Epilepsy & Behavior最新文献

{"title":"Levetiracetam in epilepsy and autism spectrum disorder: analysis of safety, tolerability, and efficacy","authors":"Jon Allard ,&nbsp;William Henley ,&nbsp;Brendan McLean ,&nbsp;Lance Watkins ,&nbsp;Mary Parrett ,&nbsp;Sanjeev Rajakulendran ,&nbsp;Melissa Maguire ,&nbsp;Shan Ellawela ,&nbsp;Phil Tittensor ,&nbsp;Juliet Bransgrove ,&nbsp;Arjune Sen ,&nbsp;Rajiv Mohanraj ,&nbsp;Many Bagary ,&nbsp;Sunil Ram ,&nbsp;Sarah Pashley ,&nbsp;Rohit Shankar","doi":"10.1016/j.yebeh.2025.110678","DOIUrl":"10.1016/j.yebeh.2025.110678","url":null,"abstract":"<div><h3>Purpose</h3><div>One in five people with autism spectrum disorder have epilepsy and take Anti-Seizure Medications (ASM). However, the impact of ASM on people with autism is under researched. This study evaluates the efficacy and tolerability of Levetiracetam (LEV) for autistic people and epilepsy.</div></div><div><h3>Method</h3><div>Data was derived from the English Epilepsy Research Database Register which compares ASM responses in those with neurodevelopmental disorders to those without. Age range was 18–50 years as there were no autistic research participants with autism prescribed LEV over 50. Twelve-month ASM data, including withdrawal rate, seizure frequency and adverse effects were compared. Fisher’s exact test was used to assess univariate associations between outcomes and autism with significance accepted as p &lt; 0.05. Logistic regression was used to assess autism group differences after adjustment for potential confounders (age, gender, presence of baseline physical and mental health conditions).</div></div><div><h3>Results</h3><div>Of 175 (aged 18–50) research participants across 18 NHS Trusts, prescribed LEV between 2000 and 2020, 40 were autistic. There was no significant association between withdrawal rate (P = 0.626), or grouped side effects (physical P = 0.165, mental health P = 0.791). Autism was significantly associated with aggression with LEV in univariable analysis but this association was no longer significant after accounting for multiple testing A significant non-linear relationship between efficacy and the autism group (P &lt; 0.001) was found.</div></div><div><h3>Conclusions</h3><div>This study supports the use of LEV for people with autism and epilepsy as there is no difference in response noted to those without autism. However, they may have less prominent changes in efficacy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110678"},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908810","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 and safety of perampanel in critically ill pediatric patients with refractory and super‐refractory status epilepticus: a retrospective study from a Chinese tertiary medical center","authors":"Rui Qu ,&nbsp;Anmin Han ,&nbsp;Lingjian Meng ,&nbsp;Xiangju Qu ,&nbsp;Yali Zhu ,&nbsp;Yuanyuan Dai","doi":"10.1016/j.yebeh.2025.110655","DOIUrl":"10.1016/j.yebeh.2025.110655","url":null,"abstract":"<div><h3>Objective</h3><div>Status epilepticus (SE) is a life-threatening neurological emergency in critically ill children. Limited data exist regarding the use of perampanel for benzodiazepine-resistant SE in this population. This study was conducted to evaluate the effectiveness and safety of perampanel in Chinese critically ill children and adolescents with SE.</div></div><div><h3>Methods</h3><div>This retrospective observational study was conducted from March 2020 to March 2025 at a tertiary hospital in China. Efficacy was defined as seizure cessation within 72 h of perampanel administration, confirmed by clinical and continuous video electroencephalograph monitoring. Adverse effects were defined using predefined criteria, primarily within 7 days post-administration.</div></div><div><h3>Results</h3><div>Of 237 pediatric patients identified as experiencing SE, 32 (13.5 %) received perampanel, including 15 females with median age 12.0 years (range, 4.3–17.0 years; IQR, 8.8–16.0 years). The overall response rate was 40.6 %, highest in the focal motor SE group (8/12, 66.7 %) compared to the generalized tonic-clonic seizures (3/10, 30.0 %) and nonconvulsive status epilepticus groups (2/10, 20.0 %). Non-responders had a higher maximal perampanel dose compared to responders. Among responders, those receiving concomitant midazolam required a lower dose versus those without midazolam. No significant liver enzyme elevation was noted pre- and post- perampanel administration.