Epilepsy & Behavior最新文献

{"title":"Exploring the interplay between depressive symptoms and seizure outcomes: A single-centre study of drug-resistant epilepsy patients treated with vagus nerve stimulation","authors":"Outi Brander ,&nbsp;Mari-Ann Lehtinen ,&nbsp;Pabitra Basnyat ,&nbsp;Niina Lähde ,&nbsp;Sanna Ruuhonen ,&nbsp;Kai Lehtimäki ,&nbsp;Tomi Sarkanen ,&nbsp;Jukka Peltola","doi":"10.1016/j.yebeh.2025.110499","DOIUrl":"10.1016/j.yebeh.2025.110499","url":null,"abstract":"<div><h3>Background</h3><div>Vagus nerve stimulation (VNS) is a safe and effective treatment option for patients with drug-resistant epilepsy (DRE) and for those with treatment-resistant depression. VNS can lead to the amelioration of depressive symptoms in patients with DRE, independent of its impact on seizure control. However, the relationship between depressive symptoms and seizure outcomes in patients receiving VNS therapy remains uncertain.</div></div><div><h3>Objective</h3><div>This study aimed to assess whether the presence or absence of depressive symptoms influences seizure outcomes in patients with DRE treated with VNS.</div></div><div><h3>Methods</h3><div>This follow-up study included 51 consecutive adult DRE patients treated with VNS at the Neurology Outpatient Clinic at Tampere University Hospital. All patients underwent a psychiatric evaluation before VNS at baseline (pre-implantation). The severity of depressive symptoms was assessed using the Beck Depression Inventory-1A (BDI) at baseline and repeatedly throughout the follow-up period. We categorized patients into two groups based on the presence or absence of depressive symptoms, as determined by their BDI scores at baseline and during the follow-up after VNS implantation: i) patients with depressive symptoms (PWE + DS), with a BDI score &gt; 12 at least once either at baseline or during the follow-up, and ii) patients without depressive symptoms (PWE - DS), with all BDI scores ≤ 12. The primary seizure outcome measure was the number of patients with &gt; 50 % seizure reduction (responders) for their predominant seizure type.</div></div><div><h3>Results</h3><div>At baseline, psychiatric comorbidities were diagnosed in 29.4 % of patients, and the average baseline BDI score was 7.0 (median 5.0, range 0–41). PWE + DS comprised 41.2 % and PWE - DS 58.8 % of the study population. The median duration of follow-up was 39 months (range 6–102 months). The overall responder rate was 52.1 % for the predominant seizure type, with significantly more responders in the PWE + DS group than in the PWE - DS group (73.7 % vs. 37.9 %, <em>p</em> = 0.027). Among the 11 patients whose predominant seizure type was focal to bilateral tonic-clonic seizures (FBTCS), 81.8 % were responders, and 72.8 % achieved seizure freedom for this seizure type.</div></div><div><h3>Conclusion</h3><div>Our study indicates that DRE patients with depressive symptoms respond better to VNS therapy for their predominant seizure type than those without depressive symptoms. This unexpected finding may be explained by the shared neurobiological background of seizures and depressive symptoms, potentially influenced by VNS treatment. Patients with FBTCS as their predominant seizure type achieved the most favourable outcomes. Further investigations in a larger cohort of DRE patients with depressive symptoms are warranted to validate our results.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110499"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterising seizure cycles in pediatric epilepsy","authors":"Hannah Kamitakahara ,&nbsp;Philippa J. Karoly ,&nbsp;Rachel E. Stirling ,&nbsp;Ewan S. Nurse ,&nbsp;Gabriel Dabscheck ,&nbsp;Dean Freestone ,&nbsp;Mark J. Cook ,&nbsp;Wendyl D’Souza ,&nbsp;Jodie Naim-Feil","doi":"10.1016/j.yebeh.2025.110507","DOIUrl":"10.1016/j.yebeh.2025.110507","url":null,"abstract":"<div><h3>Background</h3><div>Multiday cyclic patterns underlying the timing of seizures are well-established in adults with epilepsy. However, longer-term patterns underpinning these models are yet to be explored extensively in pediatric cohorts. This study aims to identify and compare multiday seizure cycles between pediatric and adult cohorts, followed by a preliminary validation of cycle-based methods for estimating seizure likelihood in a pediatric cohort.</div></div><div><h3>Methods</h3><div>Multiday seizure cycles were extracted retrospectively from 325 (71 pediatric) electronic seizure diary users with confirmed epilepsy. Cycles were grouped (k-means clustering) and seizure cycles quantified (synchronisation index) with significant cycles identified (Rayleigh test (<em>p</em> &lt; 0.05)). Wilcoxon rank-sum test assessed differences in prevalence and strength of cycle groups between pediatric and adult cohorts. The accuracy of cycle-based models to track pediatric seizure occurrence was calculated from the receiver operating characteristic (area under the curve; AUC) comparing estimated cycles to shuffled surrogate data and further validated with a moving average model.