Epilepsy & Behavior最新文献

{"title":"Semiological feature of epileptic seizures originated from subgenual ventromedial prefrontal cortex: Insight from neuroethological view","authors":"Yichen Ji ,&nbsp;Hongjuan Lu ,&nbsp;Zhe Wu ,&nbsp;Qiting Long ,&nbsp;Xiaolei Zhang ,&nbsp;Wei Zhang ,&nbsp;Wei Sun","doi":"10.1016/j.yebeh.2025.110520","DOIUrl":"10.1016/j.yebeh.2025.110520","url":null,"abstract":"<div><h3>Objective</h3><div>Seizures originating from the ventromedial prefrontal cortex (vmPFC) have been infrequently documented in prior literature. The purpose of the present study is to highlight the semiological features of seizures arising from subgenual vmPFC.</div></div><div><h3>Method</h3><div>We presented three cases with stereoelectroencephalography (SEEG)-confirmed epileptogenic zones localized to the subgenual vmPFC (sg-vmPFC), all achieving favorable surgical outcomes (seizure freedom or significant reduction).</div></div><div><h3>Results</h3><div>Distinct from the panic-driven behaviors (e.g., agitation, hyperkinetic movements) reported in seizures involving the pregenual anterior cingulate or orbitofrontal cortex, the semiology of our cases was characterized by anxiety-related and risk-assessment behaviors, such as visual scanning, olfactory exploration (sniffing), oral automatisms (lip-licking), and manual exploration (hand fumbling), accompanied by vigilant/anxious facial expressions. These features closely align with the pre-threat phase of the Threat Imminence Continuum Theory, which prioritizes environmental surveillance and threat anticipation over immediate defensive actions.</div></div><div><h3>Conclusion</h3><div>Based on our findings, we propose that anxiety-dominated behaviors should be recognized as semiological hallmarks of seizures triggered by vmPFC hyperactivation or early ictal involvement. This paradigm challenges traditional classifications that conflate anxiety and panic semiology, offering a refined framework for localizing vmPFC-related epilepsy and tailoring interventions to its unique network dynamics.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110520"},"PeriodicalIF":2.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262371","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":"Subjective and objective memory in a community-derived sample of people with epilepsy: Evidence from the crimes and four doors tests","authors":"Richard J. Allen ,&nbsp;Steven Kemp ,&nbsp;Amy L. Atkinson ,&nbsp;Sarah Martin ,&nbsp;Kata Pauly-Takacs ,&nbsp;Courtney M. Goodridge ,&nbsp;Ami Gilliland ,&nbsp;Alan D. Baddeley","doi":"10.1016/j.yebeh.2025.110519","DOIUrl":"10.1016/j.yebeh.2025.110519","url":null,"abstract":"<div><div>Subjective self-reports of difficulties with memory are relatively common in people with epilepsy, though these do not always align with performance on objective memory tasks. The current study gathered qualitative and quantitative subjective reports of memory function in a group of people with epilepsy who were recruited via the charity Epilepsy Action, along with controls. Participants also carried out one of two recently developed experimental tasks (Crimes or Four Doors) that provide objective measures of long-term memory and forgetting, along with an additional verbal learning and recall task, each of which assess retention over a one-week period. Relative to controls, people with epilepsy reported memory problems across all the subjective measures, while also showing more objective forgetting on Crimes and Four Doors. When combining the epilepsy and control samples, subjective forgetting and memory satisfaction correlated with objective delayed recall and forgetting. Within the epilepsy sample, delayed recall correlated with subjectively experienced forgetting. These findings provide new evidence for subjective and objective memory difficulties in epilepsy and indicate the need for development of appropriate tools to detect atypical forgetting in this population.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110519"},"PeriodicalIF":2.