Epilepsy & Behavior最新文献

{"title":"Interictal head-turning sign in patients with idiopathic generalized epilepsy during initial medical interview: A matched multicenter study","authors":"Shuichiro Neshige ,&nbsp;Shiro Aoki ,&nbsp;Narumi Ohno ,&nbsp;Megumi Nonaka ,&nbsp;Hidetada Yamada ,&nbsp;Yoshiko Takebayashi ,&nbsp;Haruka Ishibashi ,&nbsp;Takeo Shishido ,&nbsp;Dai Agari ,&nbsp;Yu Yamazaki ,&nbsp;Koji Iida ,&nbsp;Hirofumi Maruyama","doi":"10.1016/j.yebeh.2024.110039","DOIUrl":"10.1016/j.yebeh.2024.110039","url":null,"abstract":"<div><h3>Background</h3><div>Utilizing interictal manifestations for the diagnosis of epilepsy is challenging. We investigated whether an interictal “head-turning sign,” typically indicative of dependence on others observed in Alzheimer’s disease, can act as a behavioral marker of idiopathic generalized epilepsy.</div></div><div><h3>Methods</h3><div>This multicenter study examined 579 consecutive patients, with a mean age of 36.8 ± 20.4 years, who did not have an intellectual disability and had their first outpatient visit for epilepsy evaluation between 2019 and 2023. Patients were categorized into IGE, non-IGE epilepsy, non-epileptic, and psychiatric conditions based on their ultimate diagnostic outcomes to identify difference of the occurrence of the head-turning sign among them. Additionally, we extracted data from patients under the age of 40, specifically adolescents and young adults (AYA). Then we used propensity score matching to confirm the reproducibility of observed differences and to identify associated factors within the AYA age group.</div></div><div><h3>Results</h3><div>The occurrence of the head-turning sign was significantly more prevalent in the IGE group compared to the non-IGE group (20.4 % vs. 2.2 %; P&lt;0.0001) and non-epileptic group (20.4 % vs. 8.3 %; P=0.033). Following the matching, the head-turning sign was still evident in IGE relative to non-IGE patients (14.6 % vs. 4.5; P=0.004), yielding a 94 % specificity for IGE. IGE diagnosis (P&lt;0.0001), myoclonic seizure (P&lt;0.0001), being visited by a parent (P=0.017), and comorbidity with headache (P=0.021) were significantly associated with the head-turning sign. Multivariate analysis revealed that IGE (odds ratio: OR=2.80, P=0.028), attending with a parent (OR=2.92, P=0.029), and comorbidity with headache (OR=4.06, P=0.016) were independently associated with the head-turning sign.</div></div><div><h3>Conclusions</h3><div>We confirmed a substantial association between the interictal “head-turning sign” and IGE. This unique sign may reflect a tendency towards dependence on others in IGE, and may serve as a promising diagnostic auxiliary marker for identifying IGE in the AYA age group.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417042","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":"What do ketogenic dietitians and physicians need? A survey from the KetoCollegeAdvance™ training in United Kingdom","authors":"Eric H. Kossoff ,&nbsp;Zoe Simpson ,&nbsp;Julie Fountain","doi":"10.1016/j.yebeh.2024.110071","DOIUrl":"10.1016/j.yebeh.2024.110071","url":null,"abstract":"<div><h3>Introduction</h3><div>The ketogenic diet is a valuable nonpharmacologic therapy for the treatment of refractory epilepsy in children and adults. It can be time-intensive for ketogenic teams, typically comprised of a physician and dietitian at a minimum. Challenges and barriers to providing ketogenic diet services to patients by members of these teams has not been studied extensively.</div></div><div><h3>Methods</h3><div>A survey was created and distributed to attendees at a ketogenic diet training conference (KetoCollegeAdvance™) held 21–23 May 2024 in United Kingdom. Questions included Likert scales and fill-in responses. Surveys were provided by 63 attendees (mostly dietitians) from 17 countries.</div></div><div><h3>Results</h3><div>Respondents were mostly dietitians (45/63, 71 %) and from the United Kingdom. In regards to perceived interest levels in KD in general in their countries, dietitians were perceived as 80 % very or extremely interested, parents (66 %), and neurologists (45 %). The majority of teams included a dietitian (79 %) and physician (78 %). The majority, 43 (68 %) of respondents, assumed care of all aspects of epilepsy care once the KD was started. Common barriers to starting KD services included a long waiting list, lack of adult KD services, funding dietitians, and low referrals. Barriers to continuing KD services included poor patient compliance, a lack of financial resources for some families to afford foods, and a need for more pre-made ketogenic foods including bread, pizza, pasta, potato fries, and chocolates.