</div></div><div><h3>Findings</h3><div>30,019 seizures (pediatric: Median = 51, IQR (Q1 = 30, Q3 = 115), Range (21–661), adult: Median = 46, IQR (Q1 = 31, Q3 = 93), Range (20–1112) were analysed and seizure cycles grouped across circadian (0.5–1.5 days), about-weekly (2–12 days), about-fortnightly (13–22 days) and about-monthly (23–32 days) periodicities. Significant cycles were identified in each cycle group, with no differences in prevalence or cycle strength between pediatric and adult cohorts. Estimated cycles showed a reliable assessment of observed seizure occurrence (significantly (p &lt; 0.05) better performance compared to random models for 88% (44 of 50) and moving average models for 50% (25 of 50) of observed daily seizure occurrence).</div></div><div><h3>Significance</h3><div>Multiday seizure cycles estimated from seizure diaries present a viable model for identifying longer-term seizure patterns in a pediatric cohort. Knowledge of these individual seizure cycles has potential to reduce the unpredictability of seizure timing and inform clinical decision-making.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110507"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and application of in-hospital emergency nursing plan for children with epileptic seizures","authors":"Haiqin Wang ,&nbsp;Yaqi Luo ,&nbsp;Cong Jiang,&nbsp;Wen Zhang,&nbsp;Qihong Wang,&nbsp;Li Dai","doi":"10.1016/j.yebeh.2025.110503","DOIUrl":"10.1016/j.yebeh.2025.110503","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this study was to develop an in-hospital emergency nursing plan for children with epileptic seizures and evaluate its clinical application effectiveness.</div></div><div><h3>Methods</h3><div>From March 2023 to December 2024, a pre − and post evaluation study was conducted at the epilepsy monitoring unit (EMU) of a tertiary Grade A children’s specialized hospital in China.</div></div><div><h3>Results</h3><div>The response time to seizures in the experimental group was shorter than that in the control group (p &lt; 0.001), and the proportion of nurses in the experimental group who recognized both clinical and electrical seizures was higher than that in the control group (p &lt; 0.001); The incidence of adverse events in the experimental group was lower than that in the control group, with reduced rates of limb trauma and aspiration (p = 0.020; p = 0.011). The incidence of children with seizure frequency of 4–8 episodes was lower in the experimental group than in the control group (p = 0.021; p = 0.035; p = 0. 160). The seizure frequency was 1–3 episodes, with no statistically significant difference in incidence between the two groups. (p = 0.573; p = 0. 161).</div></div><div><h3>Conclusion</h3><div>The application of in-hospital emergency nursing plan for children with epileptic seizures can reduce the occurrence of adverse events, shorten the response time to seizure events.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110503"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suggestive seizure induction techniques in paediatric functional/dissociative seizures: an extensive protocol","authors":"Valentina Baglioni ,&nbsp;Dario Esposito ,&nbsp;Serena Cesario ,&nbsp;Federica Gigliotti ,&nbsp;Federica Di Santo ,&nbsp;Senam Keisha Daniel ,&nbsp;Giuliana Lentini ,&nbsp;Mario Mastrangelo ,&nbsp;Francesco Pisani","doi":"10.1016/j.yebeh.2025.110514","DOIUrl":"10.1016/j.yebeh.2025.110514","url":null,"abstract":"<div><div>Functional/Dissociative Seizures (FDS) are complex neuropsychiatric events frequently misdiagnosed as epilepsy, particularly in children and adolescents. Accurate and timely diagnosis remains challenging, especially when standard or prolonged EEG recordings fail to capture typical episodes. This retrospective study evaluated the diagnostic utility and clinical correlates of a structured, non-invasive Suggestive Seizure Induction Technique (SSIT) protocol integrated within video-EEG. Twenty-five paediatric patients with suspected FDS (mean age = 14.7 years; onset = 13.1 years; 72 % females), all of whom had previously undergone inconclusive standard EEGs (and in 48 % of cases, also non-diagnostic prolonged vEEGs), were included. The SSIT protocol employed verbal suggestion, tuning fork stimulation, and soaked pad application over a mean duration of 33.8 min (SD = 11.3). A seizure response was observed in 52 % of the total sample, and 72 % showed nonspecific somatoform or dissociative reactions. Verbal suggestion and soaked pad techniques were the most effective, each eliciting seizure responses in 20 % of participants. All patients with a seizure SSIT response ultimately received a documented FDS diagnosis, while the review of the clinical documentation revealed that additional diagnoses were achieved during follow-up via prolonged or standard EEG. Psychological assessments revealed a significant association between seizure responses to verbal suggestion and dissociative symptoms, particularly “loss of control” (p &lt; 0.05), while lower working memory scores were also linked to higher seizure responsiveness during SSIT (p &lt; 0.05). These findings support the potential role of SSITs in accelerating diagnosis within a stepwise framework and highlight the relevance of dissociative and cognitive factors in paediatric FDS.