Epilepsy & Behavior最新文献

{"title":"Impact of Ramadan Intermittent fasting on patients with epilepsy: A clinical and laboratory study","authors":"Sally Shaaban ,&nbsp;Shorouk Mohsen ,&nbsp;Asmaa Ayman ,&nbsp;Reem Nabil ,&nbsp;Mohamed Eladrousi ,&nbsp;Reem Algamal ,&nbsp;Ahmed Hamdy","doi":"10.1016/j.yebeh.2025.110489","DOIUrl":"10.1016/j.yebeh.2025.110489","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the changes in seizures frequency and key physiological blood parameters in Muslim patients with epilepsy upon the observance of Ramadan fasting.</div></div><div><h3>Methods</h3><div>This prospective cohort study was carried out at the Neurology Department of the Faculty of Medicine, Mansoura University, Egypt. The study involved monitoring the same group of patients over three distinct periods: pre-Ramadan (<em>Shaaban</em>), during Ramadan, and post-Ramadan (<em>Shawal</em>), to track seizure frequency. The study involved 20 adult Muslim patients with epilepsy who observed fasting during Ramadan with equal distribution between male (n = 10) and female (n = 10) participants and mean age of 39.2 ± 9. Demographic and clinical characteristics were documented. Laboratory measurements, including hematocrit, sodium, potassium, and beta-hydroxybutyrate levels, were recorded during both fasting and non-fasting periods (Ramadan and Shawaal).</div></div><div><h3>Results</h3><div>Nearly one-third of participants remained seizure-free throughout Ramadan (n = 7). Patients who experienced seizures during Ramadan had significantly poorer seizure control during the six months leading up to Ramadan (P-value = 0.003). Prolonged fasting periods were linked to increased seizure risk (P-value = 0.02). Also, Patients on polytherapy were more likely to have seizures during Ramadan fasting compared to those on monotherapy or dual therapy (P-value = 0.03). Blood beta-hydroxybutyrate, sodium and hematocrit levels were significantly higher during the fasting period in Ramadan compared to the post-Ramadan non-fasting period in Shawaal (P-value; &lt;0.001, &lt;0.001, = 0.01, respectively). These differences did not show a significant impact on seizure status during Ramadan (based on Mann–Whitney test, P- value = 0.1, 0.5, 0.4 respectively). Potassium levels remained stable between Ramadan and Shawaal (P-value = 0.4). However, Patients with higher potassium levels were significantly noticed to experience seizures during Ramadan (P-value = 0.005).</div></div><div><h3>Conclusions</h3><div>Fasting during Ramadan may be associated with increased risk of seizures in patients with poorly controlled epilepsy, especially those on polytherapy and long fasting period. Changes in hydration status and electrolyte levels during fasting may have a role in influencing seizure status.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"170 ","pages":"Article 110489"},"PeriodicalIF":2.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072688","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":"Auditory P300 event related potential and cognitive function in adults with drug resistant and newly diagnosed epilepsy","authors":"Athira S.B ,&nbsp;Pravati Pal ,&nbsp;Pradeep P Nair ,&nbsp;Rajeswari Aghoram ,&nbsp;Nivedita Nanda","doi":"10.1016/j.yebeh.2025.110431","DOIUrl":"10.1016/j.yebeh.2025.110431","url":null,"abstract":"<div><h3>Objective</h3><div>Cognitive impairment associated with epilepsy affects multiple domains of cognition. We aimed to assess the cognitive function and factors affecting cognition in drug resistant epilepsy (DRE) and newly diagnosed epilepsy (NDE), compared to controls.</div></div><div><h3>Methods</h3><div>In adults with DRE (n = 88), NDE (n = 88) and healthy controls (n = 88), auditory event-related potential P300, Montreal cognitive assessment (MoCA), frontal assessment battery (FAB) and digit span were assessed. The data was analyzed and compared across the groups.