Epilepsy & Behavior最新文献

{"title":"Epilepsy surgery in infants and young children with tuberous sclerosis","authors":"A. Simon Harvey","doi":"10.1016/j.yebeh.2025.110589","DOIUrl":"10.1016/j.yebeh.2025.110589","url":null,"abstract":"","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110589"},"PeriodicalIF":2.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663638","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":"Risk of anxiety disorders after epilepsy diagnosis: A nationwide retrospective cohort study","authors":"Seung Won Lee ,&nbsp;Chaeyoon Kang ,&nbsp;Unbi Choi ,&nbsp;Hohyun Jung ,&nbsp;Youngoh Bae","doi":"10.1016/j.yebeh.2025.110602","DOIUrl":"10.1016/j.yebeh.2025.110602","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the long-term psychiatric consequences of an epilepsy diagnosis on the incidence of anxiety disorders among patients in South Korea.</div></div><div><h3>Method</h3><div>This study utilized data from the Korean National Health Insurance Service spanning 2002–2013 to analyze longitudinal risks and contributing factors for anxiety disorders among 2109 patients with epilepsy compared to 21,090 matched controls.</div></div><div><h3>Results</h3><div>Patients with epilepsy demonstrated a significantly higher risk of developing anxiety disorders, with an incidence rate of 65.38 per 1000 person-years (95 % CI, 59.61–71.28) versus 33.13 per 1000 person-years (95 % CI, 31.89–34.38) for controls. The incidence rate ratio (IRR) was 1.97 (95 % CI, 1.79–2.18), indicating nearly double the risk relative to the control group. This risk was particularly pronounced in males and individuals under 60, underscoring age and male sex as key risk factors for anxiety post-epilepsy diagnosis.</div></div><div><h3>Conclusion</h3><div>The findings underscore the critical need for prompt psychological evaluations and interventions in the management of epilepsy. Addressing these psychological impacts early can significantly enhance outcomes and quality of life for patients, particularly among those at greater risk such as males under the age of 60.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110602"},"PeriodicalIF":2.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653621","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":"From consensus to classroom: Delphi-derived epilepsy management competencies for school teachers","authors":"Sulena Sulena ,&nbsp;Gagandeep Singh ,&nbsp;Khushboo Bhagat ,&nbsp;Marami Das ,&nbsp;Shikha Jain ,&nbsp;Hobinder Arora ,&nbsp;Pooja Pathak ,&nbsp;Prasenjit Patil ,&nbsp;Rajani Sharma ,&nbsp;Tanvi Kiran ,&nbsp;Mehzabin Haider Hazarika ,&nbsp;Sujiv Akkilagunta ,&nbsp;Jitendra Kumar Sahu","doi":"10.1016/j.yebeh.2025.110604","DOIUrl":"10.1016/j.yebeh.2025.110604","url":null,"abstract":"<div><h3>Background</h3><div>Children with epilepsy are particularly vulnerable to stigma, inadequate management, and exclusion from educational opportunities, especially in low-resource school environments. Despite the high prevalence of epilepsy, current school-based educational interventions are often fragmented and lack a structured, evidence-informed framework. This study aimed to develop a competency-based epilepsy education curriculum for school teachers to enhance seizure identification, appropriate response, and inclusive classroom support.</div></div><div><h3>Methods</h3><div>A mixed-methods, Delphi-guided study was conducted from February to July 2024 across five diverse Indian regions (urban and rural). Curriculum development followed Kern’s six-step model, informed by Social Cognitive Theory and Adult Learning Principles. A comprehensive needs assessment identified core domains, including focus group discussions, stakeholder interviews, and literature review. A 42-member multidisciplinary expert panel participated in two Delphi rounds to refine content and learning objectives. Quantitative analysis (mean scores, per cent agreement, IQR) guided item consensus classification. Reflexive thematic analysis was applied to qualitative inputs.</div></div><div><h3>Results</h3><div>A comprehensive competency-based epilepsy awareness curriculum for school teachers was developed. A needs assessment involving 60 participants across three centres identified eight thematic domains, including knowledge gaps, misconceptions, emergency response limitations, communication barriers, and resource constraints. This and the literature review informed the identification of 11 curriculum domains. Expert consensus through a two-round Delphi process (n = 42) finalised ten core domains and one introductory topic. An interdisciplinary panel formulated 58 competencies and 170 SMART learning objectives. The curriculum underwent preliminary field testing, and iterative refinements were made based on feedback from end users to enhance clarity, relevance, and applicability in school settings.