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110514"},"PeriodicalIF":2.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agreeing to disagree: Discrepancies between self and parent reported social functioning in adolescents with epilepsy without intellectual disability","authors":"Tamara P Tavares ,&nbsp;Lindsay D Oliver ,&nbsp;Mary Desrocher ,&nbsp;Mary Lou Smith","doi":"10.1016/j.yebeh.2025.110506","DOIUrl":"10.1016/j.yebeh.2025.110506","url":null,"abstract":"<div><h3>Objective</h3><div>Adolescence is a distinct developmental period involving profound changes in social processing and motivation. As epilepsy is associated with risk for social challenges, it is important to assess the impact of epilepsy on social functioning during this developmental period. The primary aim of this study was to compare levels of social functioning in adolescents (ages 12–18) with epilepsy and without an intellectual disability, and their similarly aged, healthy peers, as reported both by the adolescents and by their parents. Additional aims were to assess parent-youth agreement and examine the association between social functioning and epilepsy characteristics.</div></div><div><h3>Method</h3><div>Adolescents with epilepsy (n = 100), healthy controls (n = 56) and their parents completed questionnaires assessing the adolescent’s social competence, peer challenges, and close friendships. Controlling for adolescents’ age, sex, and total household income, multiple linear regressions were completed to compare social functioning between adolescents with and without epilepsy and to examine associations between epilepsy characteristics and social functioning.</div></div><div><h3>Results</h3><div>Compared to parents of healthy peers, parents of adolescents with epilepsy reported poorer social functioning outcomes. In contrast, adolescents with epilepsy reported similar levels of social functioning to healthy controls. Among the epilepsy group, having seizures within the past 12 months, greater epilepsy severity, and having a temporal lobe focus were independently associated with poorer social functioning.</div></div><div><h3>Conclusion</h3><div>Adolescence with epilepsy may be at increased risk for peer difficulties and lower social competence compared to their healthy peers. Discrepancies between adolescent and parent reports of social functioning should be carefully considered in psychological assessments and future research.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110506"},"PeriodicalIF":2.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An international survey on withdrawing the ketogenic diet therapy for epilepsy","authors":"Noémie Donnard ,&nbsp;Sophie Höhn ,&nbsp;Anita M Devlin ,&nbsp;Eric H. Kossoff ,&nbsp;Natasha E Schoeler ,&nbsp;Elles van der Louw ,&nbsp;Jong M. Rho ,&nbsp;Blandine Dozières-Puyravel ,&nbsp;Stéphane Auvin","doi":"10.1016/j.yebeh.2025.110481","DOIUrl":"10.1016/j.yebeh.2025.110481","url":null,"abstract":"<div><h3>Background</h3><div>While initiation and maintenance guidelines for ketogenic diet therapies (KDT) are well established, evidence guiding KDT discontinuation remains limited. We aim to explore practices surrounding KDT weaning and identify key factors influencing clinical decisions.</div></div><div><h3>Methods</h3><div>An online 24-question survey was distributed via the International Neurological Ketogenic Society (INKS) between March and May 2024. Responses from 53 healthcare professionals (HCPs), including dietitians and physicians, from diverse global regions were analyzed.</div></div><div><h3>Results</h3><div>Most HCPs adopt individualized KDT weaning protocols, often after 2 years of effective KDT, with weaning durations typically lasting 2 to 6 months. Factors influencing discontinuation include seizure control, epilepsy syndrome, diet tolerance, and family preferences. EEG monitoring and ketone tracking during weaning are common practices. For effective KDT, a gradual reduction in dietary ratio is preferred, with various strategies used (e.g., stepwise ratio reduction, liberalizing carbohydrates). Adherence issues and concerns about seizure recurrence are frequent challenges.