Epilepsy Research最新文献

{"title":"Use of oral anti-seizure medication via nasogastric tube to treat IV-diazepam resistant status epilepticus in a setting with limited resources: An observational study","authors":"Fitri Octaviana ,&nbsp;Adrian Ridski Harsono ,&nbsp;Winnugroho Wiratman ,&nbsp;Luh Ari Indrawati ,&nbsp;Astri Budikayanti","doi":"10.1016/j.eplepsyres.2025.107544","DOIUrl":"10.1016/j.eplepsyres.2025.107544","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the availability of new antiseizure medications (ASM), status epilepticus (SE) is still associated with a high mortality rate. One third of cases present with benzodiazepine resistance. The availability of intravenous ASMs in Indonesia is limited, meaning that the use of oral ASMs to treat SE is unavoidable. This study aimed to determine whether oral formulations of levetiracetam, topiramate, and valproic acid could successfully terminate diazepam-resistant SE.</div></div><div><h3>Methods</h3><div>This prospective cohort study was conducted at Dr. Cipto Mangunkusumo National Hospital between June 2021 and March 2023. Patients with SE aged over 18 years, who achieved clinically apparent seizure cessation with second-line oral ASMs following diazepam, were enrolled. Plasma levels of ASMs were assessed 24 h after the last seizure. Demography, clinical characteristics, and the percentage of successful seizure termination was recorded, as well as duration of seizure termination.</div></div><div><h3>Results</h3><div>Of the 53 participants, 33, 15, and 5 subjects were administered levetiracetam, topiramate, and valproic acid respectively. Of these, 26 (79 %), 15 (100 %), and 4 (80 %) achieved seizure termination. The median dose required to terminate clinically apparent seizures for oral formulations of levetiracetam, topiramate, and valproic acid were 23 mg/kg, 6 mg/kg, and 20 mg/kg. Seizure termination duration was significantly longer in the topiramate group. Median plasma levels (µg/ml) for levetiracetam, topiramate, and valproic acid among subjects who achieved seizure termination with one second-line ASM were 18.3, 9.5, and 43.2. The 30-day mortality rate among subjects administered levetiracetam, topiramate, and valproic acid, was 15 %, 53 %, and 40 %, respectively.</div></div><div><h3>Conclusion</h3><div>Oral ASMs can be a viable option for the treatment of diazepam-resistant SE in settings with limited resources, where intravenous formulations are not attainable.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"212 ","pages":"Article 107544"},"PeriodicalIF":2.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of seizure video recordings in the diagnosis of referred drug-resistant epilepsy: A stepwise approach","authors":"Duy Duan Nguyen ,&nbsp;Thi Kim Anh Tran ,&nbsp;Thi Phuoc Yen Tran ,&nbsp;Quoc Nguyen Bao Pham ,&nbsp;Toan Dinh Nguyen","doi":"10.1016/j.eplepsyres.2025.107530","DOIUrl":"10.1016/j.eplepsyres.2025.107530","url":null,"abstract":"<div><h3>Background</h3><div>Patient-recorded videos offer a practical alternative for diagnosing epilepsy and psychogenic nonepileptic seizures (PNES), yet their diagnostic value across sequential clinical questions remains underexplored.</div></div><div><h3>Objective</h3><div>To assess the diagnostic utility of patient-recorded seizure videos in distinguishing epilepsy from PNES, classifying seizure types, and localizing and lateralizing epileptic foci, as well as their impact on physician confidence and interrater reliability.</div></div><div><h3>Methods</h3><div>In this prospective two-phase study, 40 patients referred for drug-resistant epilepsy evaluation were screened, 30 of whom met the inclusion criteria. Diagnoses were made by one neurologist and confirmed by an independent neurologist via clinical data, electroencephalography, neuroimaging, and patient-recorded videos. Three neurologists independently reviewed cases across four diagnostic steps: (1) epilepsy vs. PNES, (2) focal vs. generalized epilepsy, (3) seizure localization: temporal vs. extratemporal, and (4) seizure lateralization: right vs. left. Diagnostic accuracy, physician confidence, and interrater reliability were analyzed before and after video integration.</div></div><div><h3>Results</h3><div>Diagnostic accuracy achieved excellent results before and after watching videos in Step 1 (91.67–95 %) and Step 2 (95.93–100 %). After the videos were reviewed, the accuracies in Steps 3 and 4 were good, reaching 83.87 % and 81.48 %, respectively. Videos significantly increased physician confidence across all steps. Interrater reliability improved for Steps 1 and 2–0.67 and 1.00, respectively. Those of seizure localization and lateralization slightly decreased, accompanied by increased accuracy, reflecting a trend toward inconsistent alterations to correct diagnoses among physicians.