</div></div><div><h3>Significance</h3><div>Our data support the efficacy of perampanel in treating refractory-SE and super-refractory SE in critically ill pediatric patients and variability in treatment response based on the different subtypes of SE. Combination therapy with midazolam might reduce the perampanel dose required to achieve seizure cessation. However, further studies are warranted in a larger patient population.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110655"},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908809","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":"Electroclinical features and surgical outcome of cingulate epilepsy","authors":"Cuiping Xu ,&nbsp;Di Wu ,&nbsp;Xiaoming Yan ,&nbsp;Xiaohua Zhang ,&nbsp;Runshi Gao ,&nbsp;Duanyu Ni ,&nbsp;Xi Zhang ,&nbsp;Xueyuan Wang ,&nbsp;Liang Qiao ,&nbsp;Kai Ma ,&nbsp;Yuping Wang ,&nbsp;Tao Yu ,&nbsp;Liankun Ren","doi":"10.1016/j.yebeh.2025.110665","DOIUrl":"10.1016/j.yebeh.2025.110665","url":null,"abstract":"<div><h3>Background</h3><div>Cingulate epilepsy is rare and can manifest with variable semiology features. The symptomatic diversity elucidates ictal involvement of certain subregions of the cingulate gyrus and early spread patterns. Knowledge of the features of cingulate epilepsy is important for better localization and surgical strategy.</div></div><div><h3>Objective</h3><div>The purpose of this study was to characterize the electroclinical features and report our experience in the diagnosis and surgical treatment of patients with focal epilepsy originating from the cingulate gyrus.</div></div><div><h3>Methods</h3><div>Thirty-one patients with epilepsy were retrospectively analyzed (mean age, 21; range 2–48), who had a mean epilepsy duration of 10 years (range 1–23). We report the clinical semiology, the scalp electroencephalography (EEG)/stereo-electroencephalography (SEEG) findings, surgical strategy, and postoperative follow-up (mean 48 months; range 12–136).</div></div><div><h3>Results</h3><div>Twelve patients (38.7 %) had circumscribed lesions on magnetic resonance imaging (MRI). All patients underwent noninvasive presurgical evaluation, and 26 (83.9 %) underwent invasive recordings with SEEG (n = 18) or subdural electrodes (n = 8). The ictal patterns of scalp EEG were various. The anterior cingulate epilepsy (ACE) patients showed ipsilateral frontal, frontal-temporal, or bifrontal regions discharges. The ictal discharges involved the ipsilateral frontal, temporal, or central-parietal regions in patients with middle cingulate epilepsy (MCE), and the posterior cingulate epilepsy (PCE) patients showed ipsilateral temporal, occipital-temporal, bitemporal-parietal, or generalized discharges. Secondary generalization seizures originated from each subregion of the cingulate gyrus. The ACE patients showed hypermotor seizures, including twisting trunk, pedaling, and flailing. Limbs or body trembling was observed in both MCE and PCE patients, and dialeptic seizures were observed in PCE patients. 58.1 % of patients were seizure-free, and 77.4 % had a satisfactory surgical outcome (Engel I and II).</div></div><div><h3>Conclusions</h3><div>Cingulate epilepsy is a rare and diagnostically challenging form of epilepsy with diverse and variable electroclinical features. In patients with non-lesional MRI, invasive recording is required to identify defined seizure focus, and the surgical outcome of 1-year follow-up is favorable.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110665"},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908811","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 Epilepsy Surgery Satisfaction Questionnaire (ESSQ-19): linguistic adaptation and validation of the Russian version","authors":"F. Rider ,&nbsp;A. Turchinets ,&nbsp;M. Zinchuk ,&nbsp;G. Kustov ,&nbsp;O. Tikhonova ,&nbsp;S. Popova ,&nbsp;A. Yakovlev ,&nbsp;S. Wiebe ,&nbsp;V. Krylov ,&nbsp;A. Guekht","doi":"10.1016/j.yebeh.2025.110676","DOIUrl":"10.1016/j.yebeh.2025.110676","url":null,"abstract":"<div><h3>Objective</h3><div>Satisfaction with epilepsy surgery is an important patient-reported outcome that provides a patient-centered view of the overall effects of surgery. We aimed to validate the Russian version of the Epilepsy Surgery Satisfaction Questionnaire (Ru-ESSQ-19).