Epilepsy & Behavior最新文献

{"title":"The relationship between self-efficacy, illness-related fear, and intolerance of uncertainty in patients who have epilepsy in eastern Türkiye: A path analysis","authors":"Yasemin Erden ,&nbsp;Gülcan Bahçecioğlu Turan ,&nbsp;Nurgul Karakurt ,&nbsp;Ercan Bakır","doi":"10.1016/j.yebeh.2025.110367","DOIUrl":"10.1016/j.yebeh.2025.110367","url":null,"abstract":"<div><h3>Background</h3><div>The effects of psychological factors such as self-efficacy, illness-related fear, and intolerance of uncertainty on illness management and quality of life of patients who have epilepsy have important roles in understanding the health behaviors of individuals.</div></div><div><h3>Aim</h3><div>The present study was conducted to examine the relationship between self-efficacy, illness-related fear, and intolerance of uncertainty in patients who have epilepsy and to investigate the mediating role of illness-related fear in the relationship between self-efficacy and intolerance of uncertainty.</div></div><div><h3>Method</h3><div>This cross-sectional and correlational study had a descriptive design and was conducted with 150 epilepsy patients who met the inclusion criteria and applied to the neurology clinic of a university hospital. The study population comprised epilepsy patients who applied to the Neurology Clinic of a university hospital in eastern Türkiye between May 2024 and August 2024. The data were collected by using the Personal Information Form, Epilepsy Self-Efficacy Scale, Illness-Related Fear Scale, and Mishel Uncertainty in Illness Scale − Community Form. The Structural Equation Modeling and Bootstrapping Methods were used to analyze the study data. The study was reported following the STROBE Recommendations.</div></div><div><h3>Results</h3><div>Based on the findings, self-efficacy was found to negatively affect intolerance of uncertainty about the illness (b = −0.384, 95 % CI [−0.462 to −0.306], p &lt; 0.01) and illness-related fear (b = −0.449, 95 % CI [−0.544 to −0.344], p &lt; 0.01). Also, illness-related fear was found to positively affect intolerance of uncertainty (b = 0.688, 95 % CI [0.586 to 0.789], p &lt; 0.01). The indirect effect of self-efficacy on intolerance of uncertainty through illness-related fear (b = -0.309, 95 % CI [-0.444 to −0.210], p &lt; 0.01) was found to be negative and significant and the total effect (b = -0.693, 95 % CI [−0.789 to −0.597], p &lt; 0.01) was also negative and significant. Self-efficacy explained 34 % of the illness-related fear and 59 % of the total intolerance of uncertainty in the model. The estimated effects were calculated with 5000 repeated operations and were evaluated to be significant because the indirect effects did not include zero in the 95 % Confidence Interval.</div></div><div><h3>Conclusion</h3><div>The results of the present study showed that self-efficacy has a direct negative impact on intolerance of uncertainty in patients who have epilepsy and that fear related to the illness plays mediating roles in this effect.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110367"},"PeriodicalIF":2.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681724","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":"MK-212 precipitates seizure-induced death in amygdala-kindled mice via a non-5-HT2C receptor-mediated mechanism","authors":"Katelyn G. Joyal ,&nbsp;Nicole A. Boodhoo ,&nbsp;Gordon F. Buchanan","doi":"10.1016/j.yebeh.2025.110385","DOIUrl":"10.1016/j.yebeh.2025.110385","url":null,"abstract":"<div><div>Epilepsy is a common neurological condition that affects over 65 million people worldwide. Despite an increasing number of anti-seizure medications being made available, many patients do not find seizure freedom with medication. The leading cause of death in this refractory population is sudden unexpected death in epilepsy (SUDEP). Both human and animal research has implicated serotonin (5-HT) in modulating seizure proclivity, severity, and mortality. More recently, evidence has pointed to the 5-HT_2C receptor as a salient target for investigating the mechanisms of seizure facilitation and mortality. Various seizures models have been used previously to assess the role of the 5-HT_2C receptor in seizure expression and morphology. However, limbic kindling models have been underutilized in this endeavor. We used the selective 5-HT_2C receptor agonist MK-212 to examine the effect of 5-HT_2C receptor activation in amygdala kindled mice. C57BL/6J mice were instrumented with an EEG/EMG headmount and a bipolar electrode in the basolateral amygdala (BLA). The animals then received vehicle or MK-212 (10, 30 mg/kg) prior to seizure induction. 