Epilepsy & Behavior最新文献

{"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}

{"title":"Exploring neurodevelopment in CDKL5 deficiency disorder: Current insights and future directions","authors":"Giovanni Battista Dell’Isola ,&nbsp;Martina Giorgia Perinelli ,&nbsp;Alessia Frulli ,&nbsp;Gianluca D’Onofrio ,&nbsp;Antonella Fattorusso ,&nbsp;Margherita Siciliano ,&nbsp;Pietro Ferrara ,&nbsp;Pasquale Striano ,&nbsp;Alberto Verrotti","doi":"10.1016/j.yebeh.2025.110504","DOIUrl":"10.1016/j.yebeh.2025.110504","url":null,"abstract":"<div><div>CDKL5 Deficiency Disorder (CDD) is a rare and severe neurodevelopmental condition marked by profound developmental delays, early-onset epilepsy, and significant impairments in motor and communication skills. The outcomes in CDD are shaped by various factors, including early-onset epilepsy and environmental influences. Genotype-phenotype correlations reveal that specific CDKL5 mutations impact developmental milestones, although considerable variability persists.</div><div>Recent advancements have introduced novel antiseizure medications and emerging treatments such as gene therapy and targeted molecular interventions. Despite these promising developments, managing CDD effectively requires a comprehensive approach that integrates pharmacological treatments with neuro-rehabilitation strategies.</div><div>Research has progressed in developing validated tools for assessing motor and language abilities in CDD, but monitoring neurodevelopment remains challenging due to the absence of longitudinal studies and standardized measures.</div><div>This study delves into the developmental delays associated with CDD, providing an in-depth analysis of its clinical characteristics, pathogenetic mechanisms, and genetic background. It aims to uncover the pathways disrupted by CDKL5 mutations and their effects on neuronal development and function. Additionally, the study reviews potential therapeutic strategies to mitigate CDD’s impact, offering a comprehensive overview of interventions to enhance patient outcomes.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110504"},"PeriodicalIF":2.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131739","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":"A preliminary efficacy study of eye movement desensitisation and reprocessing therapy in reducing epilepsy-related anxiety","authors":"K. Broekman-Labinac ,&nbsp;L. Aben ,&nbsp;R.D. Thijs ,&nbsp;H.M.M. Smeding ,&nbsp;A. de Jongh ,&nbsp;K. van der Hiele","doi":"10.1016/j.yebeh.2025.110493","DOIUrl":"10.1016/j.yebeh.2025.110493","url":null,"abstract":"<div><h3>Objective</h3><div>To determine whether eye movement desensitisation and reprocessing (EMDR) therapy reduces anxiety in people with epilepsy-related anxiety. Secondary outcomes included health-related quality of life (HRQOL), subjective cognitive functioning and seizure frequency.</div></div><div><h3>Methods</h3><div>Prospective uncontrolled study with a pre-post follow-up design, including measurements before, immediately after, and three months after EMDR therapy, focused on the individuals’ fear of future seizures (i.e. flashforwards). We recruited participants with epilepsy-related anxiety from a Dutch tertiary epilepsy centre. Questionnaires were used to monitor general and epilepsy-related anxiety, HRQOL, subjective cognitive functioning and seizure frequency. Repeated-measures ANOVA was used.</div></div><div><h3>Results</h3><div>Eleven participants were included. We observed a significant reduction in general and epilepsy-related anxiety from before to immediately after EMDR treatment, and three months hereafter (p ≤ 0.001, η² = 0.698 and p ≤ 0.001, η² = 0.641, respectively). This coincided with an improvement in HRQOL (<em>p</em> ≤ 0.001, η² = 0.550). Despite a main treatment effect for subjective cognitive functioning (<em>p</em> = 0.023, η² = 0.415), no significant post hoc effects were observed. No effects were found for informant-reported cognitive functioning (<em>p</em> = 0.261, η² = 0.236) and seizure frequency (<em>p</em> = 0.495, η² = 0.075).</div></div><div><h3>Conclusion</h3><div>This study provides preliminary evidence that EMDR therapy reduces anxiety in people with epilepsy-related anxiety. This effect sustained over three months and coincided with an improved HRQOL. Subjective cognitive functioning and seizure frequency did not change over time. Our findings suggest that EMDR therapy is a potentially safe treatment for epilepsy-related anxiety.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110493"},"PeriodicalIF":2.