Epilepsy Research最新文献

{"title":"Adequate and inadequate dosing of anti-seizure medications in status epilepticus","authors":"Susan Schrader,&nbsp;Melissa Smith","doi":"10.1016/j.eplepsyres.2025.107569","DOIUrl":"10.1016/j.eplepsyres.2025.107569","url":null,"abstract":"<div><h3>Background</h3><div>Status epilepticus (SE) is defined as five or more minutes of continuous seizures or two or more discrete seizures with incomplete recovery of consciousness.¹ The incidence of SE in the United States ranges from 18.3 to 41 per 100,000 patients per year². Reviews of SE clinical literature demonstrate that 70–75 % of patients did not receive an adequate dose of benzodiazepine according to clinical guidelines. Underdosing of benzodiazepines increases the risk of refractory SE and unfavorable outcomes.^8–9</div></div><div><h3>Methods</h3><div>This single center retrospective cohort study evaluated the dosing of benzodiazepines and other anti-seizure medications in adult patients with SE. The primary outcomes were incidence of breakthrough seizures in patients with appropriate dosing benzodiazepines compared to inappropriate dosing of benzodiazepines within 24 h of the first dose and incidence of breakthrough seizures in patients with appropriate loading dose of maintenance anti-seizure medication compared to inappropriate loading dose of anti-seizure medication within 24 h of the first dose.</div></div><div><h3>Results</h3><div>Thirty-eight patients received adequate benzodiazepine dosing compared to 155 with inadequate dosing. Eighty-seven percent of patients with adequate dosing of benzodiazepine experienced a breakthrough seizure compared to 84 % of patients with inadequate dosing (p = 0.62). Sixty-three percent of patients with adequate dosing of benzodiazepines required first non-benzodiazepine anti-seizure medication compared to 63 % of patients with inadequate dosing (p = 0.76). Breakthrough seizures within 24 h after the first load of non-benzodiazepine anti-seizure medication occurred in 21 % of patients in the adequate dosing group compared to 28 % in the inadequate dosing group (p = 0.73).</div></div><div><h3>Conclusion</h3><div>While benzodiazepines and rescue anti-seizure medications are frequently underdosed in patients with status epilepticus, there was no difference in recurrent seizures comparted to those with adequate dosing.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"214 ","pages":"Article 107569"},"PeriodicalIF":2.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879017","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":"Pharmacological inhibition of PLC and PKC triggers epileptiform activity in hippocampal neurons","authors":"S.G. Gaidin ,&nbsp;S.A. Maiorov ,&nbsp;V.P. Zinchenko ,&nbsp;D.P. Laryushkin ,&nbsp;S.T. Tuleukhanov ,&nbsp;B.K. Kairat ,&nbsp;A.M. Kosenkov","doi":"10.1016/j.eplepsyres.2025.107570","DOIUrl":"10.1016/j.eplepsyres.2025.107570","url":null,"abstract":"<div><div>Calcium signaling pathways play a crucial role in neuronal and glial function, yet the effects of inhibiting specific components of these pathways remain poorly understood. Here, we investigated how various inhibitors affect calcium dynamics in neurons and astrocytes within hippocampal co-cultures under normal conditions and during bicuculline-induced epileptiform activity. We found that phospholipase C (PLC) inhibitor U73122 and protein kinase C (PKC) inhibitors BIM IX and Go 6976 independently induced epileptiform activity in neurons, characterized by synchronized calcium oscillations similar to those caused by bicuculline. Notably, these inhibitors did not affect astrocytic calcium dynamics. In contrast, IP3 receptor inhibitor 2-APB and calmodulin inhibitor calmidazolium triggered significant calcium responses in both neurons and astrocytes. The 2-APB application led to an immediate increase in neuronal calcium levels and cessation of calcium oscillations, while also inducing varied calcium responses in astrocytes. Calmidazolium caused elevated calcium levels in both cell types, with neurons maintaining calcium oscillations at increased baseline levels. Interestingly, PI3 kinase inhibitor AS-605240 and ryanodine receptor inhibitor dantrolene showed no significant effects on calcium dynamics in either cell type. Electrophysiological recordings confirmed that both PLC and PKC inhibition induced paroxysmal depolarization shifts similar to those observed during bicuculline-induced epileptiform activity. These findings reveal previously unknown effects of commonly used signaling pathway inhibitors on neuronal excitability and calcium homeostasis, which should be considered when designing experiments and interpreting results involving these compounds. Our results also suggest a potential role for PLC and PKC in maintaining the excitation-inhibition balance in neuronal networks.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"214 ","pages":"Article 107570"},"PeriodicalIF":2.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877199","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":"Seizure in the emergency department: Risk and predictors of early recurrency during observation","authors":"Umberto Magliola ,&nbsp;Emanuele E.G. Pivetta ,&nbsp;Alessandro Balducci ,&nbsp;Enrico Lupia ,&nbsp;Gabriella Paglia","doi":"10.1016/j.eplepsyres.2025.107572","DOIUrl":"10.1016/j.eplepsyres.2025.107572","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to determine the risk of early seizure recurrence and identify potential predictive factors for focal or generalized seizures among patients presenting to the emergency department.