12.5% of WT animals that received 10 mg/kg MK-212 experienced seizure-induced respiratory arrest and died following seizure induction. When the dose was raised to 30 mg/kg, 100% of the animals succumbed following a seizure. These fatal seizures persisted when the same doses of MK-212 were administered to mice lacking the 5-HT_2C receptor. This suggests that a non-5-HT_2C mediated effect of MK-212 facilitates seizure-induced death in a dose-dependent manner. While amygdala kindling is not a model that is traditionally associated with seizure-induced death, these results suggest that there are circuits that, when recruited, will cause death following kindled seizures. Uncovering these circuits will both deepen our understanding of the amygdala kindling model and provide a new technique for researchers to test novel therapeutic interventions to lessen SUDEP risk.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110385"},"PeriodicalIF":2.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681722","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":"Association between metabolic patterns in 18-FDG PET-CT scan and postsurgical seizure outcomes in patients with temporal lobe epilepsy","authors":"Pilar Robles-Lomelín ,&nbsp;Salvador Martínez-Medina ,&nbsp;Jimena Gonzalez-Salido ,&nbsp;Jimena Colado-Martinez ,&nbsp;Irving Fuentes-Calvo ,&nbsp;Iván Díaz-Meneses ,&nbsp;Nora Kerik-Rotenberg ,&nbsp;Juan Salvador Rosales-García ,&nbsp;Guillermo Axayacalt Gutiérrez-Aceves ,&nbsp;Alfonso Arellano-Reynoso ,&nbsp;Sergio Moreno-Jiménez ,&nbsp;Betsy C. Vázquez-Cruz ,&nbsp;Fernando Vasquez-Lopez ,&nbsp;Antonio Camiro-Zúñiga ,&nbsp;Rodolfo Solís-Vivanco ,&nbsp;Mario A. Sebastián-Díaz ,&nbsp;Iris E. Martínez-Juárez","doi":"10.1016/j.yebeh.2025.110387","DOIUrl":"10.1016/j.yebeh.2025.110387","url":null,"abstract":"<div><h3>Introduction</h3><div>Temporal lobe epilepsy (TLE) is the most common type of drug-resistant epilepsy in adults, and surgery is a standard treatment, offering seizure freedom in 60–70 % of patients. Despite advanced imaging, many TLE patients show inconsistent MRI findings, making functional imaging such as 18-FDG PET-CT scans essential in identifying epileptogenic zones. This study aims to assess the association between concordant or non-concordant metabolic patterns in presurgical 18-FDG PET-CT scans and postoperative outcomes in TLE patients.</div></div><div><h3>Methods</h3><div>This retrospective, observational study included people with epilepsy (PWE) who underwent TLE surgery at a clinic in Mexico City and had a presurgical 18-FDG PET-CT scan. Seizure outcomes were measured using Engel and ILAE classifications at a two-year follow-up. The concordant group had only temporal hypometabolism ipsilateral to the epileptogenic zone, while the non-concordant group had normal, extratemporal, or bitemporal hypometabolism.</div></div><div><h3>Results</h3><div>The study included 49 PWE: 28 with concordant PET-CT scans and 21 with non-concordant scans. Comparisons of seizure outcomes using the Engel and ILAE classifications at two years post-surgery revealed no significant differences between the groups (p = 0.972 and p = 0.279, respectively). The use of anti-seizure medications (ASM) after surgery did not differ significantly between groups (p = 0.649).</div></div><div><h3>Conclusion</h3><div>At our center, preoperative evaluation emphasizes the alignment of clinical findings, video-EEG, and MRI. At the two-year follow-up, no significant difference in seizure freedom was observed between patients with temporal lobe hypometabolism alone and those with other patterns.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110387"},"PeriodicalIF":2.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681723","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":"Effects of electrical stimulation of the lateral cerebellar nucleus on PTZ-kindled seizures","authors":"Leonid S. Godlevsky ,&nbsp;Mykhailo P. Pervak ,&nbsp;Olha S. Yehorenko ,&nbsp;Serhii V. Marchenko","doi":"10.1016/j.yebeh.2025.110377","DOIUrl":"10.1016/j.yebeh.2025.110377","url":null,"abstract":"<div><h3>Background</h3><div>In recent years, the cerebellum and its nuclei have become an essential target for understanding and suppressing the mechanisms of seizures. This study aimed to investigate the effects of electrical stimulation (ES) applied to the Lateral Cerebellar Nucleus (LCN) in rats at the early and fully developed pentylenetetrazol (PTZ) kindled seizures.