</div></div><div><h3>Conclusion</h3><div>A telehealth-delivered, competency-based epilepsy curriculum was developed to address key knowledge and response gaps among school teachers. Informed by stakeholder input and expert consensus, it offers a scalable, evaluable model for improving school-based epilepsy care and may inform similar interventions for other chronic conditions.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110604"},"PeriodicalIF":2.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663641","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":"Comparative analysis of APACHE II, STESS, and nSTESS scores, and a novel scale for mortality prediction in status epilepticus","authors":"Yu-Shiue Chen ,&nbsp;Ming-Chi Lai ,&nbsp;Tzu-Hsin Huang ,&nbsp;Chin-Wei Huang","doi":"10.1016/j.yebeh.2025.110594","DOIUrl":"10.1016/j.yebeh.2025.110594","url":null,"abstract":"<div><h3>Purpose</h3><div>Status epilepticus (SE) is a neurological emergency with high morbidity and mortality. While various clinical scales exist to predict mortality in SE, there is no consensus on their accuracy. The Acute Physiology and Chronic Health Evaluation (APACHE) II assesses general disease severity in intensive care units (ICU). Currently, no score combines this critical care assessment and current scales for mortality prediction.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed SE patients admitted to our ICU between January 2016 and December 2023. Data included Status Epilepticus Severity Score (STESS), Newly Modified STESS (nSTESS), and APACHE II scores, with patients categorized into survivor and non-survivor groups. Variables identified through univariate analysis and clinical relevance from nSTESS and APACHE II were entered into logistic regression to develop the novel SPAA2 score.</div></div><div><h3>Results</h3><div>Of 93 identified patients, 66 were included (mean age 58.1 ± 16.2 years; 54.5 % male). In-hospital mortality was 21.2 %, with generalized convulsive seizures being most common (51.5 %). APACHE II score, nSTESS, and SPAA2 revealed significant differences between survival and non-survival group (<em>p</em> &lt; 0.001, <em>p</em> = 0.048, <em>p</em> &lt; 0.001), while STESS did not (<em>p</em> = 0.189). APACHE II score, previous seizure history and anti-seizure medication use were independently associated with mortality (<em>p</em> = 0.001, <em>p</em> = 0.006 and <em>p</em> = 0.019). Receiver operating characteristic analysis revealed an area under the curve of 0.798 (APACHE II), 0.657 (nSTESS), 0.563 (STESS) and 0.879 (SPAA2). A SPAA2 cut-off ≥4 was identified for mortality prediction.</div></div><div><h3>Conclusion</h3><div>The SPAA2 score outperformed APACHE II, STESS, and nSTESS in predicting in-hospital mortality for ICU patients with SE, combining both critical care and SE-specific parameters. Further external validation is warranted.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110594"},"PeriodicalIF":2.3,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633279","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 effect of motivational interviewing technique on social anxiety and quality of life of adolescents with epilepsy","authors":"Eliz Gectan ,&nbsp;Hatice Yildirim Sari","doi":"10.1016/j.yebeh.2025.110585","DOIUrl":"10.1016/j.yebeh.2025.110585","url":null,"abstract":"<div><h3>Background and objectives</h3><div>The aim of this study was to evaluate the effect of motivational interviewing on social anxiety and quality of life of adolescents with epilepsy.</div></div><div><h3>Methods</h3><div>The study was conducted with 72 children aged 12–15 years who met the inclusion criteria and agreed to participate in the study. Data were collected using the ‘‘Personal Information Form’’, ‘‘Social Anxiety Scale for Adolescents’’, ‘‘General Child Quality of Life Scale’’ and ‘‘KINDL Epilepsy Quality of Life Module for Children’’. The group that received motivational interviewing formed the interview group (n = 36), and the group that continued routine monitoring formed the control group (n = 36). The interview group received 7 sessions of motivational interviewing.