</div></div><div><h3>Methods</h3><div>We conducted a two-year observational study involving all consecutive patients admitted to the emergency department for seizures. Early recurrent seizures were defined as those occurring within 24 h of admission. Clinical and neurological features, blood tests, brain computed tomography scans, and electroencephalographic testing were analyzed. Kaplan-Meier survival analysis was used to determine the median time median time to early recurrent seizures. Univariable and multivariable logistic and Cox proportional hazards models were used to investigate potential predictors of recurrence.</div></div><div><h3>Results</h3><div>Among the 433 enrolled patients, 92 (21 %) experienced an early recurrent seizure within 24 h. Sixty-three patients had a recurrence within 6 h, while only 19 patients (4.4 %) experienced recurrence between 12 and 24 h after arrival. Abnormal EEG findings (epileptiform or non-epileptiform alterations) and alcohol withdrawal were significantly associated with early recurrent seizures in univariate and multivariate analyses.</div></div><div><h3>Conclusion</h3><div>Overall, about a fifth of patients presenting with seizures to the emergency department experienced early recurrence within 24 h, with most of these occurring within the first 6 h. Abnormal EEG findings and alcohol withdrawal were significantly associated with an increased risk of early recurrence.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"214 ","pages":"Article 107572"},"PeriodicalIF":2.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882080","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":"Optimizing drug-resistant epilepsy identification in the Veterans Health Administration","authors":"Zulfi Haneef ,&nbsp;Stephan Eisenschenk ,&nbsp;Maria R. Lopez ,&nbsp;Andrea Hildebrand ,&nbsp;Rizwana Rehman ,&nbsp;Sruthi Gopinath Karicheri ,&nbsp;Marcella A. Coutts ,&nbsp;Omar I. Khan ,&nbsp;Marissa Kellogg ,&nbsp;for the Veterans Epilepsy Learning, Collaborative Research, and Operations (VELCRO) investigators","doi":"10.1016/j.eplepsyres.2025.107568","DOIUrl":"10.1016/j.eplepsyres.2025.107568","url":null,"abstract":"<div><h3>Background</h3><div>Accurate identification of drug-resistant epilepsy (DRE) is crucial for accurate disease measurement, effective clinical intervention and improved patient outcomes. Prior attempts to define DRE in administrative data using the 2010 International League against Epilepsy (ILAE) criteria have faced complexities.</div></div><div><h3>Methods</h3><div>This retrospective study utilized national administrative data from the Veterans Health Administration (VHA) to identify patients with possible DRE. This was a multicenter national cohort that uses a common, non-commercial medical record system. A panel of six epileptologists conducted chart reviews to identify DRE using the 2010 ILAE criteria. Logistic regression was used to analyze epilepsy-related variables of interest to develop algorithms identifying DRE.</div></div><div><h3>Results</h3><div>Among 260 included patients, 93 (35.8 %) had DRE, 148 (56.9 %) did not have DRE, and 19 (7.3 %) were undetermined. Out of 96 algorithms assessed, the best-performing algorithm had a high accuracy (F1 score=0.726) and defined DRE as those on ≥ 3 ASMs in addition to those on ≥ 2 ASMs for ≥ 365 days with at least one intractable ICD code. The algorithm demonstrated high sensitivity (0.74), specificity (0.81), and area under the curve (AUC 0.78). Factors such as age, number of ASMs, EEG, and MRI procedures, and intractable epilepsy ICD codes were associated with DRE.</div></div><div><h3>Discussion</h3><div>Our optimal algorithm for DRE identification is like previously published algorithms that determined the importance of number and duration of ASMs. However, it differs in the particular combination of factors that best identified DRE. These differences highlight the importance of fine-tuning algorithms for specific care settings. Further validation in a larger, more heterogenous cohort are needed to determine our algorithm's applicability and potential impact.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"214 ","pages":"Article 107568"},"PeriodicalIF":2.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879026","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":"Cannabis derivatives and their synthetic analogs for treatment-resistant epilepsy: A systematic review and meta-analysis","authors":"Ana Luiza Cabrera Martimbianco ,&nbsp;Roberta Borges Silva ,&nbsp;Carolina de Oliveira Cruz Latorraca ,&nbsp;Isabela Porto de Toledo ,&nbsp;Rafael Leite Pacheco ,&nbsp;Verônica Colpani ,&nbsp;Rachel Riera","doi":"10.1016/j.eplepsyres.2025.107559","DOIUrl":"10.1016/j.eplepsyres.2025.107559","url":null,"abstract":"<div><div>Background: Cannabidiol and other synthetic analogs from the <em>Cannabis sativa</em> plant have been investigated as alternative for the treatment of refractory epilepsy. Objective: to assess the effects of cannabis derivatives for the treatment of refractory epilepsy. Search methods: a search of