Epilepsy & Behavior最新文献

{"title":"The 9th annual Lafora science symposium: a rare epilepsy community makes progress towards clinical readiness","authors":"Meredith I. Williams ,&nbsp;Katherine J. Donohue ,&nbsp;Pascual Sanz ,&nbsp;Souad Messahel ,&nbsp;Jose M. Serratosa ,&nbsp;Jordi Duran ,&nbsp;Roberto Michelucci ,&nbsp;Lorenzo Muccioli ,&nbsp;Antonio Delgado-Escueta ,&nbsp;Viet-Huong V. Nguyen ,&nbsp;Berge A. Minassian ,&nbsp;Matthew S. Gentry","doi":"10.1016/j.yebeh.2025.110654","DOIUrl":"10.1016/j.yebeh.2025.110654","url":null,"abstract":"<div><div>Lafora disease (LD) is a fatal childhood progressive myoclonus epilepsy and glycogen storage disease that is caused by recessive mutations in either <em>EPM2A</em> or <em>EPM2B</em>. The hallmarks of LD are cytoplasmic, aberrant glycogen-like aggregates, called Lafora bodies (LBs), that drive disease progression. The 9th Annual Lafora Science Symposium was held in San Diego, California and brought together over 70 researchers, clinicians, academic trainees, and friends and family members of patients with LD and 80 attendees joined virtually. This symposium focused primarily on international collaborations for therapeutic development and biomarker identification and strategies for preparing the Lafora community for upcoming clinical trials.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110654"},"PeriodicalIF":2.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947403","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":"Clinical correlates of epilepsy self-management adherence among Hispanic people with epilepsy: Findings from the managing epilepsy well (MEW) network integrated database","authors":"Ross Shegog ,&nbsp;Farren B.S. Briggs ,&nbsp;Refugio Sepulveda ,&nbsp;Tanya M. Spruill ,&nbsp;Erica K. Johnson ,&nbsp;Barbara C. Jobst ,&nbsp;Elaine Kiriakopoulos ,&nbsp;Nicole Fiorelli ,&nbsp;Martha Sajatovic","doi":"10.1016/j.yebeh.2025.110649","DOIUrl":"10.1016/j.yebeh.2025.110649","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy self-management (ESM) by people living with epilepsy (PWE) can reduce seizure frequency and increase quality of life (QOL). ESM among Hispanic PWE is under-investigated and lacks adequate sampling and ESM assessment. The purpose of this study was to assess ESM and associated variables among Hispanic PWE using aggregate data from the Managing Epilepsy Well Network Integrated Database.</div></div><div><h3>Methods</h3><div>The sample comprised Hispanic PWE (n = 211) from nine ESM intervention studies that used common measures for socio-demographics, health status, prior 30- day seizures, depression (PHQ-9, NDDI-E), QOL (QOLIE-10), and ESM.</div></div><div><h3>Results</h3><div>The sample was 39.3 (±12.8) years, mostly female (56.1 %), preferring Spanish language (59 %), U.S. born (62.2 %), high school or college educated (35.7 %), single/partnered (43.9 %/41.0 %), employed/unemployed (33.0 %/32.1 %), with income &lt;$25,000 (59.0 %), with depressive symptoms (35.1 %), and a seizure in the past month (52.5 %). Total ESM item mean scores were positively skewed (3.6 ± 0.4 on a 5-point scale). Medication, seizure, and safety management exceeded that for information and lifestyle management. In adjusted multivariable models, medication management was associated with age and employment (homemaker) and inversely associated with marital status (never married) and depression. Lifestyle management was associated with employment (unable to work) and inversely associated with sex (female), depression, and QOL.</div></div><div><h3>Conclusion</h3><div>Hispanic PWE were more competent in managing the medical aspects of their condition than lifestyle and informational issues. This study is significant because it leverages the analytic power of a large aggregate Hispanic PWE sample to describe ESM and can inform future study design, data collection, and tailoring of ESM interventions.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110649"},"PeriodicalIF":2.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903962","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":"Women with epilepsy during pregnancy: A systematic review of current guidelines","authors":"Zhu Liu ,&nbsp;Qiulei Hong ,&nbsp;Luyan Huang ,&nbsp;Leihao Sha ,&nbsp;Anjiao Peng ,&nbsp;Lei Chen","doi":"10.1016/j.yebeh.2025.110658","DOIUrl":"10.1016/j.yebeh.2025.110658","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically evaluate the quality of existing guidelines for the management of pregnancy in women with epilepsy (WWE) and compare their key recommendations.