</div></div><div><h3>Results</h3><div>Social anxiety of adolescents with epilepsy in the motivational interview group, which was high before the interview, decreased significantly after the interview and 1 month after the end of the interview (p &lt; 0.001). In the control group, social anxiety increased significantly after the interview (p &lt; 0.001). The quality of life of adolescents with epilepsy in the motivational interview group, which was low before the interview, increased significantly after the interview and 1 month after the end of the interview (p &lt; 0.001). A significant difference was observed in the total scores of the KINDL Epilepsy Quality of Life Module for adolescents in the control group (p = 0.004).</div></div><div><h3>Conclusion</h3><div>The results of our study show that motivational interviewing is effective in reducing social anxiety and improving the quality of life of adolescents with epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110585"},"PeriodicalIF":2.3,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653622","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 cholecystokinin 2 receptor antagonist alleviates seizure severity in a mouse and miniature pig model of temporal lobe epilepsy","authors":"Shenghui Xu ,&nbsp;Stephen Temitayo Bello ,&nbsp;Fengwen Huang ,&nbsp;Mengying Chen ,&nbsp;Xiaofeng Hu ,&nbsp;Feixu Jiang ,&nbsp;Ye Liang ,&nbsp;Mengfan Zhang ,&nbsp;Junming Ren ,&nbsp;Xiao Li ,&nbsp;Zhong Pei ,&nbsp;Liping Wang ,&nbsp;Jufang He","doi":"10.1016/j.yebeh.2025.110593","DOIUrl":"10.1016/j.yebeh.2025.110593","url":null,"abstract":"<div><div>Temporal lobe epilepsy (TLE) is the most common type of acquired epilepsy characterized by recurrent spontaneous seizures. The entorhinal cortex (EC) lies in the medial temporal lobe and serves as a relay center between the hippocampus and neocortex, and contains cholecystokinin-positive (CCK+) neurons. Increased CCK expression has been reported in patients with TLE suggesting its role in epilepsy development. Here, we sought to understand whether CCK+ neurons in EC are involved in TLE development and also to evaluate the therapeutic efficacy of a CCK-2 receptor antagonist in ameliorating seizure severity in a mouse and miniature pig model of TLE<strong>.</strong> Experiments were carried out using male C57BL/6J mice, male and female miniature Bama pigs. Intrahippocampal kainic acid (KA) model of TLE was adopted to assess the dynamics of CCK-positive neurons in EC coupled with fibre photometry recording of calcium dynamics. CCK-2 receptor antagonist was administered intraperitoneally and intramuscularly in mice and miniature pigs, respectively, to evaluate its therapeutic effect on seizure frequency. The calcium dynamics of CCK-positive neurons in the EC of TLE mice were increased during both inter-ictal phase and spontaneous seizures, signifying enhanced neuronal excitability of CCK-positive neurons. Administration of CCK-2 receptor antagonist YF476 significantly suppressed convulsive seizure frequency during and post-treatment in TLE mice and was also effective in alleviating the frequency of severe and mild seizures in TLE miniature pigs when compared with phenytoin and carbamazepine. This study reveals a novel strategy for treating TLE and it provides the possibility of YF476 being adopted as a new anti-seizure drug.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110593"},"PeriodicalIF":2.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632711","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 multicenter study on the use of purified cannabidiol for children with treatment-resistant developmental and epileptic encephalopathies","authors":"Gabriela Reyes Valenzuela ,&nbsp;Alberto Espeche ,&nbsp;Sebastian Fortini ,&nbsp;Beatriz Gamboni ,&nbsp;Javier Adi ,&nbsp;Marco Semprino ,&nbsp;Lorena Fasulo ,&nbsp;Santiago Galicchio ,&nbsp;Pedro Cachia ,&nbsp;Santiago Chacón ,&nbsp;Agustin Calvo ,&nbsp;Lucas Beltran ,&nbsp;Claudia Bautista ,&nbsp;Roberto H Caraballo","doi":"10.1016/j.yebeh.2025.110590","DOIUrl":"10.1016/j.yebeh.2025.110590","url":null,"abstract":"<div><h3>Objective</h3><div>This descriptive, real-world, multicenter study aimed to evaluate the efficacy, safety, and tolerability of purified cannabidiol (CBD) as an add-on therapy in children with treatment-resistant developmental and epileptic encephalopathies (DEE).