</div></div><div><h3>Methods</h3><div>The experimental groups were represented by the male Wistar rats kindled with PTZ (35.0 mg/kg, i.p.) to myoclonus (9–11 PTZ injections) and generalized tonic-clonic seizures (21 PTZ injections). Unilateral ES (100 Hz) was delivered daily for five days after the last kindled PTZ administration, with PTZ seizure testing after ES. Seizures were videotaped, and the severity score was determined in a blinded manner.</div></div><div><h3>Results</h3><div>ES of LCN performed at the early stage of kindling facilitated the appearance of myoclonus, and increased seizure severity by 30.2 % points compared to the control group (H = 6.94; df = 2; p = 0.037) with the spikes frequency generation increased during the poststimulation period (H = 27.34; df = 5; p &lt; 0.001). In fully developed kindling, ES prevented generalized seizure and reduced seizure severity by 27.5 % (H = 9.385; df = 2; p = 0.009), while myoclonuses were present with spikes generation in brain structures.</div></div><div><h3>Conclusion</h3><div>The data obtained showed that repeated ES of LCN at the early stage promoted myoclonic seizures, while in fully PTZ-kindled rats, it suppressed generalized seizure fits, which were substituted with myoclonus.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110377"},"PeriodicalIF":2.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682165","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":"Translation and validation of the Thai version of health-related quality of life measure for children with epilepsy (CHEQOL-25)","authors":"Natcha Lueangapapong ,&nbsp;Lunliya Thampratankul ,&nbsp;Anannit Visudtibhan ,&nbsp;Chaiyos Khongkhatithum","doi":"10.1016/j.yebeh.2025.110337","DOIUrl":"10.1016/j.yebeh.2025.110337","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to translate and validate the Health-Related Quality of Life Measure for Children with Epilepsy (CHEQOL-25) into Thai version (TH-CHEQOL-25), and to evaluate factors affecting quality of life (QOL).</div></div><div><h3>Methods</h3><div>After approval by the original developer, cross cultural adaptation process of CHEQOL-25 was performed including forward translation by two translators, reconciliation, backward translation, and final approval by the original creator. TH-CHEQOL-25 was completed by 161 children with epilepsy aged 6–15 years and their parents twice in 10–14 days to assess its reliability and validity. Content validity was measured by an index of item-objective congruence (IOC) and a content validity index (CVI). The face validity and construct validity were assessed.</div></div><div><h3>Results</h3><div>Internal consistency reliability, evaluated by Cronbach’s α coefficient showed the acceptable reliability in three subscales of child self-report and four subscales of parent-proxy response scale. Both versions had good test–retest reliability as ICC for all items ranged between 0.68–0.85. The correlations between child-report and parent-proxy were acceptable. Higher number of anticonvulsants was significantly negatively correlated with poor QOL.</div></div><div><h3>Conclusions</h3><div>TH-CHEQOL-25 is a reliable and valid tool to assess health-related QOL in Thai children with epilepsy. The parent-proxy version can be used if children cannot report it themselves.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110337"},"PeriodicalIF":2.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681659","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":"Computer-Assisted planning for SEEG-Guided RF-TC in Pediatric Epilepsy: Improved surgical outcomes","authors":"Yu Sun ,&nbsp;Dongming Wang ,&nbsp;Hao Yu ,&nbsp;Chang Liu ,&nbsp;Yao Wang ,&nbsp;Yi Wang ,&nbsp;Bocheng Zhou ,&nbsp;Ruofan Wang ,&nbsp;Taoyun Ji ,&nbsp;Shuang Wang ,&nbsp;Ye Wu ,&nbsp;Xiaoyan Liu ,&nbsp;Yuwu Jiang ,&nbsp;Huili Wang ,&nbsp;Qingzhu Liu ,&nbsp;Lixin Cai","doi":"10.1016/j.yebeh.2025.110386","DOIUrl":"10.1016/j.yebeh.2025.110386","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the efficiency of an RF-TC Target Planning Software in enhancing outcomes of SEEG-guided RF-TC for pediatric drug-resistant epilepsy.