</div></div><div><h3>Conclusion</h3><div>KDT weaning remains a heterogeneous and under-studied aspect of treatment. Despite variations in protocols, common themes include cautious tapering and syndrome-specific considerations. These findings highlight the need for prospective studies to establish evidence-based data for KDT discontinuation.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110481"},"PeriodicalIF":2.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144146903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy outcomes and changes to seizure frequency during pregnancy for patients with functional seizures","authors":"Christina R.K. Catherine ,&nbsp;Janet F.R. Waters ,&nbsp;Alexandra Urban ,&nbsp;Wesley T. Kerr","doi":"10.1016/j.yebeh.2025.110501","DOIUrl":"10.1016/j.yebeh.2025.110501","url":null,"abstract":"<div><h3>Purpose</h3><div>The goal of this study was to determine the relative frequency of functional seizures (FS) with respect to pregnancy and to document pregnancy outcomes of patients with FS. Pregnancy can be a stressful period in a woman’s life and may contribute to FS in childbearing patients.</div></div><div><h3>Methods</h3><div>A retrospective chart review was conducted on pregnant patients admitted to Magee Women’s Hospital at the University of Pittsburgh Medical center from January 2015 to July 2024. We describe the characteristics of patients with FS with and without co-occurring epilepsy. Potential comorbid associated factors for FS were documented along with gestational age at delivery, obstetrical complications, mode of delivery and fetal outcome.</div></div><div><h3>Results</h3><div>This analysis included 29 patients (18 with FS only, and 11 with comorbid FS and Epilepsy) for a total of 45 pregnancies. The diagnosis of FS was made prior to pregnancy in 12 patients (41%), during pregnancy in 13 patients (44%), and after pregnancy in 4 (14%). FS frequency worsened during pregnancy in 50% (6/12) of patients diagnosed before pregnancy, in 75% (3/4) of those diagnosed after pregnancy, and occurred de novo in 13 patients diagnosed during pregnancy. FS frequency improved during pregnancy in 17% (2/12) of patients with diagnosis before pregnancy and none diagnosed after pregnancy (0/4). Cesarean section rate was 68%. The rates of multiple maternal and neonatal complications were high.</div></div><div><h3>Conclusions</h3><div>In this cohort, FS often worsened or started during pregnancy raising concern for possible maladaptation to the stresses of the parous state. To reduce seizure frequency, and improve neonatal and maternal outcomes, prompt diagnosis of FS is needed to address modifiable factors. Epilepsy and FS are not indications for cesarean section. The high rate of cesarean section noted in both of these disorders with its inherent surgical risk highlights the need for recognition of this disorder and multidisciplinary collaboration prior to delivery.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110501"},"PeriodicalIF":2.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Provocative techniques for functional/dissociative seizure: the colored pad test – a safe and reliable procedure","authors":"Angelo Pascarella ,&nbsp;Valentina Bova ,&nbsp;Roberta Cutellè ,&nbsp;Roberto Di Iorio ,&nbsp;Caterina Consuelo Paleologo ,&nbsp;Giovanbattista Gaspare Tripodi ,&nbsp;Anna Mammì ,&nbsp;Alessandro Bulgari ,&nbsp;Caterina Marano ,&nbsp;Vittoria Cianci ,&nbsp;Domenico Abelardo ,&nbsp;Sara Gasparini ,&nbsp;Umberto Aguglia ,&nbsp;Edoardo Ferlazzo","doi":"10.1016/j.yebeh.2025.110509","DOIUrl":"10.1016/j.yebeh.2025.110509","url":null,"abstract":"<div><h3>Introduction</h3><div>Suggestive seizure induction during video-EEG is a widely used and valuable tool for diagnosing functional/dissociative seizures (FDS). However, there is currently no standardized protocol. In this study, we describe the technical procedure of the induction/suppression test using colored cotton pads applied to the patient’s neck and report our experience with this method over an eight-year period in routine clinical practice.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the induction/suppression test performed using the cotton pads procedure in consecutive patients referred to our Epilepsy Centre with suspected FDS between February 2016 and July 2024. The technical details of the procedure are provided. We compared patients with a positive (T+) versus negative (T−) induction test and assessed the rate of patients responding to the suppression phase of the test.</div></div><div><h3>Results</h3><div>An FDS episode was recorded during the induction test in 82/130 (63.1 %) patients with suspected FDS. T+ patients did not differ from T− patients in terms of sex, concomitant epileptic seizures, history of psychiatric disorders, age at FDS onset, type of FDS, or neuropsychological evaluation results (all p &gt; 0.05). However, T+ patients had a significantly lower level of schooling compared to T− patients (median: 8 vs. 13 years; p = 0.016). The suppression procedure effectively terminated induced FDS episodes in 79/82 (96.3 %) of T+ patients.