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254799","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":"Global patterns and predictors of anti-seizure medication adherence in pediatric epilepsy: A systematic review and meta-analysis","authors":"Molalign Aligaz Adisu ,&nbsp;Alemu Birara Zemariam ,&nbsp;Yabibal Asfaw Derso ,&nbsp;Bogale Molla Wereta ,&nbsp;Mulat Awoke Kassa ,&nbsp;Tegene Atamenta Kitaw ,&nbsp;Tesfaye Engdaw Habtie","doi":"10.1016/j.yebeh.2025.110544","DOIUrl":"10.1016/j.yebeh.2025.110544","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy is a chronic neurologic disorder that affects around 50 million individuals worldwide, disproportionately affecting children and young adults. Anti-seizure medication is vital to control seizures, yet adherence remains a key public health concern. While there are scattered individual studies addressing these issues, there is no summary of evidence. This systematic review and <em>meta</em>-analysis will give an estimate of global adherence prevalence, regional variations and determinants, and offer suggestions on improving medication adherence in this vulnerable population.</div></div><div><h3>Methods</h3><div>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched PubMed, Embase, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews for studies reporting on the adherence of anti-seizure medication among children and adolescents. We employed random-effects model to calculate pooled estimates. Additionally, heterogeneity, publication bias and sensitivity analysis was performed.</div></div><div><h3>Results</h3><div>The final analysis consisted of 41 studies on a sample of 13,747. The pooled prevalence of adherence to anti-seizure medication in children and adolescents with epilepsy was estimated to be 63.96% (95% CI: 59.36%–68.57%). Independent predictors of medication adherence in the study were: children and adolescents of mothers with highest educational levels (AOR: 2.07, 95% CI: 1.01–3.14), recently diagnosed children and adolescents with epilepsy (AOR: 2.20, 95% CI: 1.25–3.16), parents with annual healthcare costs of over $7,000 (AOR: 0.53, 95% CI: 0.30–0.76), and patients on monotherapy (AOR: 3.03, 95% CI: 2.47–3.60).</div></div><div><h3>Conclusion</h3><div>This <em>meta</em>-analysis found that there was a suboptimal rate of adherence to anti-seizure medication in children and adolescents. Predictors were maternal education, time since diagnosis, cost, and polypharmacy. The findings confirm the necessity of intervention into socioeconomic status and treatment complexity to improve adherence.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110544"},"PeriodicalIF":2.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255264","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":"Social determinants of health (social risk) and epilepsy in older adults living in low-resource rural settings","authors":"Oscar H. Del Brutto ,&nbsp;Denisse A. Rumbea ,&nbsp;Emilio E. Arias ,&nbsp;Robertino M. Mera","doi":"10.1016/j.yebeh.2025.110546","DOIUrl":"10.1016/j.yebeh.2025.110546","url":null,"abstract":"<div><h3>Background</h3><div>Information of the link between social risk and epilepsy in remote rural settings is limited. This study aims to assess this association in older adults enrolled in the Three Villages Study cohort.</div></div><div><h3>Methods</h3><div>Following a population-based cross-sectional design, older adults living in rural Ecuador underwent social risk determinations based on social determinants of health components from the Gijon’s Social-Familial Evaluation Scale (SFES) together with clinical interviews to determine epilepsy history. Both unadjusted and multivariate logistic regression models were fitted to assess the association between the total Gijon’s SFES and each of its components and epilepsy (dependent variable).</div></div><div><h3>Results</h3><div>The study included 682 individuals aged ≥ 60 years (mean age: 68 ± 7.3 years; 55 % women). The mean Gijon’s SFES score was 10.1 ± 3.1 points, and the crude prevalence of epilepsy was 35.1 per 1,000 population. In unadjusted analysis participants in the highest tertile of social risk had significantly higher odds of having epilepsy compared to those in the lowest tertile (OR: 5.37; 95 % C.I.: 1.73 – 16.7). This association persisted when age, sex, and level of education were added to the model. Analysis of individual components of the Gijon’s SFES showed that only social relationships and support networks were significantly associated with epilepsy.