Epilepsy & Behavior最新文献

{"title":"Surgical versus medical treatment of drug resistant epilepsy in children: Seizure and non-seizure outcomes","authors":"M.Scott Perry ,&nbsp;Dax Bourcier ,&nbsp;Paula Brna","doi":"10.1016/j.yebeh.2025.110269","DOIUrl":"10.1016/j.yebeh.2025.110269","url":null,"abstract":"<div><div>The goal of epilepsy treatment is to achieve the most significant seizure reduction, aiming for seizure freedom, in the absence of consequential adverse effects. For children with drug resistant epilepsy (DRE), surgical therapy may offer the best chance of seizure freedom, but is vastly underutilized. In cases where seizure freedom is not possible, surgery may still provide meaningful seizure reduction over that expected from continued medical management. In addition, seizure freedom and reduction can have meaningful impact on non-seizure outcomes including mortality, cognition, behavior, and cost of care. It is essential to compare the relative risks and benefits of continued medical therapy versus surgical therapy in order to best inform choice of treatment in pediatric DRE and avoid unnecessary delays. In this review, we explore the seizure and non-seizure benefits of epilepsy surgery, including curative procedures and those expected to result in meaningful seizure reduction, compared to continued medical management in children.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110269"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444649","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":"Integrating manual preprocessing with automated feature extraction for improved rodent seizure classification","authors":"An Yu ,&nbsp;Mannut Singh ,&nbsp;Abhineet Pandey ,&nbsp;Elizabeth Dybas ,&nbsp;Aditya Agarwal ,&nbsp;Yifan Kao ,&nbsp;Guangliang Zhao ,&nbsp;Tzu-Jen Kao ,&nbsp;Xin Li ,&nbsp;Damian S. Shin ,&nbsp;Ming-Ching Chang","doi":"10.1016/j.yebeh.2025.110306","DOIUrl":"10.1016/j.yebeh.2025.110306","url":null,"abstract":"<div><h3>Hypothesis/Objective</h3><div>Rodent models of epilepsy can help with the search for more effective drug candidates or neuromodulatory therapies. Yet, preclinical screening of candidate options for anti-epileptic drugs (AED) using rodent models may require hours of video monitoring. Data processing is also time-consuming, subjective, and error-prone. This study aims to develop an AI-enabled quantitative analysis of rodent behavior, including epilepsy stage classification.</div></div><div><h3>Approach/Method</h3><div>We leveraged deep learning and computer vision techniques to develop a semi-automatic pipeline and framework for animal seizure detection and recognition, which requires manual preprocessing of the dataset. Our hybrid approach combines model-based and data-driven methods but is dependent on manually preprocessed and segmented video clips to facilitate the automatic classification of epilepsy stages.</div></div><div><h3>Results</h3><div>We collected two datasets comprising rat skeleton keypoints and seizure behavior videos in the lab. The proposed method, PoseC3D, for rat seizure stage classification of the collected database achieved an accuracy between 64.7–90.3 % when tested on four different seizure phenotypes using the Racine classification scale.</div></div><div><h3>Conclusions</h3><div>This study demonstrates the feasibility of video-based seizure stage detection and classification for rodent models of temporal lobe seizures using a semi-automatic pipeline that requires manual preprocessing of data. However, our method is not capable of fully automated seizure detection and has not been tested on unseen animals, which limits its generalizability and applicability for broader use. Despite these limitations, the approach underscores our ability to undertake quantitative analysis of rodent behavior, which can also support other studies of animal behavior involving motor functions and future considerations for non-motor symptomology such as mood disorders.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110306"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444645","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":"Does the interval between the first unprovoked seizure and EEG influence the diagnostic yield?","authors":"Vaidehi Naganur ,&nbsp;Jacqueline Tse ,&nbsp;Jayan Muthusamy ,&nbsp;Shakira Snell ,&nbsp;Shuyu Wang ,&nbsp;Udaya Seneviratne","doi":"10.1016/j.yebeh.2025.110311","DOIUrl":"10.1016/j.yebeh.2025.110311","url":null,"abstract":"<div><h3>Objective</h3><div>There is no consensus on the optimum time for an EEG after the first seizure. We sought to investigate whether the timing of an EEG after a first unprovoked seizure influences its diagnostic yield.