</div></div><div><h3>Conclusion</h3><div>The accuracy of epilepsy diagnosis in steps 1 and 2 is excellent, and that in steps 3 and 4 is good. Their integration with v-EEG and other diagnostic modalities, such as neuroimaging and invasive techniques, can enhance diagnostic workflows by providing complementary semiological information. Further studies with larger cohorts are warranted to confirm these findings and optimize their application in clinical practice.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"211 ","pages":"Article 107530"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Significant reduction of seizure frequency in patients with drug-resistant epilepsy by vagus nerve stimulation: Systematic review and meta-analysis” [Epilepsy Res. 210 (2025) 107510]","authors":"Malaisamy Muniyandi ,&nbsp;Karthick Chelvanayagam ,&nbsp;Sahil Abdul Salam ,&nbsp;Sathishkumar Vadamalai ,&nbsp;Kavitha Rajsekar ,&nbsp;Rajeswari Ramachandran","doi":"10.1016/j.eplepsyres.2025.107519","DOIUrl":"10.1016/j.eplepsyres.2025.107519","url":null,"abstract":"","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"211 ","pages":"Article 107519"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Long-term outcome and predictors of vagus nerve stimulation for drug-resistant epilepsy: Real-world evidence from the Korean National Hospital Consortium” [Epilepsy Res. 210 (2025) 107511 0920-1211]","authors":"Seo-Young Lee ,&nbsp;Hyesung Lee ,&nbsp;Jae-Wook Cho ,&nbsp;Kyung Wook Kang ,&nbsp;Jong-Geun Seo ,&nbsp;Jon Soo Kim ,&nbsp;Joon-Won Kang ,&nbsp;Daeyoung Kim ,&nbsp;Young-Soo Kim ,&nbsp;Sun Ah Choi ,&nbsp;Jeonghoon Park ,&nbsp;Ji Hoon Phi ,&nbsp;Sang Ook Nam ,&nbsp;Won Seop Kim ,&nbsp;Jae-Moon Kim ,&nbsp;Ki Joong Kim ,&nbsp;Korean National Hospital Consortium for VNS Outcome Study","doi":"10.1016/j.eplepsyres.2025.107522","DOIUrl":"10.1016/j.eplepsyres.2025.107522","url":null,"abstract":"","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"211 ","pages":"Article 107522"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracellular bromide enhances GABAA receptor function in the immature, but not the adolescent rat pilocarpine epilepsy model","authors":"Heiner Kolp ,&nbsp;Jana K. Hackert ,&nbsp;Marco Heerdegen ,&nbsp;Christa Unger ,&nbsp;Tina Sellmann ,&nbsp;Katrin Porath ,&nbsp;Valentin Neubert ,&nbsp;Marco Weiergräber ,&nbsp;Timo Kirschstein ,&nbsp;Rüdiger Köhling","doi":"10.1016/j.eplepsyres.2025.107535","DOIUrl":"10.1016/j.eplepsyres.2025.107535","url":null,"abstract":"<div><h3>Objective</h3><div>To study the effects of extracellular bromide in a novel immature rat pilocarpine model compared to the standard adolescent rat model.</div></div><div><h3>Methods</h3><div>We employed an immature rat model of repetitive pilocarpine-induced status epilepticus (340 mg/kg on postnatal days 9, 11 and 15). The electrophysiological characterization of the Schaffer collateral CA1-synapse and of CA1 pyramidal neurons was performed in 30–70 day-old animals. To explore the effects of bromide, 20 mM NaCl in the bath solution was replaced by 20 mM NaBr. We compared our findings in the immature model with data from the standard adolescent model of a single pilocarpine-induced status epilepticus (340 mg/kg on postnatal day 30) obtained from 40−90 day-old animals.</div></div><div><h3>Results</h3><div>In the immature, but not in the adolescent model, extracellular bromide (20 mM) enhanced the GABA_A-receptor component of the inhibitory postsynaptic potential, hyperpolarized the GABA_A-receptor reversal potential and reduced intrinsic excitability. However, bromide left high-frequency stimulation-induced long-term potentiation unaltered – in both the immature and the adolescent model.</div></div><div><h3>Significance</h3><div>The immature model, but not the commonly used adolescent pilocarpine model, showed a persistent bromide-enhanced GABA_A-receptor function leading to reduced intrinsic excitability. Hence, we suggest that immature animal models are needed to explore novel therapeutic strategies for epilepsies acquired during infancy.