</div></div><div><h3>Methods</h3><div>Patients with focal drug-resistant epilepsy (PDRE) who underwent epilepsy surgery between January 2014 and January 2023 were recruited at least one year after surgery. Clinical and demographic data were collected. Following translation and back-translation, patients completed the Ru-ESSQ-19 and a set of validated questionnaires to assess construct validity. Spearman’s rank correlation assessed construct validity, and Cronbach’s alpha evaluated internal consistency. Multiple linear regression was used to identify postoperative predictors of satisfaction with surgery.</div></div><div><h3>Results</h3><div>Sixty-six of 119 eligible patients residing in Moscow participated in the study. The questionnaire demonstrated high internal consistency in the four domains (Cronbach’s alpha = 0.74–0.93). The ESSQ-19 mean summary score was 74.6 (SD 18) and had significant correlations in the expected direction with other measures, such as quality of life and seizure-related disability. The questionnaire also demonstrated good discriminant validity for predicting 1 year seizure freedom (AUC = 0.78, 95 % CI = 0.67–0.88) and self-rating epilepsy as disabling (AUC = 0.85, 95 % CI = 0.74–0.93). Seizure-related disability and number of anti-seizure medications were the main predictors of satisfaction with epilepsy surgery.</div></div><div><h3>Conclusion</h3><div>The Russian version of the ESSQ-19 is a reliable and valid self-reported questionnaire for assessing patient satisfaction with epilepsy surgery. This study is the first to provide insights into the level of satisfaction with epilepsy surgery in Russian patients.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110676"},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908812","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":"Balancing foetal disadvantage and seizure freedom in women capable of pregnancy – the Australian pregnancy register experience","authors":"Frank Vajda ,&nbsp;Terence J. O’Brien ,&nbsp;Janet Graham ,&nbsp;Alison Hitchcock ,&nbsp;Piero Perucca ,&nbsp;Cecilie Lander ,&nbsp;Mervyn Eadie","doi":"10.1016/j.yebeh.2025.110663","DOIUrl":"10.1016/j.yebeh.2025.110663","url":null,"abstract":"<div><h3>Objective</h3><div>To determine which antiseizure medications (ASMs) provide the best overall compromise between a lower risk of foetal malformation and continuing control of maternal epilepsy during pregnancy.</div></div><div><h3>Methods</h3><div>Analysis of relevant data on women taking one of the 5 most commonly prescribed ASMs (levetiracetam (LEV), lamotrigine (LTG), carbamazepine (CBZ). Topiramate (TPM) and valproate (VPA)) in 2403 pregnancies of women with epilepsy (WWE) contained in the Raoul Wallenberg Australian Pregnancy Register of Antiepileptic Drugs (APR).</div></div><div><h3>Results</h3><div>LEV offered the greatest advantage with regard to low risk of foetal malformation, followed by LTG, then CBZ and then VPA. In relation to preserving seizure freedom throughout pregnancy valproate (VPA) was best, followed by LEV and CBZ, then LTG. When these individual rankings, equally weighted, were combined, LEV scored highest, followed by VPA and then LTG and CBZ (equal). However, if avoiding foetal malformation was weighted more heavily, the sequence became LEV, then LTG and CBZ, and then VPA. TPM rated poorly to all criteria assessed.</div></div><div><h3>Significance</h3><div>Overall, LEV appeared the most advantageous ASM to employ in the population studied, balancing the risk of foetal malformations with the chance of maintaining seizure control. This outcome is broadly in conformity with prescriber behaviour determined largely by trial-and-error experience in contemporary Australian practice.