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123276","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":"Impact of ictal spread on preoperative memory and language functions and postoperative seizure outcomes in drug-resistant epilepsy","authors":"Isha Snehal ,&nbsp;Yashwanth Pulluru ,&nbsp;Makayla Schissel ,&nbsp;Joshua Matyi ,&nbsp;Mathew Garlinghouse ,&nbsp;Hesham T. Ghonim ,&nbsp;Vaishali Phatak ,&nbsp;Olga Taraschenko","doi":"10.1016/j.yebeh.2025.110497","DOIUrl":"10.1016/j.yebeh.2025.110497","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Recent studies in patients with drug-resistant epilepsy (DRE) have shown that including areas of ictal spread in resections may result in better postoperative seizure control. However, it remains unclear whether the extent or speed of ictal spread affects neuropsychological test (NP) performance. In the present study, we assessed the relationship between the speed of initial ictal spread and preoperative measures of language and memory, as well as postoperative seizure outcomes in patients with refractory focal epilepsy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A retrospective chart review and analysis of patients with DRE who underwent intracranial EEG (iEEG) monitoring and surgical resections from 2008 to 2016 was conducted at the level 4 epilepsy center at the University of Nebraska Medical Center. The scores reflecting immediate and delayed verbal and visual memory functions were extracted from the preoperative Logical Memory I, II, and Visual Reproduction I, II tests of the Wechsler Memory Scale III or IV, respectively. The scores defining the language function were extracted from the preoperative Boston Naming or Neuropsychology Assessment Battery Naming test. The relevant demographic and clinical data were also collected. Raw tracings of the ictal iEEG recordings were reviewed independently by two epileptologists, and the speed of ictal spread was labeled as early or late based on the 10-second cutoff. The postoperative seizure outcomes were assessed using the Engel score. The patient’s performance on the preoperative NP tests and their postoperative seizure status were compared between the early and late ictal spread groups.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of 111 patients who underwent iEEG during the target period, 68 met the inclusion criteria. Based on the iEEG recordings and other studies, temporal epilepsy was diagnosed in 64.7% of patients, while temporal plus epilepsy and extratemporal epilepsy were found in 25% and 10.3% of patients, respectively. Early ictal spread was identified in 38 (55.9%) patients, while late onset was found in 30 (44.1%) patients. Immediate verbal memory scores (median and interquartile range) in early and late ictal spread groups were 37.0 (5.0; 63.0) and 26.5 (5.0; 56.5), respectively, while immediate visual memory scores in the same groups were 25.0 (3.5; 50.0) and 37.0 (16.0; 63.0), respectively. The naming scores were 18.0 (7.0; 46.0) and 8.0 (1.0; 21.0) in the early and late ictal spread groups. There were no differences in the performance on the verbal and visual memory or language tests in patients with early and late ictal spreads. Further, there were no differences in postoperative seizure outcomes in these two groups.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Significance&lt;/h3&gt;&lt;div&gt;We found that the speed of ictal spread assessed with iEEG does not influence performance on the standard preoperative tests of memory and language or postoperative seizure outcomes in patients with DRE. To detec","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110497"},"PeriodicalIF":2.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123467","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":"Electroclinical features of myoclonic absence epilepsy: A single-center cohort analysis in Southwest China","authors":"Qiao Hu,&nbsp;Yuanyuan Luo,&nbsp;Siqi Hong,&nbsp;Ping yuan,&nbsp;Li Jiang","doi":"10.1016/j.yebeh.2025.110505","DOIUrl":"10.1016/j.yebeh.2025.110505","url":null,"abstract":"<div><h3>Background and Objective</h3><div>To date, few analyses of the electroclinical features and prognosis of patients with epilepsy with myoclonic absences (EMA) have been performed. We reviewed the clinical and electroencephalography (EEG) features, response to antiseizure medications, and long-term prognosis of patients with EMA in a single center in Southwest China, with the goal of increasing the understanding of the disease, strengthening early clinical diagnosis and treatment, and improving prognosis.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the data of 11 children with EMA at the Epilepsy Center of Children’s Hospital of Chongqing Medical University. The patients’ history of EEG (including ictal EEG), medical history, head magnetic resonance imaging (MRI), medication, cognition and development were retrospectively analyzed.