</div></div><div><h3>Results</h3><div>We found a significantly prolonged latency (p &lt; 0.001) and reduced amplitude (p &lt; 0.001) of P300 in DRE and NDE compared to controls. The scores of MoCA, FAB and digit span were significantly low (p &lt; 0.001) in DRE and NDE compared to controls. Also, the P300 latency was greater, and the scores were significantly lower in DRE compared to NDE. The total seizure episode was negatively associated with MOCA (p = 0.03), FAB (p = 0.04), and backward digit span (p = 0.008) in NDE.</div></div><div><h3>Conclusions</h3><div>Cognitive performance was reduced in individuals with DRE and NDE compared to controls and this impairment was more for the DRE. Uncontrolled seizures and polytherapy worsen cognitive impairment in people with epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"168 ","pages":"Article 110431"},"PeriodicalIF":2.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913110","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 and validation of the epilepsy scale among the system of quality of life instruments for chronic diseases QLICD-EP (V2.0):A multicenter longitudinal study","authors":"Yujie Zhou ,&nbsp;Wenhua Chi ,&nbsp;Mengke Ding ,&nbsp;Haifeng Ding ,&nbsp;Chuanzhi Xu ,&nbsp;Chonghua Wan","doi":"10.1016/j.yebeh.2025.110444","DOIUrl":"10.1016/j.yebeh.2025.110444","url":null,"abstract":"<div><h3>Objectives</h3><div>To develop and evaluate the epilepsy scale among the System of Quality of Life Instruments for Chronic Diseases QLICD-EP(V2.0).</div></div><div><h3>Methods</h3><div>The QLICD-EP(V2.0) was developed based on a modular approach and programmed decision procedures with multiple nominal and focus group discussions. The data measuring quality of life (QOL) three times before and after treatment of patients with epilepsy (PWE) was used to evaluate the psychometric properties of the scale, including reliability, validity, and responsiveness.</div></div><div><h3>Results</h3><div>The Cronbach’s α coefficient of the total scale was 0.902. The test–retest reliability of the total scale was 0.913, and the ICC(95 %CI) of the total scale was 0.953(0.928,0.969). Correlation and confirmatory factor analyses by the structural equation model confirmed good construct validity. Correlation analysis showed good criterion-related validity when using the Short Form-36 Health Survey (SF-36) as a criterion. The paired <em>t</em>-test results showed that the special mentality facet was statistically significant (<em>P</em> &lt; 0.05) before and after the treatment with standard response mean (SRM) being 0.31, there was no statistical significance in other domains and facets with SRM being less than 0.50, which was a low effect.</div></div><div><h3>Conclusion</h3><div>QLICD-EP (V2.0) can be used to clinically assess the QOL of PWE in China. Providing a scientific basis for precision medicine and contributing to global health.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"169 ","pages":"Article 110444"},"PeriodicalIF":2.3,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899820","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":"Predictive value of the polygenic risk score for developing epilepsy: a systematic review and meta-analysis","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.2025.110438","DOIUrl":"10.1016/j.yebeh.2025.110438","url":null,"abstract":"<div><h3>Purpose</h3><div> <!-->This study aimed to integrate the findings of previous studies to clarify the predictive value of the polygenic risk score (PRS) for epilepsy.</div></div><div><h3>Methods</h3><div>The MEDLINE, EMBASE, and CENTRAL databases were systematically searched for studies investigating PRS in epilepsy. Additionally, a <em>meta</em>-analysis was performed using random-effects models of studies that included PRS calculations using similar methodologies. The main outcome was the odds ratio (OR) for developing epilepsy based on the generalized or focal epilepsy PRS. The risk of bias (Q-Genie tool) and heterogeneity between the studies were also assessed.