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 68 cases at Peking University First Hospital from May 2018 and November 2023 was conducted. Of these, software-assisted planning and manual planning were utilized in 27 and 41 patients, respectively. Surgical parameters, primarily the number of contact pairs, planning time, and postoperative results were analyzed. Statistical analysis compared seizure-free rates and other key metrics across the two planning groups.</div></div><div><h3>Results</h3><div>A larger group with software-assisted planning was associated with a significantly higher number of contact pairs for RF-TC and lower planning time. The software-assisted group’s seizure-free rate was 77.78 % after 23 months, compared to 29.41 % over 57.97 months for the manual planning group. Transient contralateral limb weakness was observed in 11.11 % of software-assisted cases, but full recovery was eventually noted for all patients.</div></div><div><h3>Interpretation</h3><div>The RF-TC Target Planning Software enhances the effectiveness and efficiency of SEEG-guided RF-TC by improving electrode contact pair choice, reducing planning time, and increasing postoperative seizure-free rates. In complex situations, such as hypothalamic hamartomas, the software displays its value by reducing the risk of missed electrode pairings. Notwithstanding its advantages, the software-assisted approach may raise transient postoperative neurological deficits slightly. Additional studies with expanded cohorts and extended follow-ups are necessary for a comprehensive assessment of this technique’s long-term effectiveness.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110386"},"PeriodicalIF":2.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital communication and social cognition in adults with frontal lobe epilepsy: A scoping review","authors":"Panayiotis Patrikelis ,&nbsp;Theodoros Fasilis ,&nbsp;Lambros Messinis ,&nbsp;Vasileios Kimiskidis","doi":"10.1016/j.yebeh.2025.110363","DOIUrl":"10.1016/j.yebeh.2025.110363","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Patients with Frontal Lobe Epilepsy (FLE) face problems with social cognition (SC) since their difficulties in humor appreciation, facial and eye gaze emotional recognition. The effects of frontal (and temporal) seizures on SC may be understood in terms of emotion recognition (ER), Theory of Mind (ΤοΜ), empathy, and social behavior deficits in relation to their relevant pathophysiology. The impact of FLE on SC as expressed in digital environments still represents a &lt;em&gt;terra incognita,&lt;/em&gt; as well as the objective of this exploratory work.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;We aimed at exploring, elaborate and critically examine a) the ways deficits in SC impact digital communication (DC) in FLE; b) the way specific neuropsychological abnormalities that may disrupt DC in FLE; c) how to integrate neuropsychological assessment and rehabilitation to provide FLE patients strategies and enhance social outcomes in DC. We anticipate that a) since FLE as other types of frontal syndromes present with deficits in SC, frontal seizures will adversely affect DC; b) executive dysfunction, besides deficits in working memory (WM) and ToM, vigilance and attention, memory and thought in FLE may interfere with SC during online interactions; c) considering FLE’s neurobehavioral and emotional breakdowns in DC, compensatory neurorehabilitation approaches along with psychological and stigma-related ones may be planned, respectively.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;A scoping review approach was opted as the most approp&lt;em&gt;ri&lt;/em&gt;ate one due to the exploratory nature of our research questions, which aim to map the existing literature, identify gaps, and understand the breadth of evidence available on this topic.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The effects of FLE (and TLE) on SC may be translated into deficits of ER, ToM, empathy, and social behavior in either physical or DC environments. Particularly in FLE, response maintenance/inhibition deficits link to aberrant emotional control and impulsivity, while during on-line interactions inferential reasoning may be secondarily affected. Executive dysfunction in FLE may impair encoding and retrieval, plus the ability to coherently organize thinking and clearly communicate on social media. Deficits in WM systems may further disrupt DC in FLE, since the prefrontal involvement in the temporal organization of conscious behavior. Such neurocognitive abnormalities can help to understand problems in interpreting emotional behavior and exerting emotional control, making social judgments and appropriate decisions in digital environments encountered in FLE. Excessive use of digital devices seems to impact both brain anatomy and physiology with cognitive impairments resembling dementia. Neurobehavioral abnormalities linked to the use of digital tools in psychiatric patients should be given careful consideration, since their cognitive deficits parallel those of FLE and may likewise interact and ","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110363"},"PeriodicalIF":2.