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"211 ","pages":"Article 107535"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inductive reasoning with large language models: A simulated randomized controlled trial for epilepsy","authors":"Daniel M. Goldenholz ,&nbsp;Shira R. Goldenholz ,&nbsp;Sara Habib ,&nbsp;M. Brandon Westover","doi":"10.1016/j.eplepsyres.2025.107532","DOIUrl":"10.1016/j.eplepsyres.2025.107532","url":null,"abstract":"<div><h3>Introduction</h3><div>To investigate the potential of using artificial intelligence (AI), specifically large language models (LLMs), for synthesizing information in a simulated randomized clinical trial (RCT) for an anti-seizure medication, cenobamate, demonstrating the feasibility of inductive reasoning via medical chart review.</div></div><div><h3>Methods</h3><div>An LLM-generated simulated RCT was conducted, featuring a placebo arm and a full-strength drug arm with a cohort of 240 patients divided 1:1. Seizure counts were simulated using a realistic seizure diary simulator. The study utilized LLMs to generate clinical notes with four neurologist writing styles and random extraneous details. A secondary LLM pipeline synthesized data from these notes. The efficacy and safety of cenobamate in seizure control were evaluated by both an LLM-based pipeline and a human reader.</div></div><div><h3>Results</h3><div>The AI analysis closely mirrored human analysis, demonstrating the drug's efficacy with marginal differences (&lt;3 %) in identifying both drug efficacy and reported symptoms. The AI successfully identified the number of seizures, symptom reports, and treatment efficacy, with statistical analysis comparing the 50 %-responder rate and median percentage change between the placebo and drug arms, as well as side effect rates in each arm.</div></div><div><h3>Discussion</h3><div>This study highlights the potential of AI to accurately analyze noisy clinical notes to inductively produce clinical knowledge. Here, treatment effect sizes and symptom frequencies derived from unstructured simulated notes were inferred despite many distractors. The findings emphasize the relevance of AI in future clinical research, offering a scalable and efficient alternative to traditional labor-intensive data mining.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"211 ","pages":"Article 107532"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seizures associated with dural arteriovenous fistulas: A systematic review of cases","authors":"Léa Proulx-Chartier ,&nbsp;Ève Parenteau ,&nbsp;Jimmy Li ,&nbsp;Jean-Simon Dallaire ,&nbsp;Cassandra C. Areal ,&nbsp;Izumi Kuramochi ,&nbsp;Charles Deacon ,&nbsp;Ann-Marie Beaudoin","doi":"10.1016/j.eplepsyres.2025.107531","DOIUrl":"10.1016/j.eplepsyres.2025.107531","url":null,"abstract":"<div><h3>Objective</h3><div>Dural arteriovenous fistulas (DAVFs) are an unusual cause of seizures. In this systematic review, we aim to describe the clinical features, paraclinical findings, management, and prognosis of cases of DAVF-related seizures, raising awareness for a potentially treatable cause of epilepsy.</div></div><div><h3>Methods</h3><div>This review was registered on PROSPERO (CRD42024529316). We searched OVID MEDLINE, OVID Embase, Web of Science, and Google Scholar for case reports/series of patients presenting with seizures associated with DAVFs. Original studies describing at least two out of four outcome categories (clinical features, paraclinical findings, treatment, and prognosis) were included. The methodological quality of each study was evaluated using a standardized tool. We performed descriptive analyses to summarize the clinical characteristics of all cases. We repeated these analyses while excluding cases where seizures may have had a likelier cause than DAVFs.</div></div><div><h3>Results</h3><div>In total, 120 patients were included from 94 articles. Median age was 57 years, and most patients were male (70 %). The most common manifestations accompanying seizures were headaches (22 %). Status epilepticus occurred in 38 % of cases. DAVFs were most commonly in the left hemisphere. The main venous sinus involved was the transverse sinus. Cortical venous reflux was present in almost all cases (93 %); most DAVFs were considered aggressive according to Cognard and Borden classifications. Seizure freedom was most common following angiographic interventions.</div></div><div><h3>Conclusion</h3><div>DAVFs, even when uncomplicated, can be a potential cause of treatable seizures. More aggressive DAVFs with cortical venous reflux seem to be the main culprit. Angiographic interventions can help achieve seizure freedom.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"211 ","pages":"Article 107531"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personal impact of epilepsy and well-being in individuals with epilepsy","authors":"Ozlem Ozdemir ,&nbsp;Fatih Tuglu","doi":"10.1016/j.eplepsyres.2025.107536","DOIUrl":"10.1016/j.eplepsyres.2025.107536","url":null,"abstract":"<div><h3>Aim</h3><div>The aim was to examine the personal impact of epilepsy on well-being, and influencing factors in individuals with epilepsy.