</div></div><div><h3>Results</h3><div>Overall, 585 records were retrieved on April 27, 2024. Eleven studies were included in this systematic review. Most studies were conducted on cohorts with European ancestry. The risk of developing epilepsy increased with a higher PRS, which was more pronounced in patients with generalized epilepsy. The total Q-Genie tool score of the included studies was 50.9 (good quality: &gt;45). The <em>meta</em>-analysis included two studies and found that the ORs for generalized epilepsy were 2.18 (95 % confidence interval [CI] 1.91–2.48), 2.65 (95 % CI 2.07–3.39), and 4.62 (95 % CI 3.45–6.20) for the top 20 %, 5 %, and 0.5 % of the PRS distribution, respectively; the respective ORs for focal epilepsy were 1.19 (95 % CI 0.84–1.67), 1.40 (95 % CI 1.28–1.52), and 1.69 (95 % CI 1.27–2.24). Significant heterogeneity was found only in the top 20 % of PRS cases for focal epilepsy (I² = 97.0 %; Q test p &lt; 0.0001).</div></div><div><h3>Conclusion</h3><div>The PRS could be an effective tool for predicting development of epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"169 ","pages":"Article 110438"},"PeriodicalIF":2.3,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902125","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":"Cenobamate and pregnancy: A-single level 4 epilepsy center experience","authors":"Anthony D. Jimenez ,&nbsp;Isabel Toghramadjian ,&nbsp;Chinenye M. Okafor ,&nbsp;Aurelie Hanin ,&nbsp;Xin Zhou ,&nbsp;Maria Kristina C. Dorotan ,&nbsp;Poojith Nuthalapati ,&nbsp;Sagune Sakya ,&nbsp;Lawrence J. Hirsch ,&nbsp;Hamada H. Altalib ,&nbsp;Aaron Lazorwitz ,&nbsp;Aline Herlopian","doi":"10.1016/j.yebeh.2025.110440","DOIUrl":"10.1016/j.yebeh.2025.110440","url":null,"abstract":"<div><h3>Objective</h3><div>Data on Cenobamate (CNB) use in females of childbearing age with epilepsy (FCAWE) and during pregnancy is limited. We report four patients who became pregnant on CNB and its pharmacokinetic profile during pregnancy.</div></div><div><h3>Methods</h3><div>Single-center retrospective chart review of FCAWE receiving CNB between 2020 and 2024. Data on contraceptive use, pregnancy outcomes, and medication levels were analyzed.</div></div><div><h3>Results</h3><div>147 out of 215 adult female patients received CNB were FCAWE. Thirty-three patients had documented use of contraceptive methods. Four unintended pregnancies occurred. Contraceptive methods included condoms (n = 1), hormonal contraceptive (n = 2), and no contraception (n = 1). One had a live early-term birth, two had elective terminations due to medical comorbidities, and one had spontaneous miscarriage. The child born had no reported congenital malformations or developmental delays up to 5 months of age. One patient had ASM levels measured throughout pregnancy and post-partum period, displaying a trend towards decreased concentration-to-dose ratio (CDR) during pregnancy compared to baseline and similar levels in the one-month post-partum period.</div></div><div><h3>Discussion</h3><div>While our report remains anecdotal and preliminary given the very small sample size, we underscore the importance of pre-conceptual counseling in FCAWE to prevent unintended pregnancies and undesired outcomes, particularly when using ASM with limited data regarding teratogenicity. We also shed light on drug level monitoring during pregnancy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"169 ","pages":"Article 110440"},"PeriodicalIF":2.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899822","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":"Diagnosis of NCSE in elderly patients with impaired level of consciousness treated in the emergency department of a general hospital","authors":"Gloria M.A.S. Tedrus","doi":"10.1016/j.yebeh.2025.110460","DOIUrl":"10.1016/j.yebeh.2025.110460","url":null,"abstract":"<div><div>An impaired level of consciousness is common in elderly patients treated in the emergency department. However, the rate of occurrence of nonconvulsive status epilepticus (NCSE) is not yet known.</div></div><div><h3>Objective</h3><div>To evaluate the occurrence of NCSE in patients aged ≥ 60 years who presented with a decreased level of consciousness in the emergency department of a general hospital. The study also compared the clinical and EEG findings and 30-day mortality rates between patients diagnosed with NCSE and those with other diagnoses.