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644050","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":"The multidimensional impact of Dravet syndrome on caregivers: A comprehensive review","authors":"Katerina Poprelka ,&nbsp;Theodoros Fasilis ,&nbsp;Panayiotis Patrikelis ,&nbsp;Evniki Ntinopoulou ,&nbsp;Anastasia Verentzioti ,&nbsp;Maria Stefanatou ,&nbsp;Athanasia Alexoudi ,&nbsp;Lampis C. Stavrinou ,&nbsp;Stefanos Korfias ,&nbsp;Stylianos Gatzonis","doi":"10.1016/j.yebeh.2025.110376","DOIUrl":"10.1016/j.yebeh.2025.110376","url":null,"abstract":"<div><h3>Background</h3><div>Dravet syndrome (DS) is a rare developmental and epileptic encephalopathy that places a substantial burden on both affected individuals and their informal caregivers. The aim of this review is to examine the multifaceted impact of DS on informal caregivers, focusing on key factors that contribute to their challenges and overall burden.</div></div><div><h3>Methods</h3><div>The PRISMA guidelines were followed and a comprehensive search of electronic databases (PubMed, Science Direct, Taylor &amp; Francis) was conducted to identify original research articles from January 2015 till the end of December 2024 in English language. Two reviewers independently carried out the screening. The quality of studies was assessed using the AXIS Critical Appraisal Tool for Cross-Sectional Studies. Relevant data was extracted and a narrative synthesis was performed to integrate the findings.</div></div><div><h3>Results</h3><div>The review included ten studies involving 887 caregivers of patients with DS. Most studies reported a higher proportion of female caregivers. Additionally, all studies were conducted in Europe and the USA. Patient-related characteristics, caregiver characteristics, psychological and physical strain, family functioning, access to support system, financial burden, and difficulties in balancing caregiving responsibilities and personal needs were found to influence caregivers’ experiences and overall well-being. Women, especially mothers, were found to face greater psychological and physical burden, along with productivity loss and difficulties in managing caregiving and personal responsibilities.</div></div><div><h3>Conclusion</h3><div>Caregivers of individuals with DS face significant challenges. More research is needed to understand the full impact of DS on caregivers. Targeted interventions and improved resources are essential to reduce strain and improve care for both caregivers and individuals with DS.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110376"},"PeriodicalIF":2.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637678","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":"Distinguishing epileptic seizures from imitators: A video-based evaluation of non-epileptologist physicians","authors":"Giulia Battaglia ,&nbsp;Vito Sofia ,&nbsp;Gaetano La Delfa ,&nbsp;Gaetano Cantalupo ,&nbsp;Giuseppe Didato ,&nbsp;Barbara Mostacci ,&nbsp;Loretta Giuliano ,&nbsp;on behalf of the Epilepsy and Gender Commission ,&nbsp;Videoteca Commission of the Italian League Against Epilepsy LICE and Italian chapter of the ILAE","doi":"10.1016/j.yebeh.2025.110369","DOIUrl":"10.1016/j.yebeh.2025.110369","url":null,"abstract":"<div><h3>Objectives</h3><div>Epileptic seizures can present with various clinical manifestations, often resembling other conditions—referred to as “imitators of epileptic seizures”—making differential diagnosis challenging. Among them, psychogenic non-epileptic seizures (PNES) or functional/dissociative seizures (FDS) are particularly prevalent in females. This study aimed to evaluate the ability of various non-epileptologist physicians to distinguish epileptic seizures from imitators by viewing video recordings of several paroxysmal events. We also assessed whether variables, such as medical specialty and years of professional experience, could impact diagnostic accuracy.