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted at a tertiary hospital in Australia. Adult patients who presented with a first unprovoked seizure were studied. Using multivariable logistic regression, we investigated the association of EEG timing, seizure presentation, and risk factors for epilepsy with the presence of interictal epileptiform discharges (IED) in the EEG as the outcome. The chi-square test compared EEG yields across each week after the seizure.</div></div><div><h3>Results</h3><div>Among 452 patients, the time from seizure to EEG did not show a statistically significant impact on the presence of IEDs (OR = 1, 95 % CI 0.99–1, p = 0.095). The yield of epileptiform abnormalities generally declined over time but was not statistically significant across weeks (p = 0.40). A modest but significant relationship was found between age and the likelihood of detecting IEDs, with older age associated with a lower yield of abnormalities (OR = 0.98, 95 % CI 0.973–0.997, p = 0.016).</div></div><div><h3>Conclusion</h3><div>Our results suggest that the timing of the EEG following the first unprovoked seizure does not significantly impact the diagnostic yield.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110311"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444648","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":"Stratifying cognitive and behavioral comorbidities in children with new-onset seizures – The influence of sociodemographic disadvantage","authors":"Karina Morales ,&nbsp;Tracy De Los Santos ,&nbsp;Danielle Harvey ,&nbsp;David Dunn ,&nbsp;Jana Jones ,&nbsp;Anna Byars ,&nbsp;Joan Austin ,&nbsp;Bruce Hermann ,&nbsp;Temitayo Oyegbile-Chidi","doi":"10.1016/j.yebeh.2025.110267","DOIUrl":"10.1016/j.yebeh.2025.110267","url":null,"abstract":"<div><h3>Rationale</h3><div>Children with new-onset epilepsy often experience co-morbid cognitive and behavioral challenges, which can be influenced by Social Determinants Of Health (SDOH) such as household income and parental education level. Although unsupervised machine learning has identified distinct cognitive and behavioral phenotypes at or near diagnosis, the relationship between these clusters remains underexplored. This study aims to examine the relationship between cognitive and behavioral clusters and the impact of SDOH among children with new-onset seizures.</div></div><div><h3>Methods</h3><div>We recruited 312 children (ages 6–16) within six weeks of their first recognized seizure. Each participant underwent a comprehensive neuropsychological assessment, from which factor analysis identified four primary domains: language, processing speed, executive function, and verbal memory. Parents also completed the Child’s Behavior Checklist (CBCL). K-means cluster analysis was applied to the mean factor scores and CBCL T-scores to identify unique clusters. We assessed SDOH factors, including maternal education level, child’s race, household income, and parental marital status, along with clinical epilepsy characteristics such as age at seizure onset, seizure frequency/intensity, seizure syndrome, MRI/EEG abnormalities, and neurologic examination findings to distinguish these clusters.</div></div><div><h3>Results</h3><div>We identified two primary clusters within both cognitive and behavioral scores: Resilient and At-Risk. Children in the Resilient Cognitive Cluster exhibited fewer behavioral problems, while those in the Resilient Behavior Cluster demonstrated higher cognitive performance. Conversely, the At-Risk Cognitive Cluster was associated with greater behavioral problems, and the At-Risk Behavior Cluster correlated with lower cognitive performance. Notably, almost two-thirds of participants showed congruence in clustering, either displaying resilience in both cognition and behavior or vulnerability in both domains. Resilient children exhibited lower levels of sociodemographic disadvantage, whereas those in the At-Risk Clusters faced significant disadvantages. Sociodemographic factors were more pronounced in differentiating clusters compared to traditional clinical epilepsy characteristics.</div></div><div><h3>Conclusions</h3><div>Among children with new-onset seizures, some display significant resilience to multimorbidities, while others are particularly vulnerable to neurobehavioral challenges, often linked to sociodemographic disadvantages. Future research should explore whether early interventions targeting SDOH can mitigate these risks and improve outcomes for children with new-onset epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110267"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444647","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":"Anticipatory guidance and care in pediatric and adult neurology for people with epilepsy who became pregnant","authors":"Amy K. Tao ,&nbsp;Jasmin Rivero-Guerra ,&nbsp;Katherine N. McFarlane ,&nbsp;Wesley T. Kerr ,&nbsp;Page B. Pennell ,&nbsp;Judy C. Chang ,&nbsp;Traci M. Kazmerski ,&nbsp;Elizabeth I. Harrison ,&nbsp;Laura Kirkpatrick","doi":"10.1016/j.yebeh.2025.110292","DOIUrl":"10.1016/j.yebeh.2025.110292","url":null,"abstract":"<div><h3>Objective</h3><div>To assess documentation of pregnancy-related counseling and care for people with epilepsy of childbearing potential (PWECP) in pediatric and adult neurology who became pregnant.