</div></div><div><h3>Methodology</h3><div>During the year 2023, patients aged ≥ 60 with a consciousness impairment who were admitted to the emergency department of the PUC-Campinas hospital and submitted to EEG at admission were consecutively included. According to the clinical-EEG aspects, the cases were classified into the NCSE and “other diagnoses” groups. Clinical variables and the 30-day mortality rate were compared between the groups<strong>.</strong></div></div><div><h3>Results</h3><div>Of 124 elderly included (mean age 73.9 ± 8.0 years; 64 females), the diagnosis of NCSE was made in 31 (25 %) cases and of “other diagnoses” in 93 (75 %) cases. There was no difference between the groups in age, gender, history of epilepsy, etiology (acute vs. non-acute), and the characteristics of the initial clinical manifestation. In the EEG, there was a high occurrence of delta or theta rhythm and epileptiform discharges (EDs) in the NCSE group. Within 30 days, 46 (37 %) patients died. Mortality was higher in the NCSE group [T test; 20 (64.5 %) vs. 26 (27.9 %); <em>p</em> &lt; 0.001], in cases with acute etiology, with EDs on the EEG, and when the clinical presentation was coma.</div></div><div><h3>Conclusion</h3><div>NCSE occurred in 25% of the elderly with impaired consciousness who were treated in the emergency department of a general hospital. Unlike the clinical manifestations, the EEG findings differed between elderly patients with NCSE and those with other diagnoses. The mortality rate was high, and there was a higher occurrence in the NCSE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"169 ","pages":"Article 110460"},"PeriodicalIF":2.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894516","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":"Qualitative analysis of written accounts of functional/dissociative seizures","authors":"Qing Xue ,&nbsp;Gregg H. Rawlings ,&nbsp;Steven C. Schachter ,&nbsp;Markus Reuber","doi":"10.1016/j.yebeh.2025.110436","DOIUrl":"10.1016/j.yebeh.2025.110436","url":null,"abstract":"<div><h3>Objective</h3><div>Subjective experiences of functional/dissociative seizures (FDS) are important for diagnosis and treatment formulation. This study aims to improve the symptomatological understanding of these seizures by analysing written narratives provided by authors with personal FDS experience.</div></div><div><h3>Methods</h3><div>Descriptions of FDS were extracted from contributions to the book “In Our Words: Personal Accounts of Living with Non-Epileptic Seizures”. Immediately preictal, ictal or postictal seizure symptoms were identified and subjected to summative content analysis. Themes and subthemes were derived inductively and deductively.</div></div><div><h3>Results</h3><div>Of 93 authors with FDS who submitted contributions to the book, 75 mentioned seizure symptoms. In most narratives, FDS involved a complex, multidimensional symptomatology. Six superordinate symptom domains emerged: ‘consciousness’, ‘movements’, ‘sensations’, ‘arousal’, ‘emotions’, and ‘cognition’. Within the superordinate theme of ‘consciousness’ (63/75 writings), ‘awareness’ was most frequently topicalised, followed by impairment of ‘self-control/ responsiveness’ and ‘disconnection’. The second most prominent superordinate theme of motor symptoms (58/75 authors) included ‘positive’ (excessive activity), ‘negative’ (reduced motor activity) and ‘mixed’ symptoms. Accounts of sensations similarly included ‘hypersensitivity’, ‘hyposensitivity’ and ‘mixed’ symptoms. ‘Pain’ was another prominent sensory subtheme (13/75 narratives). The ‘arousal’ theme (20/75 accounts) captured ‘hyper-‘ more often than ‘hypoarousal’. In the superordinate theme ‘emotions’ (22/75 authors) ‘anxiety’ symptoms were particularly prominent. The superordinate ‘cognition’ theme (14/45 writings) mainly captured ‘foggy thinking’ and ‘memory deficits’.</div></div><div><h3>Conclusions</h3><div>In the words of individuals with personal experience, FDS emerge as complex and heterogeneous phenomena spanning physical, emotional, autonomic and cognitive domains. The characterization of FDS symptomatology should help with earlier diagnoses.