</div></div><div><h3>Conclusions</h3><div>These results from a conference of international ketogenic dietitians and physicians highlights common difficulties in providing the ketogenic diet successfully. Addressing these barriers may help expand the usage of this therapy for more patients with epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406260","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 processing in patients with temporal lobe epilepsy: A systematic review and meta-analysis","authors":"Dimitra Angeli ,&nbsp;Eirini Kelmali ,&nbsp;Vasilios K. Kimiskidis ,&nbsp;Doris-Eva Bamiou ,&nbsp;Vasiliki Maria Iliadou","doi":"10.1016/j.yebeh.2024.110069","DOIUrl":"10.1016/j.yebeh.2024.110069","url":null,"abstract":"<div><h3>Background</h3><div>Hearing efficiency is known to influence and interact with communication and mental health. Hearing impairment may be hidden when co-occurring with neurological disorders.</div></div><div><h3>Purpose</h3><div>We performed a systematic review and <em>meta</em>-analysis in order to address the following questions: 1) which specific tools of auditory processing show clear deficits, separating Temporal Lobe Epilepsy (TLE) patients from normal controls,2) How well is TLE evaluated in terms of hearing and auditory processing?</div></div><div><h3>Methods</h3><div>The study inclusion criteria were: 1) patients diagnosed with temporal lobe epilepsy, 2) presence of a normal control group, 3) auditory processing assessment using auditory stimuli with behavioral tests and/or P300 or Mitch Match Negativity (MMN) latency and/or amplitude, 4) publications written in English, 5) publication date after 2000. 132 articles were retrieved and based on PRISMA &amp; PICO criteria 23 articles were analyzed.</div></div><div><h3>Results</h3><div>Temporal resolution and processing as measured by the behavioral tests of Gaps-In-Noise (GIN) and Duration Pattern Test (DPT) document deficiencies in TLE patients and separate them from normal controls. Electrophysiology as measured by MMN &amp; P300 shows statistically significant differences in TLE patients compared to controls with patients showing deficient auditory processing. A clear difference between studies with psychoacoustic assessment as opposed to electrophysiology ones may be due to lacking or incomplete evaluation of peripheral hearing by gold standard tools (76.9% in electrophysiology studies).</div></div><div><h3>Conclusion</h3><div>Auditory processing is deficient in patients with TLE. There is a clear need to evaluate hearing efficiency before proceeding to auditory processing evaluation with behavioral or electrophysiological tests.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406248","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":"Neuromodulation strategies in developmental and epileptic encephalopathies","authors":"Debopam Samanta ,&nbsp;Zulfi Haneef ,&nbsp;Gregory W. Albert ,&nbsp;Sunil Naik ,&nbsp;Puck C. Reeders ,&nbsp;Puneet Jain ,&nbsp;Taylor J. Abel ,&nbsp;Ruba Al-Ramadhani ,&nbsp;George M. Ibrahim ,&nbsp;Aaron E.L. Warren","doi":"10.1016/j.yebeh.2024.110067","DOIUrl":"10.1016/j.yebeh.2024.110067","url":null,"abstract":"<div><div>Developmental and epileptic encephalopathies (DEEs) are a group of childhood-onset epilepsy syndromes characterized by frequent seizures, severe cognitive and behavioral impairments, and poor long-term outcomes. These conditions are typically refractory to currently available medical therapies, prompting recent exploration of neuromodulation treatments such as deep brain stimulation (DBS) and responsive neurostimulation (RNS), which aim to modulate epileptic networks spanning cortical and subcortical regions. These advances have occurred alongside an improved understanding of syndrome-specific and interictal epileptiform discharge/seizure-specific brain networks. By targeting key nodes within these networks, DBS and RNS hold promise for influencing seizures and associated cognitive and behavioral comorbidities. Initial experiences with centromedian (CM) thalamic DBS for Lennox-Gastaut syndrome (LGS) have shown modest efficacy across multiple seizure types. Reports also indicate the application of DBS and RNS across various genetic and structural etiologies commonly associated with DEEs, with mixed success. Although DBS and RNS are increasingly used in LGS and other DEEs, their mixed efficacy highlights a knowledge gap in understanding why some patients with LGS do not respond and which neuromodulation approach is most effective for other DEEs. To address these issues, this review first discusses recent neuroimaging studies showing similarities and differences in the epileptic brain networks underlying various DEEs, revealing the common involvement of the thalamus and the default-mode network (DMN) across multiple DEEs. We then examine thalamic DBS for LGS to illustrate how such network insights may be used to optimize neuromodulation. Although network-based neuromodulation is still in its infancy, the LGS model may serve as a framework for other DEEs, where optimal treatment necessitates consideration of the underlying epileptic networks. Lastly, the review suggests future research directions, including individualized connectivity assessment and biomarker identification through collaborative efforts, which may enhance the therapeutic potential of neuromodulation for individuals living with DEEs.