</div></div><div><h3>Method</h3><div>This cross-sectional descriptive study was conducted on 138 individuals with epilepsy. Data were collected using the \"Descriptive Information Form,\" the \"Personal Impact of Epilepsy Scale (PIES),\" and the “World Health Organization-Five Well-Being Index (WHO-5)”. In the statistical analysis, p &lt; 0.05 was considered significant.</div></div><div><h3>Results</h3><div>The mean age of individuals with epilepsy was 31.22 ± 13.12 years, and the mean duration of epilepsy diagnosis was 9.93 ± 6.84 years. The mean WHO-5 Well-Being Index score was 62.55 ± 26.26 and the mean PIES scale score was 34.27 ± 20.27. According to the regression analysis results, well-being (β = −0.568; p = 0.000) and the duration of epilepsy diagnosis (β = −0.130; p = 0.041) were negative predictors, while the number of seizures (β = 0.209; p = 0.001) and age (β = 0.180; p = 0.010) were positive predictors of PIES. This explained 52.8 % of the total PIES score.</div></div><div><h3>Conclusion</h3><div>The well-being of individuals with epilepsy was found to be above average, and the personal impact of epilepsy was found to be low. Low well-being of individuals with epilepsy increased the negative impact of epilepsy on the individual. Number of seizures, older age, and the shortness of the diagnosis period negatively affected the individual with epilepsy personally. Health professionals need to focus on the influencing factors of individuals with epilepsy to increase their well-being and reduce the negative effects of epilepsy.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"212 ","pages":"Article 107536"},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychogenic non-epileptic seizures and epilepsy: How are they affected by associated psychiatric disorders?","authors":"Prateek Kumar Panda,&nbsp;Indar Kumar Sharawat","doi":"10.1016/j.eplepsyres.2025.107534","DOIUrl":"10.1016/j.eplepsyres.2025.107534","url":null,"abstract":"","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"211 ","pages":"Article 107534"},"PeriodicalIF":2.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of valproate therapy on timing of puberty in adolescents with childhood-onset epilepsy","authors":"Nirmeen A. Kishk ,&nbsp;Amr Mohamed Fouad ,&nbsp;Shereen El-Sawy ,&nbsp;Nourhan A. Soliman ,&nbsp;Rehab Magdy","doi":"10.1016/j.eplepsyres.2025.107533","DOIUrl":"10.1016/j.eplepsyres.2025.107533","url":null,"abstract":"<div><h3>Background</h3><div>Data regarding the timing of puberty in adolescents with childhood-onset epilepsy is scarce. This study aimed to explore whether pre-pubertal valproate intake negatively affects the timing of puberty.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, adolescents with childhood-onset epilepsy were asked to report when they attained Tanner 2 thelarche and gonadarche, respectively, using a Tanner self-staging score. Girls aged 13–18 years and boys aged 14–18 years -the ages at which the definition of delayed puberty can be applied- were included. Data regarding the pre-pubertal period were recorded, including seizure frequency/month, longest seizure-free interval, valproate intake, and duration.</div></div><div><h3>Results</h3><div>Eighty-one PWE (48 boys and 33 girls) were included. Forty-nine patients received valproate during the pre-pubertal period. Only 18 patients (22.2 %) had delayed onset puberty (4 girls and 14 boys). Delayed menarche was identified in 7 girls. Patients with delayed onset puberty had significantly younger age at epilepsy onset and shorter pre-pubertal longest seizure-free interval than patients with normal onset (P = 0.01, for each). Furthermore, the percentage of patients who received pre-pubertal valproate was significantly higher in patients with delayed puberty (94.4 %) than in patients with normal onset puberty (50.7 %), with significantly longer treatment duration in the former group (P = 0.0006). Duration of pre-pubertal valproate intake was an independent predictor for delayed onset puberty (OR=1.36, 95 %CI =1.14–1.62) while female sex had a protective effect (OR=0.21, 95 %CI =0.04–0.92).</div></div><div><h3>Conclusion</h3><div>Pre-pubertal valproate intake might delay pubertal onset in both sexes with epilepsy. Serial assessment to track pubertal development across the adolescence period is highly needed.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"211 ","pages":"Article 107533"},"PeriodicalIF":2.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}