</div></div><div><h3>Methods</h3><div>We reviewed health records for primigravida PWECP prescribed an antiseizure medication (ASM) who delivered between June 2014 and May 2024 within one academic medical center. We used chi-squared tests to compare counseling, ASM prescriptions, and recommendations for supplemental folic acid between individuals in pediatric and adult neurology care before pregnancy. We performed logistic regression for these outcomes of pre-pregnancy counseling associated with type of neurology care, race, ethnicity, intellectual disability (ID), teratogenic profile of ASMs prescribed, and ASM polytherapy.</div></div><div><h3>Results</h3><div>173 PWECP (84 % White non-Hispanic, 9 % with intellectual disability (ID) were included. Twenty-one (12 %) transferred from pediatric to adult neurology care due to pregnancy (“pediatric group”) and 152 (88 %) were previously established with adult neurology (“adult group”). PWECP in the pediatric group compared to the adult group had lower rates of documentation of clinician discussion of ASM teratogenicity (43 % vs 66 %, p = 0.041) and folic acid use (24 % vs 63 %, p = 0.001) before pregnancy. PWECP established with adult neurology prior to pregnancy were significantly more likely to have been taking folic acid before pregnancy (OR 5.21, 95 % CI 1.78–15.3). Individuals with ID were significantly less likely to have documentation of discussion of ASM teratogenicity (OR 0.18, 95 % CI 0.05–0.62).</div></div><div><h3>Conclusion</h3><div>Our findings suggest a need for improvement in providing pre-pregnancy guidance and care for PWECP, especially for PWECP in pediatric neurology care and those with ID.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110292"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444646","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":"Seizures exacerbate depressive symptoms in persons with epilepsy","authors":"Maria Pleshkevich ,&nbsp;Amit Ahituv ,&nbsp;Eden Tefera ,&nbsp;Anureet Kaur ,&nbsp;Dan V. Iosifescu ,&nbsp;Claude Steriade","doi":"10.1016/j.yebeh.2025.110304","DOIUrl":"10.1016/j.yebeh.2025.110304","url":null,"abstract":"<div><div>The mechanisms behind comorbid symptoms of depression in persons with epilepsy (PWE) remain largely unknown. Our study aimed to learn whether seizures moderate fluctuations in depressive symptoms in PWE when controlling for preictal symptoms of depression. We enrolled 57 adult PWE admitted to the New York University (NYU) Langone Epilepsy Monitoring Unit (EMU) from 2021 to 2024. Thirty-seven participants had a seizure. Twenty of the admitted patients did not have seizures during the admission period and therefore served as controls. All participants were seizure free for &gt; 7 days prior to participation. Upon admission, all participants completed the Montgomery-Asberg Depression Rating Scale (MADRS) to evaluate baseline mood. The MADRS was repeated acutely (4–24 h post seizure or admission) and subacutely (2–7 days post seizure or discharge) for both groups. Linear regression models revealed that individuals with higher baseline MADRS scores (indicating higher depressive symptoms) experienced worse mood acutely post-seizure, while lower baseline MADRS scores were associated with acute mood improvement (<em>R</em>² = 0.59, <em>p</em> &lt; 0.001). Experiencing a seizure was not associated with subacute mood outcomes, which were instead driven by acute mood state (<em>R</em>² = 0.56, <em>p</em> &lt; 0.001). In conclusion, we found that seizures exacerbate pre-ictal depressive symptoms and that post-ictal depressive symptoms persist up to 7 days after seizure resolution. This study may provide evidence for a bidirectional relationship and demonstrate a vicious cycle between depression and epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110304"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143452892","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":"Quantitative EEG biomarkers of cognitive performance in drug-resistant temporal lobe epilepsy","authors":"Sofía Lallana ,&nbsp;Samuel López-Maza ,&nbsp;Gemma Ortega ,&nbsp;Elena Fonseca ,&nbsp;Manuel Quintana ,&nbsp;Laura Abraira ,&nbsp;Enric Bellido ,&nbsp;Daniel Campos-Fernández ,&nbsp;Estevo Santamarina ,&nbsp;Agustín Ruiz ,&nbsp;Lluís Tárraga ,&nbsp;Mercè Boada ,&nbsp;Manuel Toledo","doi":"10.1016/j.yebeh.2025.110323","DOIUrl":"10.1016/j.yebeh.2025.110323","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to explore quantitative electroencephalography (qEEG) biomarkers of cognitive performance in drug-resistant temporal lobe epilepsy (TLE) and analyze their relationship with clinical characteristics.