</div></div><div><h3>Materials and methods</h3><div>Ten video recordings of authorized informational material were presented to non-epileptologist physicians. Five videos depicted non-epileptic events, including syncope, hyperkinetic movement disorder episodes, cataplexy, PNES/FDS, and REM behavior disorder. The remaining videos featured focal and generalized seizures. Participants completed an anonymous questionnaire to classify each event as epileptic or non-epileptic.</div></div><div><h3>Results</h3><div>Seventy specialists (44 men, 26 women) from psychiatry (12.9%), internal medicine (12.9%), neurosurgery (14.3%), neurology (14.3%), emergency (18.6%), anesthesiology. (18.6 %) and others (7.1 %) were enrolled. The mean age was 49.9 ± 8.7 years; years of work experience were 0–20 years for 53 % and 21–40 years for 47 %. Epileptic seizures were correctly. recognized in 50.3% of cases, whereas non-epileptic paroxysmal events were. misdiagnosed in 49.7% of cases. The most accurately recognized event was tonic-clonic seizure (88.6%), while the most frequently misdiagnosed was PNES/FDS (94.3%).</div></div><div><h3>Discussion and conclusion</h3><div>Correctly diagnosing epileptic and non-epileptic paroxysmal events can be challenging when relying solely on video recordings. This study highlights the importance of implementing training for adequate diagnosis and subsequent correct management of these conditions.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110369"},"PeriodicalIF":2.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637679","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":"Cognitive and neuro-psychiatric profile in adult patients with epilepsy secondary to Tuberous Sclerosis Complex","authors":"Clara Toscano-Prat ,&nbsp;Carmen García-Sánchez ,&nbsp;Victoria Ros-Castelló ,&nbsp;Ainara Barguilla-Arribas ,&nbsp;Ignasi Gich Saladich ,&nbsp;Kevin Rodríguez-Clifford ,&nbsp;Roser Torra-Balcells ,&nbsp;Susana Boronat ,&nbsp;Alba Sierra-Marcos","doi":"10.1016/j.yebeh.2025.110380","DOIUrl":"10.1016/j.yebeh.2025.110380","url":null,"abstract":"<div><h3>Introduction</h3><div>Tuberous Sclerosis Complex (TSC) is a neurocutaneous disorder associated with epilepsy (70–90% of cases) and neuropsychiatric symptoms (NPS). However, the influence of epilepsy on NPS remains unclear.</div></div><div><h3>Objectives</h3><div>This study aimed to describe the presence of NPS in our cohort and to establish their relationship with epilepsy severity and other clinical characteristics (genetic, neuroimaging, and EEG findings).</div></div><div><h3>Patients and methods</h3><div>Descriptive, cross-sectional, single-centre study of adults (18–65 years) with TSC, without significant intellectual disability. Patients underwent comprehensive neurological and neuropsychological assessment, which included cognitive, depression, and quality of life evaluations, alongside the TAND-checklist for NPS.</div></div><div><h3>Results</h3><div>Twenty-eight patients with TSC were included (19 women, 44.7 ± 14.4 years). Seven patients had <em>TSC1</em> variants and 11 had <em>TSC2</em> variants. Nineteen (67.86 %) patients had epilepsy, 7(36.84 %) of them exhibiting drug-resistant epilepsy. Five (17.86 %) presented Infantile Spasms in the past. Regarding TAND-L, the most frequent NPS were: mood swings (80 %), excessive shyness (70 %), sleep/attention disorders (60 %) and low self-esteem (50 %). A longer duration of epilepsy and a higher number of anti-seizure medications (ASM) trials correlated with poorer total IQ −Intelligence Quotient- (Pearson correlation = -0.53, significant at 0.007 and −0.45, significant at 0.03, respectively). Patients carrying a <em>TSC2</em> variant or with a history of Infantile Spasms had higher intellectual disability and worse TAND scores (p &lt; 0.05). Despite the high prevalence of NPS, only 4(14.28 %) patients had received specific psychiatric care.</div></div><div><h3>Conclusion</h3><div>Patients with TSC and severe epilepsy showed worse neuropsychiatric outcomes. The high prevalence of NPS underscores the need for specific protocols for early detection and intervention.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110380"},"PeriodicalIF":2.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637677","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}