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"169 ","pages":"Article 110436"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894517","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":"Psychological status and family burden in caregivers of adult people with epilepsy","authors":"Xiaoxiao Cui ,&nbsp;Chenyang Qi ,&nbsp;Zhe Ren ,&nbsp;Bin Wang ,&nbsp;Lei Sun ,&nbsp;Yanan Chen ,&nbsp;Na Wang ,&nbsp;Tingting Li ,&nbsp;Xiong Han ,&nbsp;Ting Zhao","doi":"10.1016/j.yebeh.2025.110458","DOIUrl":"10.1016/j.yebeh.2025.110458","url":null,"abstract":"<div><h3>Purpose</h3><div>The study aimed to assess anxiety and depression symptoms as well as family burden in the caregivers of adult people with epilepsy (PWE), and to illustrate the influencing factors in depression and anxiety in the caregivers of adult PWE.</div></div><div><h3>Methods</h3><div>178 pairs of adult PWE and their caregivers attending our epilepsy center participated in this study. Demographic characteristics, and anxiety and depression scores were collected for both PWE and their caregivers. Family burden and stress were also assessed by caregivers.</div></div><div><h3>Results</h3><div>In PWE, 45 (31.69 %) participants suffered anxiety symptoms, and 51 (35.92 %) suffered depression symptoms. Anxiety and depression symptoms were detected in 42 (29.58 %) and 40 (28.17 %) of caregivers for adult PWE respectively. Caregivers reported moderate levels of family burden (0.52 ± 0.50), while family economic burden gained the highest score (0.79 ± 0.65). Depression in PWE (B = 0.238, <em>p &lt;</em> 0.001; B = 0.319, <em>p &lt;</em> 0.001), the mental health of family members (B = 10.240, <em>p &lt;</em> 0.001; B = 8.281, <em>p &lt;</em> 0.001) and stress (B = 0.075, <em>p =</em> 0.002; B = 0.091, <em>p =</em> 0.008) in caregivers were independently associated with both anxiety and depression in caregivers.</div></div><div><h3>Conclusion</h3><div>Depression in PWE was independently associated with anxiety and depression in caregivers, respectively. Stress and the mental health of family members in caregivers were independently associated with anxiety and depression in caregivers, separately. Levels of anxiety and depression in caregivers were significantly related to family burden. Therefore, the psychological status of caregivers for adult PWE should be paid more attention in epilepsy treatment.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"169 ","pages":"Article 110458"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894518","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":"Personality assessment inventory sex differences in people with epileptic and functional seizures","authors":"Madeleine P. Smith ,&nbsp;Victoria M. Kordovski ,&nbsp;Victor A. Del Bene ,&nbsp;Mackenzie C. Cervenka ,&nbsp;S. Marc Testa ,&nbsp;Jason Brandt ,&nbsp;Alison S. Buchholz","doi":"10.1016/j.yebeh.2025.110379","DOIUrl":"10.1016/j.yebeh.2025.110379","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Previous research has shown that the Personality Assessment Inventory (PAI) is useful in differentiating individuals with functional seizures (FS) from those with epileptic seizures (ES). In these two groups, sex differences in PAI validity and clinical subscales have not been investigated. Elucidating sex differences could improve the understanding of how males and females experience FS or ES and may improve differential diagnosis and treatment planning.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;We examined sex differences across PAI scales, subscales, and validity profiles amongst adults with FS (n = 62) and ES (n = 55). Participants were evaluated and classified at the Johns Hopkins Hospital Epilepsy Monitoring Unit based on continuous video electroencephalography (cEEG) confirmed diagnoses. Among valid profiles, we conducted the following analyses: calculation of odds ratios (OR) and associated confidence intervals (CI) for each clinical, treatment, and interpersonal scale; logistic regression models to examine whether diagnostic status could be predicted by PAI scale elevations and sex; positive predictive values (PPV) and negative predictive values (NPV) to understand the diagnostic utility of scale and subscale elevations; and receiver operating characteristic (ROC) curves to determine the area under the curve (AUC) and identify PAI scales with the greatest capacity to distinguish FS presence/absence.