</div></div><div><h3>Methods</h3><div>Cross-sectional study including adult patients with drug-resistant TLE and a control group. Resting-state, eyes-closed qEEG samples were analyzed using the fast Fourier transform approach. Power spectral density was calculated for four frequency bands: delta (1–3.9 Hz), theta (4–7.9 Hz), alpha (8–12.9 Hz), and beta (13–18 Hz). Neuropsychological tests were administered to TLE patients.</div></div><div><h3>Results</h3><div>Twenty-nine TLE patients (mean age 42 ± 8.2 years; 44.8 % women) and 23 age- and sex-matched controls were enrolled. Clinically significant cognitive impairment was found in 86.2 % of patients (58.6 % amnestic). Compared to controls, TLE patients showed increased ipsilateral power spectral density for the theta (p = 0.045), alpha (p = 0.023) and beta bands in the anterior region (p = 0.029) and for the delta band in the posterior region (p = 0.03). Alpha/theta ratio (ATR) was lower in the posterior quadrant of the epileptogenic hemisphere (p = 0.013), and higher seizure frequency correlated with a lower ATR in the ipsilateral temporal region (r: −0.425; p = 0.021). Patients with amnestic cognitive impairment exhibited higher power spectral density across most frequency bands (p &lt; 0.005). Impaired verbal memory and executive function were associated with increased power density.</div></div><div><h3>Conclusion</h3><div>Increased power spectral density was evident in all frequency bands in the epileptogenic hemisphere, particularly in those patients with amnestic cognitive impairment. Moreover, higher seizure frequency correlated with a lower ATR in the temporal region. Power spectral analysis can provide useful information in drug-resistant TLE patients.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110323"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143452891","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":"Neuropsychological functioning in children and adolescents with pharmacoresistant epilepsy due to malformations of cortical development","authors":"Ana Arenivas ,&nbsp;Lisa Ferguson ,&nbsp;Brittany Lapin ,&nbsp;Yadi Li ,&nbsp;Ingmar Blumcke ,&nbsp;Imad Najm ,&nbsp;Robyn M. Busch","doi":"10.1016/j.yebeh.2025.110279","DOIUrl":"10.1016/j.yebeh.2025.110279","url":null,"abstract":"<div><h3>Purpose</h3><div>Almost half of pharmacoresistant epilepsies in childhood and adolescence are caused by malformations of cortical development (MCDs), but little is known about the associated neuropsychological morbidities. This study comprehensively characterized presurgical neuropsychological functions in children and adolescents with pharmacoresistant epilepsy due to MCDs and examined their relationships to neuropathological substrate and other clinical variables.</div></div><div><h3>Methods</h3><div>Retrospective data were obtained from 137 children and adolescents (mean age = 13 years; 58 % male) who underwent resective surgery for treatment of epilepsy and had pathologically-confirmed MCDs. Neuropsychological domain composite scores and overall cognitive phenotype were examined. Logistic regressions identified demographic and disease variables associated with neuropsychological functioning.</div></div><div><h3>Results</h3><div>Pathological diagnoses included focal cortical dysplasia (FCD, n = 69; 30 % FCD Type IIB, 20 % FCD Type IIA, 1 % FCD Type IA) and other MCDs (n = 68; 23 % mild MCD, 7 % polymicrogyria, 7 % tuberous sclerosis complex, 6 % complex MCD, 5 % mild MCD with oligodendroglial hyperplasia in epilepsy, 2 % periventricular nodular heterotopia). Performance was highly variable, ranging from superior to extremely low across cognitive domains. Impairment rates ranged from 40.1 % (visuospatial skills) to 70.8 % (fine motor skills). Of patients and parents/caregivers able to complete standardized inventories of mood and anxiety, approximately 20 % endorsed concerns for depression and anxiety. A large subset (29 %) demonstrated cognitive deficits limited to a single domain, with processing speed (24 %) and language (20 %) being the most commonly affected domains. Younger age at epilepsy onset and multilobar seizure locus were associated with lower cognitive performance across multiple domains. No significant differences in cognition existed between children and adolescents with focal cortical dysplasias and those with other MCDs.