</div></div><div><h3>Conclusion</h3><div>Study results indicate a link between high social risk and epilepsy. The direction of this association remains unclear, but a bidirectional relationship between both variables is likely. Adopting stronger community networks and social support systems could help mitigate epilepsy burden in low-resource settings.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110546"},"PeriodicalIF":2.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254798","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":"Physical activity in young people with epilepsy: development of an informational software application","authors":"Geil Han Astorga ,&nbsp;Xianyi Liang ,&nbsp;Gabriel M. Ronen","doi":"10.1016/j.yebeh.2025.110517","DOIUrl":"10.1016/j.yebeh.2025.110517","url":null,"abstract":"<div><h3>Background</h3><div>Research suggests that physical activity (PA) has potential benefits for young people with epilepsy (YPE); however, further studies are needed to explore how healthcare providers can promote effective interventions in collaboration with YPE and their families.</div></div><div><h3>Objective</h3><div>This knowledge translation project aimed to understand healthcare providers’ perspectives on PA discussions and design a tool to support PA engagement among YPE.</div></div><div><h3>Methods</h3><div>Surveys of specialists, nurses, nurse practitioners, and trainees in pediatric neurology and epilepsy programs in the USA, Canada, Israel and Turkey were conducted to assess current PA discussions in clinical care. Inductive content analysis of responses was guided by eight themes from our previous research. Findings from the surveys and prior focus groups with YPE and their parents informed the development of a web app.</div></div><div><h3>Results</h3><div>Among 73 respondents, healthcare providers emphasized the need for an accessible, easy-to-use online tool that YPE can understand and take home to review. They identified 23 activities YPE discussed during clinical visits. Content analysis of survey results yielded a Krippendorff’s Alpha of 0.846 (95% CI: 0.717–0.967) and informed the app content. Many providers reported that time constraints and limited resources hinder PA discussions in clinical settings.</div></div><div><h3>Conclusion</h3><div>Healthcare providers suggest that an accessible, user-friendly, cost-free tool may help address PA concerns and promote active lifestyles for YPE and their families. This project describes the early stages of using a translational research model to bridge evidence and practice, turning research findings into actionable interventions for patients and families.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110517"},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231385","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":"Stiripentol prevents lethal audiogenic seizures in two mouse strains, relevant for SUDEP prevention","authors":"Alexandre Bacq ,&nbsp;Alexandre Robert ,&nbsp;Gabriel Dieuset ,&nbsp;Mamadou Thiam ,&nbsp;Clara Lesueur ,&nbsp;Emmanuelle Simon O’Brien ,&nbsp;Nolwenn Leprêtre ,&nbsp;Benoît Martin ,&nbsp;Vincent Castagné","doi":"10.1016/j.yebeh.2025.110515","DOIUrl":"10.1016/j.yebeh.2025.110515","url":null,"abstract":"<div><div>Sudden Unexpected Death in Epilepsy (SUDEP) represents a severe outcome for individuals with epilepsy, with an estimated prevalence of 1 per 1000 patients. Stiripentol (STP, Diacomit©) is an antiseizure medication approved for Dravet syndrome, a rare developmental and epileptic encephalopathy with a high mortality rate (15 per 1000), wherein SUDEP accounts for approximately two-thirds of the cases. In this study, we aim to evaluate the effects of STP on lethal seizures using two preclinical models of SUDEP based on audiogenic seizures: a novel SUDEP model, the lethal audiogenic seizure (LAGS+) mouse line issued from a genetic selection, and the DBA/2JRj inbred mouse strain. The latter one was employed to perform a pharmacokinetic/pharmacodynamic (PK/PD) assessment. In both models, STP dose-dependently prevented tonic-clonic seizures and associated