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110663"},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913142","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, safety and tolerability of adjunctive cenobamate in pediatric and adult patients with Lennox Gastaut Syndrome","authors":"A.W. Pong,&nbsp;M. Wehland,&nbsp;P. Klein","doi":"10.1016/j.yebeh.2025.110660","DOIUrl":"10.1016/j.yebeh.2025.110660","url":null,"abstract":"<div><div>Lennox-Gastaut Syndrome (LGS) is a severe developmental epileptic encephalopathy of childhood consisting of a triad of drug refractory epilepsy with multiple seizure types, cognitive impairment, and a characteristic electroencephalogram (EEG). Cenobamate (CNB) is a novel antiseizure medication (ASM) effective against focal epilepsy. Proposed mechanisms of action include inactivation of persistent sodium currents and weak positive allosteric modulation of synaptic (phasic) and extrasynaptic (tonic) GABAA receptors. This is a single center study 16 LGS patients receiving CNB (F = 6, pediatric 8, median age 20y (range 9–38). Mean CNB exposure was 735 days with 81 % (13/16) continuing CNB at last follow up. RR was &gt; 50 % in 75 % (12/16), &gt;75 % in 56 % (916), &gt; 90 % in 38 % (6/16) and 100 % in 31 % (5/16) of patients. Duration of seizure freedom at the time of the data analysis ranged from 107 − 681 days, with 3/16 (19 %) seizure free for &gt; 6 months, including 2 (13 %) for 1 year. Seizure frequency increased in three patients. In all three, there was an initial seizure improvement at lower doses of up to 50 mg/d, followed by seizure exacerbation at doses up to 350 mg/d, with return to baseline after dose reduction. <em>Safety and Tolerability</em> (n = 16): 44 % patients (n = 7) developed TEAEs: somnolence (n = 5, 31.25 %), ataxia (n = 2, 12.5 %), aggression/agitation (n = 2, 12.5 %), and one (6.25 %) each dizziness, headache, blurry vision and insomnia. 4 patients had more than one reported AE. Positive side effects (cognition, behavior, verbal communication, mood, sleep) were reported in 63 % (10/16). 44 % patients (n = 7) developed TEAEs: somnolence (5), insomnia (1), ataxia (2), dizziness (1), aggression/agitation (2), and headache with blurry vision (1). 19 % (n = 3) discontinued due to TEAE (somnolence n = 2 and increased seizures (n = 3). TEAEs were generally mild to moderate. Post-CNB EEG were available for 5 patients (aged 9–18 yrs) and showed no change in one patient, partial improvement in 2 patients and complete remission of interictal epileptiform discharges (IEDs) in 2 patients. Our data suggest promising efficacy and good tolerability of adjunctive CNB treatment in LGS patients with varied etiologies. A prospective randomized controlled study of cenobamate in LGS patients is warranted.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110660"},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic screening for epilepsy, functional neurological disorder, and other paroxysmal disorders: A clinical survey study","authors":"Dominique Eden ,&nbsp;Philippa J. Karoly ,&nbsp;Benjamin H. Brinkmann ,&nbsp;Brian N. Lundstrom ,&nbsp;Nicholas M. Gregg ,&nbsp;Ewan S. Nurse ,&nbsp;Jeff R. Anderson ,&nbsp;John D. Halamka ,&nbsp;Dean R. Freestone","doi":"10.1016/j.yebeh.2025.110672","DOIUrl":"10.1016/j.yebeh.2025.110672","url":null,"abstract":"<div><h3>Objective</h3><div>Seizures, or seizure-like events, can indicate over 50 neurological disorders, and interpretation of patient-reported symptoms is subjective, leading to misdiagnosis. This study aimed to determine diagnostic utility of multi-choice questions to assess seizures in a clinical setting.</div></div><div><h3>Patients &amp; methods</h3><div>This retrospective study of Mayo Clinic neurology patients (2016 – 2021) analysed de-identified Electronic Health Records from adults with a paroxysmal disorder who completed Mayo Clinic’s ‘Epilepsy Pre-screening Questionnaire’. Diagnostic groups were epilepsy, functional neurological disorder (FND), syncope, and other neurological disorders. The main outcome was group-level separability of survey responses between diagnostic groups (assessed from response proportions using a chi-squared test with Holm-Sidak correction for multiple comparisons).