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;There were no significant differences in validity scales between FS and ES groups, both in the combined sample and when stratifying by sex (&lt;em&gt;p&lt;/em&gt;’s &gt; 0.05)&lt;em&gt;.&lt;/em&gt; On a clinical scale level, FS females produced higher elevations on stress (STR) and somatic complaints (SOM) (OR = 4.17, OR = 6.95, &lt;em&gt;p&lt;/em&gt;’s &lt; 0.05), and FS males reported higher anxiety (ANX), anxiety-related disorders (ARD), and non-support (NON) (OR = 8.0, OR = 11.25, OR = 15.2, &lt;em&gt;p&lt;/em&gt;’s &lt; 0.05) than sex-matched ES patients. On a subscale level, FS females were more likely than ES females to have clinically elevated conversion (SOM-C) and somatization (SOM-S) scales (OR = 4.72, OR = 5.78, &lt;em&gt;p&lt;/em&gt;’s &lt; 0.05), and FS males were more likely than ES males to report clinically elevated SOM-C, physiological anxiety (ANX-P), and trauma-related distress (ARD-T) (OR = 10.53, OR = 9.52, OR = 9.52, &lt;em&gt;p&lt;/em&gt;’s &lt; 0.05). ROC findings revealed that SOM-C (AUC = 0.72) and ANX-P (AUC = 0.78) had the greatest AUCs for FS females and males, respectively. In the combined sex sample, FS patients were more likely than ES patients to endorse mildly elevated paranoia (PAR) and STR and clinically elevated SOM, depression (DEP), and ARD (ORs = 4.86, 3.52, 5.10, 3.01, 4.38, respectively, &lt;em&gt;p&lt;/em&gt;’s &lt; 0.05); when entering these scales in a logistic regression model, SOM was the best predictor of FS. However, overall classification rates did not exceed 80 % (PPV = 75.5 %, NPV = 65.5 %). Among subscales, the co","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"169 ","pages":"Article 110379"},"PeriodicalIF":2.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892101","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":"Evaluating the Status Epilepticus in Pediatric patients Severity Score (STEPSS): A systematic review and meta-analysis","authors":"Xinchi Li ,&nbsp;Bowen Han ,&nbsp;Tianhao Wu ,&nbsp;Tu Chen ,&nbsp;Guiling Wang ,&nbsp;Heng Zhang","doi":"10.1016/j.yebeh.2025.110445","DOIUrl":"10.1016/j.yebeh.2025.110445","url":null,"abstract":"<div><h3>Objective</h3><div>The Status Epilepticus in Pediatric patients Severity Score (STEPSS) has been utilized to assess outcomes in children with status epilepticus (SE). This study aims to evaluate STEPSS’s diagnostic efficacy in predicting survival outcomes for SE patients.</div></div><div><h3>Methods</h3><div>A meta-analysis was conducted to address this objective, calculating pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), area under the curve (AUC), Relative Risk (RR) and corresponding 95 % confidence intervals (95 % CI). Subgroup analysis, meta-regression analysis and the Deek’s plot were used to evaluate heterogeneity.</div></div><div><h3>Results</h3><div>Eight article met inclusion criteria. The literature exhibited non-threshold effect-caused heterogeneity. Pooled sensitivity and specificity, using a random-effects model, were 0.82 (95 % CI: 0.71, 0.90) and 0.78 (95 % CI: 0.70, 0.85), respectively. DOR was 18 (95 % CI: 8, 43), and the Summary Receiver Operating Characteristic AUC (SROC-AUC) was 0.85. Pooled RR showed that the accuracy of using STEPSS for SE diagnosis was 10.74 times higher than without using it (RR = 10.74, 95 % CI: 6.12, 18.86).</div></div><div><h3>Conclusion</h3><div>STEPSS demonstrates strong predictive efficacy for pediatric SE, supporting its diagnostic use in children.</div></div><div><h3>Significance</h3><div>These findings moderately validate STEPSS’s utility in predicting outcomes in pediatric SE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"169 ","pages":"Article 110445"},"PeriodicalIF":2.3,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882554","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}