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406256","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":"Machine learning models for predicting treatment response in infantile epilepsies","authors":"Edibe Pembegul Yildiz ,&nbsp;Orhan Coskun ,&nbsp;Fulya Kurekci ,&nbsp;Hulya Maras Genc ,&nbsp;Oznur Ozaltin","doi":"10.1016/j.yebeh.2024.110075","DOIUrl":"10.1016/j.yebeh.2024.110075","url":null,"abstract":"<div><div>Epilepsy stands as one of the prevalent and significant neurological disorders, representing a critical healthcare challenge. Recently, machine learning techniques have emerged as versatile tools across various healthcare domains, encompassing diagnostics, treatment assessment, and prognosis. We compared 11 machine learning model to find the best ML model to predict drug treatment outcomes for our cohort, which we previously evaluated using classical statistical methods.</div></div><div><h3>Methods</h3><div>In our study, we evaluated patients who presented to the pediatric neurology department of our university hospital with seizures at the age of 1 to 24 months and were diagnosed with epilepsy. We utilized 11 different machine learning techniques namely Decision Tree, Bagging, K-Nearest Neighbour, Linear Discriminant Analysis, Logistic Regression, Neural Networks, Deep Neural Networks, Support Vector Machine. Besides, we compared these techniques using various performance metrics to identify anti-seizure medicine response. We also utilized the chi-square feature selection methods to enhance performance in machine learning algorithms.</div></div><div><h3>Results</h3><div>Two hundred and twenty-nine patients (110 male and 119 female) who were diagnosed between the ages of 1–24 months were included in the study. Support Vector Machine algorithm was found to be effective in drug resistant epilepsy detection, with the highest aure under curve value (0.9934) and achieving a test accuracy of 97.06 %.</div></div><div><h3>Conclusion</h3><div>This study can shed light on future studies by showing that the Support Vector Machine algorithm can effectively determine the drug resistant epilepsy. The pediatric neurologist and experts should be referred to non-medical treatment (epilepsy surgery, ketogenic diet) at the early stages and multidisciplinary approach should be provided.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406254","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":"Advances in serum thyroid hormone levels and seizures","authors":"Changfu Liu ,&nbsp;Yihong Song ,&nbsp;Xue Wang ,&nbsp;Guanghui Zhang","doi":"10.1016/j.yebeh.2024.110053","DOIUrl":"10.1016/j.yebeh.2024.110053","url":null,"abstract":"<div><div>Epilepsy, a common neurological disorder, is characterized by paroxysmal, short-term, repetitive, and stereotypical features, significantly impacting patients’ quality of life. Currently, the pathogenesis of epilepsy remains incompletely understood. Changes in neuronal excitability, imbalances in glutamate and gamma-aminobutyric acid (GABA) levels, alterations in the activity of GABA receptors, and dysfunction of GABA receptors are considered closely related to its occurrence. Thyroid hormones, vital for human growth and development, also play a crucial role in the nervous system. They mediate oxidative stress, influence reactive oxygen species production, affect mitochondrial function and neuronal excitability, and modulate glutamate and GABA levels. Also, they combine with thyroid hormone receptors and exert genomic effects by regulating the expression of numerous genes. However, once there are defects in thyroid hormone signaling, these defects may lead to severe neurodevelopmental disorders that are associated with an increased frequency of seizures. The impact of antiseizure medications (ASMs) on serum thyroid hormone levels, particularly traditional ASMs, has been extensively studied. It is reported that conventional ASMs such as phenobarbital, phenytoin sodium, carbamazepine, and valproate sodium were more likely to induce subclinical hypothyroidism (elevated TSH with normal FT4) or isolated hypothyroidism (decreased FT4 with normal TSH). However, the new ASMs, such as levetiracetam, have no effect on thyroid hormone levels. Together, seizures not only affect thyroid hormone levels, but abnormal thyroid hormone levels can also influence seizures. However, the precise mechanism underlying the interaction between serum thyroid hormone levels and seizures remains unclear. This review aims to explore the relationship between thyroid hormone levels and seizures, along with the underlying mechanisms.