</div></div><div><h3>Results</h3><div>4,130 records were included for epilepsy (n = 3,194), FND (n = 214), syncope (n = 101), other (n = 621). Seven multichoice questions provided significant separability between diagnostic groups, with event duration, specific warnings and symptoms providing greatest diagnostic utility. Those with syncope were significantly more likely to report short events, of a few seconds, compared to every other group (syncope: 27 %, other: 11 %, epilepsy: 9 %, FND: 1 %). People with FND were also significantly more likely to report events &gt; 7 min (27 %), compared to those with epilepsy (11 %). Conversely, events lasting &lt; 1 min were still reported by 23 % of people with FND and long seizures (&gt;7 mins) were reported by almost 10 % of people with epilepsy. Pre-seizure warnings were similar for focal and generalised epilepsy, contradicting the assumption that auras are mainly associated with focal epilepsy.</div></div><div><h3>Conclusion</h3><div>The results validate the diagnostic utility of general questions about event duration, related symptoms and comorbidities in a meaningfully sampled patient cohort that was representative of people presenting with seizures or seizure-like events presumed to be epilepsy (i.e. not people presenting with an obvious diagnosis of non-epileptic seizures). Findings could inform development of standardised, patient-reported surveys to aid differential diagnosis across common neurological conditions.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110672"},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908861","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":"Generative artificial intelligence-mediated counselling on first aid for seizures: The performance of publicly available chatbot versus its customised version","authors":"Alexei A. Birkun ,&nbsp;Yekaterina Kosova ,&nbsp;Anton Rudenko","doi":"10.1016/j.yebeh.2025.110680","DOIUrl":"10.1016/j.yebeh.2025.110680","url":null,"abstract":"<div><h3>Background</h3><div>The potential application of cutting-edge generative artificial intelligence chatbots in the capacity of emergency consultants is gaining growing attention. This study aimed to analyse the quality of advice on first aid for seizures generated by a commercially developed chatbot in comparison with its customised version.</div></div><div><h3>Methods</h3><div>The baseline version of ChatGPT (model GPT-4o) and the same chatbot customised using a specialised knowledge base and prompt engineering were tested in four scenarios mimicking bystander requests for instructions on how to help a victim with seizures. The scenarios included ongoing seizures and postictal states, with or without consciousness and breathing. A checklist-based evaluation was conducted.</div></div><div><h3>Results</h3><div>In total, 120 user-to-chatbot dialogues were generated (2 chatbots × 15 dialogues × 4 scenarios). The baseline chatbot always failed to consider the victim’s state, including whether the seizures are continuing, or if the victim in the postictal period is conscious and breathing normally. Its advice was non-selective and inaccurate, with frequent omissions of key recommendations on first aid and suggestions of inadequate measures. The customised chatbot-generated guidance was consistently tailored to the victim’s condition, significantly more precise and completely safe. Depending on the scenario, the mean percentage of chatbot responses that fulfilled the checklist items was 14–49 % for the baseline chatbot and 77–92 % for the customised version (<em>p</em> ≤ 0.039).</div></div><div><h3>Conclusions</h3><div>Whereas the publicly available version of the chatbot is not acceptable for first aid counselling, its expert-informed customisation ensures high accuracy and safety of generated advice. Further research in this field is advisable.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110680"},"PeriodicalIF":2.