</div></div><div><h3>Methods</h3><div>A systematic review of available clinical practice guidelines and expert consensus statements was conducted. The quality of the literature was assessed using the Appraisal of Guidelines for Research &amp; Evaluation II (AGREE II) instrument. Core information was extracted using a predefined form and subjected to comparative analysis.</div></div><div><h3>Results</h3><div>Only 14 guidelines on WWE pregnancy management have been published worldwide. Most guidelines performed well in scope definition, clarity of purpose, and presentation, but the evidence base was relatively weak. Recommendations were largely consistent across guidelines regarding preconception counseling, folic acid supplementation, vaginal delivery, breastfeeding, and avoidance of valproate. However, discrepancies were observed in the selection of certain antiseizure medications (ASMs), therapeutic drug monitoring, and the timing and dosage of folic acid supplementation. Current guidelines lack recommendations on newer ASMs and antinociceptive management during delivery.</div></div><div><h3>Conclusion</h3><div>The variability in recommendations among WWE pregnancy management guidelines reflects the insufficiency of the existing evidence base, highlighting the need for enhanced methodological rigor in guideline development and more comprehensive, evidence-based recommendations. Establishing large-scale prospective pregnancy registries is critical for improving WWE pregnancy management guidelines.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110658"},"PeriodicalIF":2.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903958","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":"Unmet needs and challenges faced by caregivers in tuberous sclerosis complex: An integrative review","authors":"Katerina Poprelka ,&nbsp;Theodoros Fasilis ,&nbsp;Panayiotis Patrikelis ,&nbsp;Maria Stefanatou ,&nbsp;Evniki Ntinopoulou ,&nbsp;Anastasia Verentzioti ,&nbsp;Athanasia Alexoudi ,&nbsp;Lampis C. Stavrinou ,&nbsp;Stefanos Korfias ,&nbsp;Stylianos Gatzonis","doi":"10.1016/j.yebeh.2025.110659","DOIUrl":"10.1016/j.yebeh.2025.110659","url":null,"abstract":"<div><h3>Purpose</h3><div>The burden of disease associated with tuberous sclerosis complex (TSC) places significant strain on both individuals with the condition and their families. Research has primarily focused on patients, with limited attention to caregiver experiences. This review aims to summarize current knowledge, identify key burden factors, and highlight the unmet needs of caregivers in TSC.</div></div><div><h3>Methods</h3><div>This review was conducted following PRISMA guidelines. A comprehensive search of electronic databases was carried out to identify original research articles. Two reviewers independently screened the studies for eligibility. The quality of the included studies was assessed using the AXIS tool. Relevant data were extracted, and a narrative synthesis was performed to collate and interpret the findings.</div></div><div><h3>Results</h3><div>Nine studies involving a total of 982 informal caregivers of both children and adults with TSC were included in the review. All included studies were carried out in Europe and the United States. Five primary factors, namely the care recipient’s age, caregivers’ characteristics, disease-related features, caregivers’ compromised mental health, and disrupted family dynamics, were identified as central themes in shaping caregivers’ experiences. Caregivers consistently reported a range of unmet needs, including inadequate access to psychological support, insufficient information about TSC management, and a lack of coordinated healthcare services.</div></div><div><h3>Conclusion</h3><div>Caregivers of individuals with TSC face significant challenges, yet meaningful support is limited. More research is needed to understand their burden, while developing tailored support, better resource access, and coordinated care are essential to improve their well-being and care quality.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110659"},"PeriodicalIF":2.