</div></div><div><h3>Methods</h3><div>Children aged 0.5 to 16 years who met the International League against Epilepsy (ILAE) criteria for drug-resistant DEE and were treated with purified CBD at 10 different centers between March 2021 and December 2024 were included.</div></div><div><h3>Results</h3><div>A total of 551 patients were enrolled. The mean age at CBD initiation was 8.5 years (SD 5 years; range 0.5–18). Median follow-up duration was 22 months (range 13–32). Etiologies were structural in 249 (45 %), genetic in 160 (28.8 %), immune-mediated in five (0.9 %), infectious in three (0.5 %), and unknown in 134 (24.3 %). After 12–32 months of follow-up, 279 patients (50.6 %) had a &gt; 50 % reduction in seizure frequency, including 78 (14.2 %) who became seizure-free. A reduction of &lt; 50 % was observed in 106 (19.1 %), and 34 (6.2 %) experienced no change. Adverse events occurred in 32.7 %, mostly mild and transient, improving with dose adjustments. At the last visit, 389 patients (70.6 %) continued CBD, with 173 (31.4 %) maintaining a &gt; 50 % reduction in seizures and 56 (10.2 %) remaining seizure-free.</div></div><div><h3>Conclusions</h3><div>This study supports the use of purified CBD as an effective, safe, and well-tolerated treatment option for children with drug-resistant DEEs of diverse etiologies.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110590"},"PeriodicalIF":2.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632710","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 psychiatric disorders and the clinical semiology of functional seizures in patients with and without comorbid epilepsy","authors":"Anja Maslowski ,&nbsp;Felix Rosenow ,&nbsp;Adam Strzelczyk ,&nbsp;Laurent M. Willems","doi":"10.1016/j.yebeh.2025.110511","DOIUrl":"10.1016/j.yebeh.2025.110511","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the association between the semiology of functional seizures (FS) and comorbid psychiatric disorders in patients with and without epilepsy.</div></div><div><h3>Methods</h3><div>Adult patients diagnosed with FS during video-electroencephalography-monitoring at the Epilepsy Centre Frankfurt Rhine-Main between 2016 and 2024 were retrospectively identified. Functional seizures were categorized into six classes based on the classification proposed by Wadwekar. Statistical analysis was performed using Kruskal–Wallis test and multivariate ordinal regression analysis (MORA).</div></div><div><h3>Results</h3><div>A total of 2,784 patients were screened, and 603 FS were analysed from 216 patients (75.0 % female, mean age 36.7 years, range 18.0–79.0 years). The most common form (30.5 %, n = 244) were non-motor FS of class VI, followed by class IV hyperkinetic (27.2 %, n = 164), class II paucikinetic (21.9 %, n = 132), class III pseudosyncope (5.0 %, n = 30), class I dystonic (3.2 %, n = 19), and class V axial dystonic (2.2 % n = 13). Univariate analysis revealed a significant association between class II FS and borderline personality disorder (BPD, p = 0.036), class III FS and post-traumatic stress disorder (PTSD, p = 0.041), and class IV FS with a diagnosis of depression (p = 0.014). Multivariate analysis revealed a significant association between class II FS and comorbid anxiety and panic disorder (p = 0.037), as well as with BPD (p = 0.010); further associations were found for class III FS with PTSD (p = 0.015) and with epilepsy (p = 0.015), and between class VI FS and living alone (p = 0.047). In patients with comorbid epilepsy, class II FS were significantly more frequent (p = 0.047).</div></div><div><h3>Significance</h3><div>The semiology of FS seems to be associated with psychiatric comorbidities which may improve the understanding of individual manifestations.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110511"},"PeriodicalIF":2.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632712","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":"Transcutaneous vagus nerve stimulation therapy for refractory epileptic encephalopathy with spike-wave activation in sleep","authors":"Yihai Dai ,&nbsp;Stéphane Jean ,&nbsp;Panashe Tevin Tagu ,&nbsp;Zhe Qian ,&nbsp;Weihong Liu ,&nbsp;Yuming Xu ,&nbsp;Tangfei Wang ,&nbsp;Zewei Lin ,&nbsp;Weitao Chen ,&nbsp;Shiwei Song","doi":"10.1016/j.yebeh.2025.110591","DOIUrl":"10.1016/j.yebeh.2025.110591","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this study was to prospectively investigate the efficacy of transcutaneous vagus nerve stimulation (t-VNS) in drug-resistant epileptic encephalopathy with spike-wave activation in sleep (EE-SWAS) pediatric patients.