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903961","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":"Understanding Children’s experiences of Long-Term Video-Electroencephalography monitoring in Drug-Resistant epilepsy","authors":"Matilda Modigh ,&nbsp;Heléne Sundelin ,&nbsp;Ronny Wickström ,&nbsp;Cecilia Bartholdson","doi":"10.1016/j.yebeh.2025.110664","DOIUrl":"10.1016/j.yebeh.2025.110664","url":null,"abstract":"<div><h3>Objective</h3><div>To explore children’s experiences of undergoing long-term video-electroencephalography monitoring (LTVEM) as part of the diagnostic process for epilepsy. Methods: This study employed a qualitative research design, specifically utilizing an exploratory approach to gain empirical knowledge and deep understanding of children’s experiences. Semi-structured interviews were conducted with 18 children aged 8–17 years who had recently undergone LTVEM. Data were analyzed using content analysis. Results: This study is the first to empirically examine children’s perspectives on LTVEM. Three main categories were identified: <em>Hope for improvement as a motivating factor, The importance of psychosocial safety, and Physical and psychological discomfort</em>. Contrary to expectations that children might find monitoring 24/7 intrusive or distressing, participants described a strong motivation to undergo the procedure, embedded in the hope of receiving a diagnosis and achieving seizure control. This sense of purpose outweighed the short-term discomforts of hospitalization, including physical restraints, sleep disruptions, and emotional distress. Children viewed LTVEM as a necessary and even empowering step toward better health, demonstrating considerable trust in the healthcare system. Notably, being accompanied by a guardian was consistently described as essential for emotional safety, regardless of the child’s age. Significance: These findings offer critical insight into the experiences and coping strategies of children undergoing LTVEM. Understanding these perspectives can inform clinical practice by promoting child-centered care and improving the planning of pediatric LTVEM admissions. The results also support the development of national guidelines that reflect the voices and needs of children, ensuring more supportive, individualized care experiences.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110664"},"PeriodicalIF":2.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903960","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":"Challenges in the management of epilepsy associated with posterior gliosis secondary to perinatal brain injury","authors":"Vrajesh Udani","doi":"10.1016/j.yebeh.2025.110645","DOIUrl":"10.1016/j.yebeh.2025.110645","url":null,"abstract":"<div><div>Posterior gliosis is a major substrate underlying drug resistant epilepsy (DRE) in children and young adults in low-middle income countries. Neonatal hypoglycemia and prolonged partial asphyxia either isolated or combined are major risk factors for posterior gliosis. The epilepsy associated with posterior gliosis has a spectrum of severity with early onset drug resistant epileptic encephalopathies with disabling co-morbidities at one end and pharmaco-responsive focal epilepsy in a normal child at the other. Intermediate severity syndromes are common. Disabling co-morbidities are typically cognitive and visual with sparing of motor skills. The imaging spectrum consist of bilateral symmetric or asymmetric parieto-occipital gliosis though unilateral occipital lesions are not uncommon. EEG too has a wide range of abnormalities but is of limited benefit in localisation and lateralisation. Standard management strategies for posterior gliosis associated epilepsy offer unique challenges in low-middle income countries where more DRE is encountered. Issues in anti-seizure medication (ASM) treatments and ketogenic diet are highlighted. Resective surgery for unilateral/asymmetric bilateral gliosis has an established place. Challenges remain in predicting post-operative visual deficits. The use of resting state fMRI is discussed. Seizure freedom is achievable in ∼25 % of medically managed patients, though ASM discontinuation fails in the majority.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110645"},"PeriodicalIF":2.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903996","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}