</div></div><div><h3>Results</h3><div>Eleven patients (7:4 male:female) with an onset age of 7.18 ± 3.72 years had myoclonic-absence (MA) seizures, and four (36.36 %) had asymmetrical features. Nine (75 %) had multiple seizure types, including MA, myoclonic, absence, and generalized tonic-clonic seizures. During the interictal period, generalized 3 Hz spike–slow wave complexes were rhythmically emitted, with two having a small amount of focal discharge. In eight patients, bilateral symmetrically synchronized 3 Hz rhythmic spike–slow wave complex bursts, which showed a lock-in relationship with myoclonic, were recorded. All patients were treated with new or adjusted antiseizure medications and were followed up for 15–44 months. Five patients (45.45 %) had no seizures and no cognitive impairment; and 4/5 (80 %) were treated with valproic acid alone. During follow-up, the EEG results of four patients showed normal. The remaining six patients had drug-resistant epilepsy. Five had daily MA seizures, and one had daily myoclonic seizures. Among these six patients, four (66.67 %) exhibited developmental delay before disease onset, three experienced language delay, one experienced motor delay at follow-up.</div></div><div><h3>Conclusion</h3><div>The clinical manifestations of EMA are highly heterogeneous. Some patients experience seizures with atypical characteristics and exhibit significant clinical heterogeneity in response to antiseizure medications and cognitive impairment. Some patients have a better prognosis, and developmental delay before disease onset may be associated with a poor prognosis.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110505"},"PeriodicalIF":2.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123468","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":"Self-management for people with epilepsy and a history of negative health events (SMART): A randomized controlled effectiveness trial","authors":"Martha Sajatovic ,&nbsp;Gena R. Ghearing ,&nbsp;Maegan Tyrrell ,&nbsp;Jessica Black ,&nbsp;Jacqueline Krehel-Montgomery ,&nbsp;Richard Barigye ,&nbsp;Joy Yala ,&nbsp;Clara Adeniyi ,&nbsp;Michael Privitera ,&nbsp;Marvin A. Rossi ,&nbsp;Farren Briggs","doi":"10.1016/j.yebeh.2025.110495","DOIUrl":"10.1016/j.yebeh.2025.110495","url":null,"abstract":"<div><h3>Objectives</h3><div>This 2-site, 6-month randomized controlled trial of an epilepsy self-management (ESM) curriculum (SMART) vs. 6-month waitlist (WL) control assessed effects on epilepsy outcomes in 160 people with epilepsy (PWE).</div></div><div><h3>Methods</h3><div>PWE had at least 1 negative health event (NHE) defined as a seizure, emergency department visit, hospitalization or self-harm attempt in the last 6 months. Primary outcomes were differences in proportions of PWE with reductions in NHEs from baseline to 6 months follow up and change in NHE/seizure counts between SMART and WL. Secondary outcomes included the Patient Health Questionnaire (PHQ-9), 36-Item Short Form Survey (SF-36), Quality of Life in Epilepsy (QOLIE-31), Epilepsy Self-Management Scale (ESMS), Epilepsy Stigma Scale (ESS), Multidimensional Scale of Perceived Social Support (MSPSS) and Epilepsy Self-Efficacy Scale (ESES).</div></div><div><h3>Results</h3><div>Mean age was 39.4 (SD 12.2), 66.9 % (N = 107) women, and 31 % (N = 50) rural. Mean PHQ-9 of 10.5 (SD 7) suggested mild/moderate depression. Seizures were the most common NHE with mean baseline past 6-month seizure count of 20.6 (SD 41.0). SMART was significantly associated with a 2-fold increase in odds of having at least 10–30 % improvement in NHEs vs. WL (p &lt; 0.05). SMART was associated with significant seizure reduction (p &lt; 0.05), significantly improved PHQ-9 (p = 0.014), QOLIE-31 seizure worry (p = &lt;0.001) and social functioning (p = 0.021), ESES (p = 0.046) and ESMS (p &lt; 0.001).</div></div><div><h3>Significance</h3><div>Compared to WL, SMART participants had improvement in NHEs and seizures, depressive symptoms, self-management competency and self-efficacy and selected elements of quality of life. Inclusion of effective ESMs into a comprehensive care of model for PWE may be warranted.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110495"},"PeriodicalIF":2.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115413","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":"EEG response to high dose nocturnal diazepam in children with developmental/epileptic encephalopathy with spike-and-wave activation in sleep (DEE/EE-SWAS)","authors":"Hassan Kiani ,&nbsp;Robyn Whitney ,&nbsp;Cristina Go ,&nbsp;Klajdi Puka ,&nbsp;Mary B Connolly ,&nbsp;Kevin C Jones ,&nbsp;Mary Lou Smith ,&nbsp;Rajesh RamachandranNair","doi":"10.1016/j.yebeh.2025.110498","DOIUrl":"10.1016/j.yebeh.2025.110498","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the response to high-dose daily nocturnal diazepam (HDD) in children with developmental and or epileptic encephalopathy with spike-wave activation in sleep (DEE/EE-SWAS)</div></div><div><h3>Methods</h3><div>A prospective cohort of patients (4–12 years), newly diagnosed with DEE/EE-SWAS and initiated on the first course of HDD therapy, was followed for one year. Sleep EEG scores (SES) pre and post-HDD were evaluated every three months for 12 months to monitor treatment response. Spike-wave index (SWI) was calculated using the percentage of 1-second bins containing at least one spike. An EEG grading system based on both sleep SW index (sSWI) (Grade: 1–4) and background distribution of epileptiform discharges (Grade: 0–4) was used and summed to yield an aggregate SES (ASES) (Grade: 1–8).