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406247","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":"Determination of complementary and alternative medicine use frequency and related factors in children with epilepsy: A descriptive Cross-Sectional study from eastern Turkey","authors":"Veysel Can ,&nbsp;Mehmet Bulduk ,&nbsp;Nesrullah Ayşin ,&nbsp;Emine Kurt Can ,&nbsp;Nihal Aydın","doi":"10.1016/j.yebeh.2024.110041","DOIUrl":"10.1016/j.yebeh.2024.110041","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study is to determine the complementary and alternative medicine (CAM) methods used in epilepsy patients admitted to a paediatric neurology clinic in Turkey and to examine the factors affecting these methods.</div></div><div><h3>Methods</h3><div>This study was conducted between October 2022 and March 2023 by using a questionnaire form prepared in line with the literature to the parents (n = 172) of children who were under the age of 18 and who had been diagnosed with epilepsy for at least 1 year and who were followed up in the paediatric neurology outpatient clinic of a secondary care hospital in Van province of Turkey. The principles of scientific ethics and confidentiality of data were complied with in all stages of the study.</div></div><div><h3>Results</h3><div>The study included 172 parents of 172 children with a mean age of 2.95 ± 0.93 years. In the study, it was found that 37.2 % of the parents had previously used CAM themselves, almost all of the parents (98.8 %) had not discussed the use of CAM with their physician or nurse, half of the parents considered CAM to be dangerous, and 28.2 % wanted to receive counselling to learn more about CAM. It was also found that 28.5 % of the parents used CAM in the treatment of their children. The most commonly preferred CAM among parents in the treatment of epilepsy was religious healing (79.6 %) which is among mind/body practices. It was found that the most common technique used by parents was regular praying (71.4 %). Religious beliefs were effective in the use of CAM in our patient population, while confidence in medical treatment was effective in not using CAM. More than half of the parents who used CAM in their child’s treatment reported benefits and reduced seizure frequency. The factors significantly associated with CAM use in children with epilepsy were parental education level, parental CAM use and disease duration. In univariate and multivariate analyses, it was found that a degree below high school increased the likelihood of CAM use by 0.017 and 0.024 times, respectively, compared to being illiterate.</div></div><div><h3>Conclusions</h3><div>Pediatric nurses’ routine examination of CAM methods used in paediatric epilepsy patients and the factors affecting these methods is very important in terms of preventing negative effects on child health, effective management of the disease process, ensuring safe use and strengthening communication to improve the quality of care.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406250","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":"Individual and relational factors related to disclosure of epilepsy in the workplace","authors":"Maimi Ogawa ,&nbsp;Mayu Fujikawa ,&nbsp;Katsuya Tasaki ,&nbsp;Kazushi Ukishiro ,&nbsp;Yosuke Kakisaka ,&nbsp;Kazutaka Jin ,&nbsp;Nobukazu Nakasato","doi":"10.1016/j.yebeh.2024.110079","DOIUrl":"10.1016/j.yebeh.2024.110079","url":null,"abstract":"<div><h3>Background</h3><div>The decision to disclose epilepsy in the workplace is complex, as it entails both advantages and disadvantages. In this study, we aimed to identify the factors associated with disclosure of epilepsy in the workplace based on the disclosure decision-making model for patients who required underwent comprehensive assessment in the Epilepsy Monitoring Unit (EMU).</div></div><div><h3>Methods</h3><div>This retrospective study included 193 patients with epilepsy (112 men, aged 18–66 years) who underwent comprehensive assessment, including long-term video-EEG monitoring, neuroimaging studies, and neuropsychological and psychosocial assessment in the Tohoku University Hospital EMU. Data were obtained from the medical records and self-reported questionnaires at our EMU. The outcome variable was disclosure of epilepsy. Predictive variables were selected based on the disclosure decision-making model: individual factors (i.e., age, sex, age at onset of epilepsy, seizure frequency, generalized tonic-clonic seizures or focal to bilateral tonic-clonic seizures in the last 2 years, experiences of viewing own seizure, and felt stigma), and relational factors (i.e., experiences of discrimination, enacted stigma, and social support). Data were analyzed using a logistic regression analysis model.