line phases) than in adults (83% overall, with the best performance during/after the initiation of second-line).</p><p><strong>Significance: </strong>Findings suggest the potential for standard CBCs to serve as a rapid, accessible tool for early prognostication in cryptogenic FIRES, particularly in children.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EpilepsiaPub Date : 2025-08-22DOI: 10.1111/epi.18588
{"title":"Epilepsia – August 2025 Announcements","authors":"","doi":"10.1111/epi.18588","DOIUrl":"https://doi.org/10.1111/epi.18588","url":null,"abstract":"<p>\u0000 <b>ILAE CONGRESSES</b>\u0000 </p><p>\u0000 \u0000 <b>XVIII Workshop on Neurobiology of Epilepsy (WONOEP 2025)</b>\u0000 \u0000 </p><p>25 - 29 August 2025</p><p>Portugal</p><p>\u0000 \u0000 <b>36th International Epilepsy Congress</b>\u0000 \u0000 </p><p>30 August - 3 September 2025</p><p>Lisbon, Portugal</p><p>\u0000 \u0000 <b>Neuroimaging in Epilepsy</b>\u0000 \u0000 </p><p>25 - 26 September 2025</p><p>\u0000 \u0000 <b>Genetic Basis of Developmental and Epileptic Encephalopathies Workshop for the Eastern Mediterranean Epilepsy Health Care Providers</b>\u0000 \u0000 </p><p>1 - 2 October 2025</p><p>Sfax, Tunisia</p><p>\u0000 \u0000 <b>Visiting Teacher Program - Tunisia</b>\u0000 \u0000 </p><p>6 - 8 November 2025</p><p>Sfax, Tunisia</p><p>\u0000 \u0000 <b>Visiting Teacher Program</b>\u0000 \u0000 </p><p>13 - 15 November 2025</p><p>Rabat, Morocco</p><p>\u0000 \u0000 <b>Epilepsy in the Elderly: At the Crossroads of Brain Aging, Neurodegeneration, and Functional Networks</b>\u0000 \u0000 </p><p>21 - 22 November 2025</p><p>Marrakech, Morocco</p><p>\u0000 <b>2026</b>\u0000 </p><p>\u0000 \u0000 <b>15th ILAE School on Pre-Surgical Evaluation for Epilepsy and Epilepsy Surgery</b>\u0000 \u0000 </p><p>19 - 23 January 2026</p><p>Brno, Czech Republic</p><p>\u0000 \u0000 <b>5th International Summer School of Neuropsychology</b>\u0000 \u0000 </p><p>19 - 24 April 2026</p><p>Picardy, France</p><p>\u0000 \u0000 <b>XIV Congreso Latinoamericano de Epilepsia</b>\u0000 \u0000 </p><p>16 - 18 May 2026</p><p>Lima, Peru</p><p>\u0000 \u0000 <b>1º Curso Latinoamericano de EEG Pediátrico</b>\u0000 \u0000 </p><p>6 - 9 August 2026</p><p>TBC</p><p>\u0000 \u0000 <b>16th European Epilepsy Congress</b>\u0000 \u0000 </p><p>5 - 9 September 2026</p><p>Athens, Greece</p><p>\u0000 \u0000 <b>16th Asian & Oceanian Epilepsy Congress</b>\u0000 \u0000 </p><p>19 - 22 November 2026</p><p>Kuala Lumpur, Malaysia</p><p>2027</p><p>\u0000 \u0000 <b>37th International Epilepsy Congress</b>\u0000 \u0000 </p><p>28 August - 1 September 2027</p><p>Amsterdam, Netherlands</p><p>ILAE Webinars</p><p>\u0000 \u0000 <b>Updates on Developmental and Epileptic Encephalopathies</b>\u0000 \u0000 </p><p>5 August 2025</p><p>\u0000 \u0000 <b>Crises prolongées : premiers secours extrahospitaliers</b>\u0000 \u0000 </p><p>12 August 2025</p><p>\u0000 \u0000 <b>Paroxysmal Non-Epileptic Events from Neonates to Children</b>\u0000 \u0000 </p><p>22 August 2025</p><p>\u0000 \u0000 ","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":"66 8","pages":"3083-3085"},"PeriodicalIF":6.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/epi.18588","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EpilepsiaPub Date : 2025-08-22DOI: 10.1111/epi.18617
Marc Zanello, Gonzague De France, Angela Elia, Marco Demasi, Cristina Filipescu, Elisabeth Landre, Alessandro Moiraghi, Bénédicte Trancart, Maimiti Seneca, Agathe Guibert, Fabrice Chretien, Alexandre Roux, Johan Pallud
{"title":"Feasibility and safety of awake craniotomy in adult patients with drug-resistant focal epilepsy.","authors":"Marc Zanello, Gonzague De France, Angela Elia, Marco Demasi, Cristina Filipescu, Elisabeth Landre, Alessandro Moiraghi, Bénédicte Trancart, Maimiti Seneca, Agathe Guibert, Fabrice Chretien, Alexandre Roux, Johan Pallud","doi":"10.1111/epi.18617","DOIUrl":"https://doi.org/10.1111/epi.18617","url":null,"abstract":"<p><strong>Objective: </strong>Although awake craniotomy can guide functional brain mapping and resection, its feasibility and safety have been poorly studied in large series of patients with drug-resistant focal epilepsy surgery.</p><p><strong>Methods: </strong>We conducted an observational, retrospective, single-center cohort study of 588 consecutive awake craniotomies (2010-2024). Patients with drug-resistant focal epilepsy were compared to controls, with a focus on subgroup analysis of patients with low-grade, developmental, epilepsy-associated brain tumor and an associated nontumoral epileptogenic brain lesion group (46/558 patients, 8.2%), patients with ≥2 years of uncontrolled epileptic seizures (32/558 patients, 5.6%), and patients on ≥2 antiseizure medications (77/588 patients, 13.1%). Feasibility outcomes included time to awakening, intraoperative cooperation, and procedure abortion. Safety outcomes included surgery-related risks and intraoperative and early postoperative epileptic seizures.</p><p><strong>Results: </strong>Compared to controls, patients with medically drug-resistant focal epilepsy (1) did not present higher rates of late awakening (6.5%-14.3% vs. 8.7%-9.8%, p = .450, p = .972, p = .143) or of insufficient intraoperative cooperation (0%-9.1% vs. 5.0%-6.1%, p = .019, p = .345, p = .173), (2) did not require abortion of the awake procedure because of epilepsy (0% vs. 0%, p = 1.0), (3) did not present a higher rate of intraoperative epileptic seizures (4.3%-9.1% vs. 2.7%-5.0%, p = .226, p = .529), (4) presented a higher rate of intraoperative epileptic seizures when presenting a ≥2-year history of uncontrolled epileptic seizures (12.9% vs. 2.3%, p < .001), and (5) did not exhibit a higher rate of early postoperative epileptic seizures (13.0%-19.3% vs. 9.8%-10.6%, p = .613, p = .143, p = .078). In multivariable analysis, drug-resistant focal epilepsy was not independently associated with time to awakening, intraoperative cooperation, procedure abortion, or occurrence of intraoperative or early postoperative epileptic seizures.</p><p><strong>Significance: </strong>Awake craniotomy appears feasible and safe in patients with medically drug-resistant focal epilepsy, with similar and low rates of adverse events, including intraoperative epileptic seizures.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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