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144904006","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":"Meteorological influences on seizure occurrence in children with epilepsy: a case-crossover analysis","authors":"Yuto Arai ,&nbsp;Tohru Okanishi ,&nbsp;Hisashi Noma ,&nbsp;Hiroshi Sunada ,&nbsp;Sotaro Kanai ,&nbsp;Masami Togawa ,&nbsp;Takako Ohno ,&nbsp;Toshiaki Tanaka ,&nbsp;Hiroyuki Yamada ,&nbsp;Masanori Maeda ,&nbsp;Takeshi Matsushige ,&nbsp;Yoshihiro Maegaki","doi":"10.1016/j.yebeh.2025.110667","DOIUrl":"10.1016/j.yebeh.2025.110667","url":null,"abstract":"<div><h3>Purpose</h3><div>Research on the association between meteorological conditions and epileptic seizures in children with epilepsy (CWE) remains limited. This study aimed to evaluate the effects of atmospheric pressure, temperature, and humidity on seizure occurrence in CWE.</div></div><div><h3>Methods</h3><div>We conducted a multicenter prospective observational study involving CWE under 16 years of age who had experienced seizures more than once per year but less than once per week over the past year. Participants were enrolled between November 1, 2022, and December 31, 2023. For one year following enrollment, meteorological data were recorded at the time of each seizure (T0) and at 6, 12, 24, and 48 h prior to T0. Control data were collected from one (T1) and two (T2) days before T0. Conditional logistic regression was used to assess associations, adjusting for common-cold symptoms, sleep duration, menstruation, missed medication, age, and sex.</div></div><div><h3>Results</h3><div>A total of 159 seizures (median: three per participant per year) occurred in 29 children. Higher maximum relative humidity within 12 and 24 h prior to T0, compared to the same intervals prior to T2, was significantly associated with increased seizure risk (12 h: odds ratio [OR], 1.026; 95 % confidence interval [CI], 1.003–1.048; <em>p</em> = 0.023; 24 h: OR 1.033; 95 % CI, 1.004–1.063; <em>p</em> = 0.025). No significant associations were found for other meteorological variables.</div></div><div><h3>Conclusion</h3><div>Elevated maximum humidity 12–24 h prior to seizure onset may increase seizure risk in CWE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110667"},"PeriodicalIF":2.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903959","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":"Preliminary psychometric validation of a novel patient-based measure evaluating outcomes following treatment for functional seizures","authors":"Lana Higson ,&nbsp;Zhibin Chen ,&nbsp;Terence J O’Brien ,&nbsp;Genevieve Rayner ,&nbsp;Rubina Alpitsis ,&nbsp;Toby Winton-Brown","doi":"10.1016/j.yebeh.2025.110673","DOIUrl":"10.1016/j.yebeh.2025.110673","url":null,"abstract":"<div><h3>Background</h3><div>A consistent measure of patient reported outcomes following treatment for functional seizures is lacking. This study presents evidence regarding preliminary validation of a novel brief questionnaire, the Functional Seizures Pre-Post Intervention Comparison Survey (FSPICS) designed to measure patient relevant metrics following treatment.</div></div><div><h3>Methods</h3><div>Exploratory and confirmatory factor analyses were conducted to assess the latent structure of the FSPICS. Spearman’s correlation coefficients were used to estimate the association between relevant FSPICS questionnaire items and changes in monthly seizure count, Short Form-12 (SF-12) physical and mental quality of life component summaries, as well as the Work and Social Adjustment Scale (WSAS) function measure.</div></div><div><h3>Results</h3><div>A total of 56 participants enrolled in the active treatment arms of a Randomised Controlled Trial who completed the FSPICS were included. The final 19-item FSPICS assessed perceived treatment effectiveness across two highly correlated latent factors (r = 0.880), “Seizure Control” and “Quality of Life”. The final model exhibited overall very good fit (CFI = 0.999, TLI = 0.999, SRMR = 0.085, RMSEA = 0.034) and had strong internal consistency and reliability for both latent factors (“Seizure Control”: Ordinal Cronbach’s α = 0.957, McDonald’s ω = 0.929; “Quality of Life”: α = 0.913, ω = 0.867). Q12 of the FSPICS, “seizure occurrence”, demonstrated significant moderate-to-strong correlations with both absolute change in monthly seizure count (Spearman’s <em>ρ</em> = -0.514, <em>p</em> &lt; 0.001) and seizure count ratio (Spearman’s <em>ρ</em> = −0.644, <em>p</em> &lt; 0.001). Q9, “<em>the strategies I use to manage my seizures help me function better in everyday life</em>” and Q13, “<em>quality of life</em>” showed significant weak correlations (Spearman’s ρ = 0.362, p = 0.006 and Spearman’s ρ = 0.286, p = 0.032 respectively) with the change in the WSAS functional impairment score.