</div></div><div><h3>Results</h3><div>Eighteen eligible children (M:F 12:6; median age, 7.6 years; range, 4.4–11.6 years) were initiated on the first course HDD (median, 0.5 mg/kg/d; range, 0.3–0.6 mg/kg/d). sSWI decreased significantly from 85.7 % (mean, SD 13.9) to 32.6 % (mean, SD 37.1) at subsequent EEG follow-up (95 % CI = −70.60, −35.62; p &lt; 0.001). ASES decreased from 6.5 (SD 1.3) to 3.1 (SD 1.9) (95 % CI = −4.17, −2.60; p &lt; 0.001). EEG relapse after a period of improvement after HDD initiation occurred in 10 children. Minimal response to HDD occurred in 2 children. Five patients manifested mild side effects, including altered behaviour (2), hyperactivity (2), and lethargy (1).</div></div><div><h3>Conclusion</h3><div>We demonstrate that using a structured EEG scoring system in DEE/EE-SWAS, combining the SWI and its distribution HDD safely and significantly reduces both sSWI and ASES. However, high rates of EEG relapse were recorded.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110498"},"PeriodicalIF":2.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114986","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":"Corrigendum to \"The awareness, attitudes and knowledge of neurologists in Hungary on sudden unexpected death in epilepsy (SUDEP)\" [Epilepsy & Behav. 169 (2025) 110442].","authors":"Nandan Ravichandra, Anna Kelemen, Joanne McCabe, Zsofia Jordan, Moran Kanaan, Rohit Shankar","doi":"10.1016/j.yebeh.2025.110496","DOIUrl":"https://doi.org/10.1016/j.yebeh.2025.110496","url":null,"abstract":"","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":" ","pages":"110496"},"PeriodicalIF":2.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132235","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":"Seizure-type-specific treatment responses in Lennox-Gastaut Syndrome: A comprehensive review of pharmacological, neuromodulatory, dietary, and surgical therapies","authors":"Debopam Samanta ,&nbsp;Sunil Naik","doi":"10.1016/j.yebeh.2025.110472","DOIUrl":"10.1016/j.yebeh.2025.110472","url":null,"abstract":"<div><div>Lennox-Gastaut Syndrome (LGS) is a severe developmental and epileptic encephalopathy characterized by multiple drug-resistant seizure types, presenting significant challenges for treatment. This comprehensive review examines seizure-type-specific response patterns to various therapeutic interventions in LGS. We conducted an extensive literature review of randomized controlled trials, observational studies, and real-world evidence, covering research up to February 2025. Our analysis shows that atonic seizures respond particularly well to corpus callosotomy (CC) and Vagus Nerve Stimulation (VNS), with CC demonstrating superior efficacy. Generalized tonic-clonic seizures (GTCS) show favorable responses to antiseizure medications (ASMs) such as felbamate, lamotrigine, topiramate, fenfluramine, lacosamide, and perampanel. Myoclonic seizures tend to respond better to clonazepam, topiramate, zonisamide, brivaracetam, and perampanel, but may show limited responsiveness to neuromodulation and CC. Atypical absence seizures may respond to valproate, topiramate, and rufinamide, but show poor responses to brivaracetam and perampanel. The ketogenic diet and resective epilepsy surgery demonstrate broad efficacy across seizure types, although specific data for each type remain limited. VNS is most effective for atonic and tonic seizures, with less consistent responses in GTCS and focal seizures. Emerging neuromodulation techniques, including deep brain stimulation (DBS) and responsive neurostimulation (RNS), show promise, particularly for tonic and GTCS, but further investigation is needed. This review underscores the importance of tailoring treatment to predominant seizure types and calls for more rigorous, seizure-type-specific outcome reporting in future clinical trials, along with the need for long-term studies. The findings advocate for a precision, network-based approach to treatment, where therapeutic decisions are guided by individual seizure patterns and supported by evidence-based, seizure-type-specific efficacy data.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"170 ","pages":"Article 110472"},"PeriodicalIF":2.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108256","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}