mortality when audiogenic seizures were induced 30 min after systemic administration of STP. The LAGS+ model required higher doses of STP to achieve seizure suppression compared to the DBA/2JRj model where a median dose of 75 mg/kg i.p. STP prevented tonic seizures between 30 min and 4 h post-administration, and conferred protection against mortality for up to 2 h. Efficacy was associated with elevated STP levels in plasma and brain tissues 1-hour post-administration, with a brain-to-plasma concentration ratio of approximately 1:4. These findings suggest that STP exerts direct effects in preventing seizures and SUDEP in the two preclinical models studied. The observed plasma and brain concentrations of STP are compatible with the involvement of multiple mechanisms in its protective effects against seizures and SUDEP.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110515"},"PeriodicalIF":2.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213057","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":"Diagnostic sensitivities of an epilepsy management smartphone application and remotely-reported EEG in newly-presenting epilepsy in the Democratic Republic of Congo","authors":"Prince Kazadi ,&nbsp;Steve Coates ,&nbsp;Najib Kissani ,&nbsp;Victor Patterson","doi":"10.1016/j.yebeh.2025.110521","DOIUrl":"10.1016/j.yebeh.2025.110521","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>To compare the sensitivities of a smartphone application (Epilepsy Management Aid, [EMA]), and remotely-reported EEG, in diagnosing epilepsy in newly-presenting patients in the Democratic Republic of Congo (DRC).</div></div><div><h3>Methods</h3><div>Consecutive patients seen by five community doctors were studied. All had their history recorded using the EMA, the summary of which was messaged to a specialist who replied with advice, and all had an EEG performed and reported remotely. As the reference standard, a convenience sample was seen by videoconsultation by an epilepsy specialist, who determined whether patients had epilepsy or not. Sensitivities of both tests were compared with the reference standard using McNemar’s test.</div></div><div><h3>Results</h3><div>Sixty-one patients with both app result and EEG were studied, of whom 21 were seen by videoconsultation. All patients seen had epilepsy. Sensitivity for the EMA was 95.2 % (95 % confidence intervals 74.1, 99.7), and for the EEG 19 % (95 % confidence intervals 6.3, 42.6). Sensitivities were significantly different with a p value of &lt;0.0001.</div></div><div><h3>Discussion</h3><div>The 95 % accuracy of the EMA suggests that it should be useful to empower doctors in low-resource settings to manage epilepsy, thus improving access for patients and reducing the epilepsy treatment gap. The system is potentially both generalisable and scalable.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110521"},"PeriodicalIF":2.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203087","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":"Unique place of ambulatory EEG (aEEG) in management of epilepsy","authors":"Hardik Doshi ,&nbsp;Richa Tripathi ,&nbsp;Zainab Alalawi ,&nbsp;Varun Chauhan ,&nbsp;Shishir Rao ,&nbsp;Aashit Shah","doi":"10.1016/j.yebeh.2025.110516","DOIUrl":"10.1016/j.yebeh.2025.110516","url":null,"abstract":"<div><h3>Purpose</h3><div>(a) evaluate yield of ambulatory EEG (aEEG) for capturing seizures/non-epileptic events (b) compare aEEG yield in capturing Inter-ictal Epileptiform Discharges (IEDs) (c) evaluate aEEG role for Anti-Seizure Drug (ASD) wean in patients who were seizure-free for ≥ 2 years preceding aEEG.</div></div><div><h3>Methods</h3><div>Retrospective chart review was performed for patients who underwent aEEG over a specified time frame of 1.5 years. “Events” were documented on a log. Variables collected: age, sex, indication for test, seizure frequency, ASDs, aEEG &amp; previous rEEG findings, etc. Follow-up clinic notes were reviewed to document impact of aEEG findings.