</div></div><div><h3>Conclusion</h3><div>This study provides encouraging evidence of the FSPIC’s capacity to assess patient-reported outcomes and experiences of functional seizure treatment within a single brief questionnaire. Future studies with larger external sample sizes are required to further validate these findings.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110673"},"PeriodicalIF":2.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903963","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":"Drawing on a multi-disciplinary approach: art therapy to support patients through epilepsy surgery","authors":"Honor Coleman ,&nbsp;Sarah Brown ,&nbsp;Tammy Shella ,&nbsp;Sarah Wilson","doi":"10.1016/j.yebeh.2025.110652","DOIUrl":"10.1016/j.yebeh.2025.110652","url":null,"abstract":"","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110652"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893459","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":"Plasticity induced loss of apnea alarm through repeated apneas: A proposed mechanism for respiratory sudden death","authors":"Ryan B. Budde ,&nbsp;Vivek Ganesh ,&nbsp;William P. Nobis ,&nbsp;Pedro P. Irazoqui","doi":"10.1016/j.yebeh.2025.110650","DOIUrl":"10.1016/j.yebeh.2025.110650","url":null,"abstract":"<div><div>We are inspired by two observations and questions. 1) In most cases of sudden unexpected death in epilepsy (SUDEP) patients experience a fatal failure to breathe which onsets a few minutes after a seizure, suggested to be of neural (not mechanical) origin. If respiration is such a critical behavior, then how could the architecture of the respiratory neural circuit <u>ever allow</u> an extended apnea to persist until it is fatal, especially in low-risk cases (first lifetime seizure) in which the patient’s brain is not measurably impaired in any way? 2) Emerging data continue to support the theory that there are often concrete, measurable physiological changes in a patient prior to SUDEP, particularly in their respiratory reflexes and apnea drive. If this theory is true, then how could the architecture of the respiratory neural circuit <u>acquire increased risk</u> of fatal extended apnea? In this article we focus on the supposed “suffocation alarm” in the respiratory neural circuit, the balance of apnea and breathing, and how the balance can shift in both healthy controls and several disorders. The variations in suffocation alarm presentation suggest that the respiratory neural network can permit extended apnea without inducing alarm, arousal, or significant compensatory hyperpnea, even in healthy subjects. This apnea comfort can be induced with existing, healthy plasticity in apnea training (swimming and diving), pathologies which might mimic apnea training (repeated apneas in epilepsy, obstructive sleep apnea), or pathologies which modify the stability and feedback of the system (carotid body resection, neurodegeneration). These similarities, along with emerging data about the fundamental dynamics of the respiratory brainstem, suggest a network structure in which apnea can become a “steady state” and persist until death unless there is an outside stimulus like cardiopulmonary resuscitation.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110650"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895047","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":"Effectiveness and safety of perampanel by concomitant antiseizure medications: Insights from the real-world PERMIT Extension study","authors":"Takamichi Yamamoto ,&nbsp;Michael Chez ,&nbsp;Dulce Campos ,&nbsp;Simona Lattanzi ,&nbsp;Sara Matricardi ,&nbsp;José Carlos Estévez-María ,&nbsp;Wendyl D'Souza ,&nbsp;Eugen Trinka ,&nbsp;Sheri Cappucci ,&nbsp;Vicente Villanueva","doi":"10.1016/j.yebeh.2025.110651","DOIUrl":"10.1016/j.yebeh.2025.110651","url":null,"abstract":"<div><div>The PERMIT Extension study is the largest pooled analysis of perampanel (PER) clinical practice data to date. A <em>post-hoc</em> analysis of PERMIT Extension assessed the effectiveness and tolerability of PER with different concomitant antiseizure medication (ASM) regimens. Effectiveness was assessed by evaluating responder and seizure freedom rates at the last observation for each participant (‘last visit’), and tolerability was assessed by evaluating adverse events. The analysis included 