</div></div><div><h3>Results</h3><div>Our results indicated that 43.5% of patients disclosed epilepsy to their employer. The factors that associated with disclosure of epilepsy were experiences of discrimination (odds ratio [OR], 7.78; 95% confidence interval [CI], 2.84–21.34, <em>p</em> &lt; 0.01), experiences of viewing own seizure (OR, 3.51; 95% CI, 1.27–9.72, <em>p</em> &lt; 0.05), and level of enacted stigma (OR, 0.69; 95% CI, 0.48–0.99, <em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>This study indicated that the decision to disclose epilepsy was associated with both individual factors, such as experience of viewing own seizures, and relational factors, such as experience of discrimination and enacted stigma.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406252","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":"Nationwide epidemiological study of epilepsy in Montenegro","authors":"Sanja Gluscevic ,&nbsp;Slavica Vujsic ,&nbsp;Aleksandar Ristic ,&nbsp;Tatjana Pekmezovic","doi":"10.1016/j.yebeh.2024.110065","DOIUrl":"10.1016/j.yebeh.2024.110065","url":null,"abstract":"<div><div>The aim of this study was to estimate the incidence and prevalence of epilepsy in Montenegro over the period 2011–2022 using hospital case records. The main sources for this study were hospital case records in every outpatient and inpatient neurological department in Montenegro, including the Clinical Center of Montenegro in the capital, a primary referral national center for epilepsy. For every patient, aged 18 and above, two neurologists reviewed all data collected to verify the validity of the diagnosis and to establish the date of clinical onset of the disease. Information on age and sex, EEG, CT scan, and MRI were included. Prevalent cases were selected in 2022 population. Incident cases of epilepsy were identified in 2011 and the incidence trend was followed up for the next 12 years. Crude and standardized incidence and prevalence were calculated. Average crude incidence rate of epilepsy for study period was 56.0 per 100,000 individuals (men 58.1; women 54.2). The age-specific incidence was lowest in the 30 s, and early 40 s and highest after 65 years. Over the 12-year period, increasing trend of standardized epilepsy incidence rates was observed for the total population and for females (p = 0.024 and p = 0.020 respectively). The crude overall prevalence of epilepsy on December 31, 2022 was 13.0 per 1000 individuals (men 13.5; women 12.6). The highest prevalence was in patients in their early 20 s and in the seventh decade. In conclusion, the incidence of epilepsy in this study was similar to those of other industrialized countries, with increasing trend during study period. Prevalence was higher compared to European countries.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406255","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":"Early vigabatrin to augment GABAergic pathways in post-anoxic status epilepticus","authors":"Carolina B. Maciel ,&nbsp;Bakhtawar Ahmad ,&nbsp;Maria Jose Bruzzone Giraldez ,&nbsp;Stephan Eisenschenk ,&nbsp;Eugene Ramsay ,&nbsp;Nicole F. Maranchick ,&nbsp;Charles A. Peloquin ,&nbsp;Lawrence Hirsch ,&nbsp;Katharina M. Busl","doi":"10.1016/j.yebeh.2024.110082","DOIUrl":"10.1016/j.yebeh.2024.110082","url":null,"abstract":"<div><div>The outcomes of patients who experience status epilepticus during the post-cardiac arrest period, or post-anoxic status epilepticus (PASE), remain dismal despite advances in resuscitation. The combination of therapeutic nihilism and the refractoriness of seizures in a setting where pessimistic prognostic impressions prevail is likely the main driver of such poor outcomes. The resulting pervasive vicious cycle perpetuates this knowledge gap, whereby hypoxic-ischemic insults as the etiology for seizures remain a ubiquitous exclusion criterion for clinal trials in status epilepticus. Effective therapies targeting hyperexcitability resulting from hypoxic-ischemic brain injury are urgently needed. Early inhibition of gamma-aminobutyric acid (GABA) transaminase with vigabatrin holds potential as an effective adjunctive therapy for PASE. This scientific premise is based on the resulting halted GABA catabolism thereby promoting synergistic augmentation of GABAergic pathway when used in combination with positive GABAergic allosteric modulators. This paper is based on a lecture presented at the 9th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures, in London 8–10 April 2024.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406251","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}