</div></div><div><h3>Results</h3><div>309 patients were included: (a) Electrographic seizures captured in 10 (3 %, only 2/10 (20 %) were reported on log), 14 had non-epileptic events vs only 1 electrographic seizure on rEEG and no non-epileptic events (b) aEEG yield for IEDs was 29 % (88/309). Of 88 patients with aEEG, 59 also had also ≥ 1 prior rEEGs and only 34/59 captured IEDs indicating higher yield of aEEG for IEDs. 25 patients had a normal rEEG who then had IEDs on aEEG (c) aEEG was ordered for ASD wean in 22. Findings: seizures 2 (9 %), rare focal IEDs 4 (18 %), frequent focal/generalized IEDs 1 each, 14 nonepileptiform aEEG. ASDs were not withdrawn in patients with seizures &amp; frequent IEDs. Of 4 with rare IEDs, 2 (50 %) had seizure recurrence after wean, 2 underwent successful (seizure-free &gt; 1 year) wean. Of 14 with nonepileptiform EEG, 3 (21 %) had recurrence after wean &amp; 11underwent successful wean.</div></div><div><h3>Conclusions</h3><div>Patients with epilepsy underestimate seizure burden. Clinical decision-making just based on verbal report can be misleading. aEEG may help provide estimation of unrecognized seizures and help guide ASD wean decision.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110516"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203089","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 “Predictive value of the polygenic risk score for developing epilepsy: a systematic review and meta-analysis” [Epilepsy Behav. 169 (2025) 110438]","authors":"Takafumi Kubota ,&nbsp;Irma Wati Ngadimon ,&nbsp;Hisashi Ohseto ,&nbsp;Sindhu Viswanathan ,&nbsp;Parthvi Ravat ,&nbsp;Mrinal Kumar Acharya ,&nbsp;Naoto Kuroda ,&nbsp;Kazutoshi Konomatsu ,&nbsp;Taku Obara ,&nbsp;Kazutaka Jin ,&nbsp;Masashi Aoki ,&nbsp;Nobukazu Nakasato","doi":"10.1016/j.yebeh.2025.110513","DOIUrl":"10.1016/j.yebeh.2025.110513","url":null,"abstract":"","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"170 ","pages":"Article 110513"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224785","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 outcomes after cortical stimulation-induced seizures: A systematic review and meta-analysis","authors":"Jonah Fox ,&nbsp;Yunting Yu ,&nbsp;Dario J. Englot ,&nbsp;Paddy Ssentongo ,&nbsp;Alain Lekoubou","doi":"10.1016/j.yebeh.2025.110518","DOIUrl":"10.1016/j.yebeh.2025.110518","url":null,"abstract":"<div><h3>Objective</h3><div>To perform a systematic review and <em>meta</em>-analysis to evaluate the association between stimulation-induced seizures and favorable surgical outcomes in drug-resistant epilepsy patients.</div></div><div><h3>Methods</h3><div>A search was conducted using PubMed, Cochrane and Embase databases to identify relevant studies. The prevalence of stimulation-induced seizures and the association between them and favorable surgical outcomes were assessed using a random effects model. A narrative review was also performed. If a patient achieved either Engel I or ILAE class 1 or 2 they were considered to have had a favorable surgical outcome. A minimum of 12 months of follow-up time was required.</div></div><div><h3>Results</h3><div>Only three studies met criteria to be included in the <em>meta</em>-analysis and over half the patients came from a single study. The pooled prevalence of stimulation-induced seizures was 59.2% (95% CI, 41.5–74.9). There was a trend towards a significant association between stimulation-induced seizures and favorable surgical outcomes in patients who received resection irrespective of stimulation settings, but it did not reach statistical significance (RR: 1.76, 95% CI 0.96–3.23). The narrative review suggested that low frequency stimulation may be less sensitive but more specific compared to high frequency stimulation for producing typical seizures and may be more predictive of surgical outcomes.</div></div><div><h3>Conclusions</h3><div>Stimulation-induced seizures were not statistically associated with surgical outcomes, but our <em>meta</em>-analysis was limited to a small number of studies and pooled results at both high and low frequency stimulation. Low frequency stimulation induced seizures were more consistently associated with favorable surgical outcomes in patients who had resection compared to high frequency stimulation induced seizures.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110518"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203088","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}