5144 people with epilepsy who had only focal (n = 4347) or only generalised (n = 797) seizures when PER was initiated, and whose type of concomitant ASM regimen at that time was known. Effectiveness and tolerability varied considerably depending on the pharmacology and mechanism of action (MoA) of concomitant ASM regimens. For example, in individuals with focal seizures receiving only one concomitant ASM at baseline, seizure freedom rates were significantly higher if the concomitant ASM was one that binds to synaptic vesicle glycoprotein 2A (SV2A) versus one that does not bind to SV2A (41.7 % vs. 24.8 %; p &lt; 0.001), and significantly lower if the concomitant ASM was a sodium channel blocker versus a non-sodium channel blocker (23.2 % vs. 35.6 %; p &lt; 0.001); whereas, in those with generalised seizures receiving one concomitant ASM at baseline, there were no significant differences in seizure freedom rates according to the concomitant ASM’s MoA. In individuals with focal and generalised seizures, tolerability appeared to be less affected by the pharmacology and MoA of concomitant ASM regimens. The findings from this study may help inform the use of rational polytherapy in clinical practice.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110651"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895048","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 multidimensional impact mechanism of treatment convenience, threat assessment, and coping evaluation on medication adherence in pediatric epilepsy patients","authors":"Chunsong Yang ,&nbsp;Rui Huang ,&nbsp;Botao Wang ,&nbsp;Jianhua Zhang ,&nbsp;Lingli Zhang","doi":"10.1016/j.yebeh.2025.110669","DOIUrl":"10.1016/j.yebeh.2025.110669","url":null,"abstract":"<div><h3>Purpose</h3><div>This study constructs a multidimensional impact mechanism model of “treatment convenience → threat assessment → coping evaluation → medication adherence,” systematically revealing the various factors affecting medication adherence in pediatric epilepsy.</div></div><div><h3>Methods</h3><div>This cross-sectional study selected pediatric epilepsy patients and their caregivers from three institutions: West China Second University Hospital (Jinjiang and West China campuses) and Sichuan Provincial Children’s Hospital. Data were collected through a questionnaire survey. Based on Protection Motivation Theory (PMT), a Structural Equation Model (SEM) was constructed to verify the relationships among treatment convenience, threat assessment, coping evaluation, and medication adherence, test the related theoretical hypotheses, and further analyze the mediating roles of threat assessment and coping evaluation in the relationship between treatment convenience and medication adherence.</div></div><div><h3>Results</h3><div>A total of 874 patients were included, with an average age of 8.85 ± 3.98 years. Among the different types of epilepsy, focal/partial seizures were the most common, accounting for 47.7 % (417 cases). The medication adherence score was 3.275 ± 1.264, the treatment convenience score was 26.783 ± 6.724, the threat assessment score was 42.013 ± 10.817, and the coping evaluation score was 34.719 ± 8.651. Significant positive correlations were found between all three scores. The reliability and validity of all scales were good. Path analysis revealed that treatment convenience, threat assessment, and coping evaluation all had a significant positive impact on medication adherence. Mediating effect analysis showed that the effect of treatment convenience on medication adherence was both direct and indirect, mediated by threat assessment and coping evaluation.</div></div><div><h3>Conclusion</h3><div>Treatment convenience affects medication adherence through both direct and mediating pathways, while threat assessment and coping evaluation have profound impacts on adherence at both cognitive and behavioral levels. Future clinical practice should focus on optimizing external conditions (such as improving treatment convenience) and internal psychological interventions (such as appropriately guiding threat perception and enhancing coping strategies) to improve patient adherence from multiple dimensions, providing scientific support for the long-term management of pediatric epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110669"},"PeriodicalIF":2.3,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889533","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}