</div></div><div><h3>Conclusion</h3><div>The induction/suppression test using colored cotton pads during video-EEG monitoring is a feasible, effective, safe and ethically sound method for achieving a diagnosis of documented FDS.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110509"},"PeriodicalIF":2.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144146905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional seizures: Scoping review of classifications and proposal of novel three-axis model","authors":"Christoph Stephan Dietze ,&nbsp;Tamar Chloé van Gorp ,&nbsp;Anne Marthe Meppelink ,&nbsp;Floortje Elisabeth Jansen ,&nbsp;William Curt LaFrance Jr ,&nbsp;Sandra Marianne Antoinette van der Salm ,&nbsp;Maeike Zijlmans","doi":"10.1016/j.yebeh.2025.110484","DOIUrl":"10.1016/j.yebeh.2025.110484","url":null,"abstract":"<div><div>Functional seizures (FS), psychogenic non-epileptic, or dissociative seizures, are paroxysmal events characterized by sudden changes in movement, sensory perception, behaviour, or responsiveness. Over the last three decades, there have been proposals to classify FS semiology, but no definitive classification exists. An overview of available literature on classification schemes for FS is relevant and might serve as a starting point for developing a globally accepted classification of FS. In this scoping review, we aim to: 1. Identify available literature on proposed classifications of FS, 2. Clarify the concepts of the different classification schemes with their essential elements, 3. Discern commonalities between the different classifications. MEDLINE and Embase databases were systematically searched until 14–06-2023, using synonyms for FS, semiology, and classification, and articles describing FS semiology classifications were included. We included 38 studies out of 593 screened abstracts. We tried to map all classification terms on a two-dimensional plane of movement versus responsiveness. We found several classes to be consistently present: 1. Nonmotor, normal responsiveness; 2. Nonmotor, impaired responsiveness 3. Minor motor, variable responsiveness; 4. Hypermotor, impaired responsiveness. Some classification terms could not be mapped as additional core characteristics of the semiology on the two-dimensional plane due to timing and ictal evolution. Current FS semiology classifications partially are aligned along the motor and responsiveness axes. Our review synthesizes timing and evolution as additional class to fully characterize semiology of individual FS. We propose a novel three-dimensional model to describe individual FS semiology, including time on a third axis.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110484"},"PeriodicalIF":2.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a support intervention model for epilepsy care in outpatient clinics","authors":"Anna Hjorth ,&nbsp;Klara Andersson ,&nbsp;Ewa-Lena Bratt ,&nbsp;Kristina Malmgren ,&nbsp;Anna Edelvik Tranberg ,&nbsp;Johan Zelano ,&nbsp;Anneli Ozanne","doi":"10.1016/j.yebeh.2025.110485","DOIUrl":"10.1016/j.yebeh.2025.110485","url":null,"abstract":"<div><div>There is limited knowledge of how to provide sufficient support to meet the specific needs of people with epilepsy (PWE) in outpatient care. This study aimed to explore facilitating and challenging aspects in outpatient epilepsy care from the dual perspective of PWE and their healthcare professionals and utilise these findings to develop a tailored support intervention model. An abductive qualitative content analysis was conducted to examine interviews with a total of 30 PWE and healthcare professionals, including both focus group and individual interviews. The results highlight challenging aspects through sociodemographic difficulties, psychological issues and organisational deficiencies. Personalised multidisciplinary support, tailored information and optimised conditions for healthcare contact facilitate participation in care and enhance self-management of epilepsy. In the organisation of epilepsy care, challenging and facilitating aspects were found on a macro-, meso-, and micro level. This was visualized by the support intervention model to draw attention to where interventions could be targeted and implemented in outpatient care. Key components of such interventions include the implementation of screening questionnaires to identify vulnerable patients requiring focused attention and development of nurse-led interventions grounded in the core principles of person-centred care.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110485"},"PeriodicalIF":2.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}