</div></div><div><h3>Conclusions</h3><div>Findings suggest the range of cognitive abilities in children and adolescents with MCDs is much broader than previously described, with over 20% demonstrating an intact cognitive phenotype. Despite high prevalence of cognitive impairment in this cohort, significant variability existed at the individual level that was not fully accounted for by demographic and clinical variables. Results highlight the importance of neuropsychological evaluation and routine emotional/behavioral screening in pediatric epilepsy caused by MCDs.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"Article 110279"},"PeriodicalIF":2.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444256","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":"Epilepsy surgery in patients with Sturge-Weber Syndrome","authors":"Maria Augusta Montenegro ,&nbsp;Kette D. Valente ,&nbsp;Matheus Dorigatti Soldatelli ,&nbsp;Leticia Brito Sampaio ,&nbsp;Anna Leticia Pinto","doi":"10.1016/j.yebeh.2025.110312","DOIUrl":"10.1016/j.yebeh.2025.110312","url":null,"abstract":"<div><div>Sturge-Weber Syndrome (SWS) is a neurovascular condition caused by a mutation in the GNAQ gene. The most common neurological manifestations of SWS are epilepsy, developmental delay, and stroke-like episodes. Seizures are often the first neurological symptom, and most patients have drug-resistant epilepsy. Predictors for unfavorable epilepsy outcomes and the need for ASM polytherapy included age of onset, bilateral brain involvement, extensive unilateral hemispheric disease, and a positive family history of epilepsy. The surgical approach to SWS is challenging due to the associated abnormal vasculature and potential complications. Hemispherotomy is associated with high seizure freedom rates and ASM discontinuation, but resective surgery may be an efficient alternative in well-selected patients. Complete seizure control is the ultimate goal of epilepsy surgery; however, reducing seizure severity and frequency may help improve cognitive outcome and quality of life.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110312"},"PeriodicalIF":2.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437139","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":"Efficacy of ACTH therapy in children with Landau-Kleffner Syndrome and Autism Spectrum Disorder: A retrospective analysis","authors":"Attila Altunel ,&nbsp;Aynur Muduroglu-Kirmizibekmez ,&nbsp;Alparslan Onder ,&nbsp;Ozlem Altunel ,&nbsp;Ali Sever ,&nbsp;Ihsan Kara","doi":"10.1016/j.yebeh.2025.110308","DOIUrl":"10.1016/j.yebeh.2025.110308","url":null,"abstract":"<div><h3>Background</h3><div>Landau-Kleffner Syndrome (LKS) and Autism Spectrum Disorder (ASD), both neurodevelopmental disorders, are frequently associated with epileptic seizures and characteristic epileptiform activity. Electrical Status Epilepticus during Sleep (ESES) is commonly observed in LKS, while Interictal Epileptiform Discharges (IEDs) are typical in ASD. Adrenocorticotropic hormone (ACTH) treatment has demonstrated the potential to reduce the indexes of these related discharges and the number of seizures.</div></div><div><h3>Objective</h3><div>This retrospective study aimed to assess the response to ACTH treatment in children diagnosed with LKS or ASD, both with and without epileptic seizures.</div></div><div><h3>Methods</h3><div>The study included 236 children, with separate analyses performed for those diagnosed with LKS or ASD. EEG recordings and treatment outcomes were retrospectively evaluated. Key assessments included changes in the indexes of ESES and IED, seizure control rates, and reported side effects.</div></div><div><h3>Results</h3><div>ACTH treatment led to significant improvements in indexes and seizure control in both LKS and ASD populations. In children with LKS and epileptic seizures, the mean ESES index reduction was 49.9 % (±17.7), with 50 % achieving complete seizure control. For children with ASD and epileptic seizures, the mean IED index reduction was 47.2 % (±16.7), with 41 % achieving complete seizure control. Rare side effects were transient and reversible, with no reports of serious adverse events.</div></div><div><h3>Conclusion</h3><div>ACTH treatment demonstrates efficacy in reducing ESES and IED indexes and controlling seizures in children with LKS and ASD. These findings underscore the importance of early intervention and careful management of side effects in optimizing outcomes for these patient populations.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110308"},"PeriodicalIF":2.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437131","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}