</div></div><div><h3>Methods</h3><div>We prospectively reviewed 11 drug-resistant epilepsy pediatric patients who underwent a 3-month t-VNS. We used a weighted phase lag index (wPLI) measure to assess the change in connectivity measures that quantify electroencephalogram (EEG) synchronization before and after stimulation. We measured the change in non-rapid eye movement (NREM) and seizure frequency following t-VNS, and cognitive functions were assessed before and after stimulation using the Chinese Wechsler Intelligence Scale for Children (C-WISC) and the Chinese Wechsler Preschool and Primary Scale of Intelligence (C-WPPSI).</div></div><div><h3>Results</h3><div>Our results show that 63.63% of EE-SWAS patients were responders to the 3- month t-VNS, with 4 being seizure-free, and resulted in a reduction of NREM, seizure frequency, and coupling strength. More specifically, there was a significant decrease in coupling strength in the frontal-occipital and central-occipital regions in the theta band; frontal-parietal, central-parietal, parietal, parietal-occipital, parietal-temporal, occipital-temporal, and temporal regions in the alpha band; and lastly, frontal-occipital, central-parietal, parietal-occipital, and occipital-temporal regions in the beta band. There were no statistically significant changes in total intelligence before and after t-VNS.</div></div><div><h3>Conclusion</h3><div>This study presents evidence that t-VNS is a safe and effective non-invasive treatment for refractory EE-SWAS. Despite the relatively short stimulation period, t-VNS resulted in a decrease in NREM, seizure frequency, and in an alteration in brain functional connectivity strength. Future studies with a larger cohort and longer stimulation duration may be necessary to substantiate our findings.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110591"},"PeriodicalIF":2.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632704","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":"Psychogenic non-epileptic seizures in patients undergoing epilepsy surgery: experience from a tertiary referral center","authors":"Filiz Azman Iste ,&nbsp;Gokce Ayhan Arslan ,&nbsp;F. Irsel Tezer ,&nbsp;Serap Saygi","doi":"10.1016/j.yebeh.2025.110592","DOIUrl":"10.1016/j.yebeh.2025.110592","url":null,"abstract":"<div><h3>Background</h3><div>The coexistence of psychogenic non-epileptic seizures (PNES) and drug-resistant epilepsy (DRE) presents significant challenges, particularly in the context of epilepsy surgery. This study aimed to investigate the clinical, demographic, and prognostic features of patients who underwent epilepsy surgery and had coexisting PNES.</div></div><div><h3>Methods</h3><div>This retrospective study was conducted at Hacettepe University Hospitals’ Epilepsy Center between October 1996 and December 2019. Thirteen patients who underwent resective or non-resective epilepsy surgery and were diagnosed with PNES were included. Data were collected from outpatient clinic records, seizure charts, and video-EEG monitoring unit (VEMU) reports. Postoperative outcomes were evaluated using the Engel classification, and the presence of epileptic seizures and PNES was recorded.</div></div><div><h3>Results</h3><div>Among 717 patients who underwent epilepsy surgery during the study period, 13 (1.8 %) had coexisting PNES. Of these, 11 had PNES in the presurgical period, and de novo PNES developed in two patients after surgery. Among the 10 patients with presurgical PNES who underwent resective surgery, 90 % achieved Engel Class I outcomes, while 10 % were classified as Engel Class III. No postoperative PNES recurrence was observed in these patients. However, in one patient who underwent corpus callosotomy, both epileptic seizures and PNES persisted. De novo PNES occurred in two cases, 1 and 7 years after surgery, despite Engel Class I outcomes.</div></div><div><h3>Conclusion</h3><div>PNES should not be seen as a reason for hesitation in referring patients for epilepsy surgery. Our findings suggest that good prognosis after epilepsy surgery can improve patients’ quality of life and may indirectly lead to positive effects on PNES. However, the occurrence of de novo PNES underscores the importance of postoperative psychological follow-up for long-term success.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110592"},"PeriodicalIF":2.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632709","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}