the literature was carried out in the several databases, as well as a manual search of the reference lists of relevant studies, gray literature and clinical trial registries. Selection criteria and analysis: randomized controlled trials were included, and the risk of bias was assessed using the Cochrane risk of bias tool. The certainty of the evidence was assessed using the GRADE approach. Main results: Seven randomized clinical trials were included. Cannabidiol 20 mg/kg/day and 10 mg/kg/day probably increased the frequency of participants who achieved a ≥ 50 % reduction in monthly seizures (20 mg/kg/day: Relative Risk [RR] 1.92; 95 % 95 %CI 1.49–2.46, n = 575, 4 RCTs; 10 mg/kg/day: RR 1.94; 95 %CI 1.32–2.86, n = 280, 2 RCTs, moderate certainty of evidence). The incidence of serious adverse events is probably increased with CBD 20 mg/kg/day (RR 2.30; 95 %CI 1.36–3.89, n = 583, 4 RCTs, moderate certainty of evidence), and may be increased with CBD 10 mg/kg/day (RR 1.62; 95 %CI 0.92–2.84, n = 272, 2 RCTs; low certainty of evidence). Certainty of evidence for other included interventions ranged from very low to low. Conclusions: For most included comparisons and outcomes, there were uncertainties regarding the effects of cannabinoids. Future RCTs could contribute to a better understanding of the effects of cannabinoids for refractory epilepsy.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"214 ","pages":"Article 107559"},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143855670","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":"Long-term musculoskeletal outcomes in pediatric hemispherotomy","authors":"Emily E. Harford ,&nbsp;Anisha Mandava ,&nbsp;Ozgur Dede ,&nbsp;Amit Sinha ,&nbsp;Martin Piazza ,&nbsp;Taylor Abel","doi":"10.1016/j.eplepsyres.2025.107560","DOIUrl":"10.1016/j.eplepsyres.2025.107560","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study is to describe long-term functional mobility and musculoskeletal interventions in a group of pediatric patients who underwent hemispherotomy and hemispherectomy (HS) for drug-resistant epilepsy.</div></div><div><h3>Methods</h3><div>We conducted a retrospective review of patients who underwent HS at UPMC Children’s Hospital of Pittsburgh from 1997 to 2023 with at least 1 year of follow-up. Gross Motor Function Classification System (GMFCS) levels and data on upper extremity function were collected pre-operatively and at 1-, 2-, 5-, 10-, and 15-years post-HS for each patient. Musculoskeletal interventions including use of orthotic devices, chemodenervation, and orthopedic surgery were also documented for each patient at follow-up timepoints.</div></div><div><h3>Results</h3><div>A total of 35 patients (51.4 % female) underwent HS at 4.26 ± 4.26 years old for drug-resistant epilepsy and presented for follow-up at 1 (n = 35), 2 (n = 29), 5 (n = 19), 10 (n = 15), and 15 (n = 13) years post-HS. All patients had post-operative hemiparesis with upper extremity functioning exhibiting the expected proximal-to-distal gradient in impairment. 20 patients (57 %) experienced no change in GMFCS levels throughout follow-up while 14 (40 %) showed improvement in GMFCS level. Use of orthotics at each timepoint ranged from 78 % to 100 % of the cohort. In total, 11 (34 %) patients underwent at least one round of chemodenervation and 11 (34 %) underwent at least one orthopedic surgical procedure.</div></div><div><h3>Conclusions</h3><div>Our study demonstrates that children who undergo HS experience minimal long-term impact on broad measures of functional mobility but may still require intervention for management of spasticity, muscle contractures, and bony deformities.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"214 ","pages":"Article 107560"},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143855671","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":"From abnormal fetal movements to neonatal seizures: A literature review","authors":"Raffaele Falsaperla ,&nbsp;Martino Ruggieri ,&nbsp;Agata Polizzi ,&nbsp;Andrea D. Praticò","doi":"10.1016/j.eplepsyres.2025.107557","DOIUrl":"10.1016/j.eplepsyres.2025.107557","url":null,"abstract":"<div><div>Fetal seizures (FS) are underestimated and underdiagnosed events with a poor prognosis that could precede neonatal seizures. FS diagnosis could be clinical or by means of ultrasound. FS causes are heterogenic. After a PubMed, Google Scholar and SCOPUS research, aimed to find publications concerning FS, we selected 23 studies, mainly case reports with literature reviews, for a total of 29 patients. We evaluated the method of diagnosis, gestational age at diagnosis of FS, FS etiology, time of etiological diagnosis, fetal/neonatal outcome and possible therapeutic options. Fetal seizures were mainly felt by the mother (20/29 cases, 69 %) or diagnosed by fetal ultrasound (17/29 cases, 58.6 %). When seizures were felt by the mother, the gestational age of the fetal seizures was comprised from 20 to 40 week (average 31.3 weeks); the range of weeks when fetal seizures were detected by ultrasound ranged from 13 to 41 weeks (average 29.3 weeks). Among the etiologies, the most frequent were Pyridoxine dependent epilepsy and arthrogryposis multiplex congenita (4/29 each, 13.8 %), followed by fatal infantile olive-ponto-cerebellar hypoplasia 3/29, 10.3 %). The outcome of the most of patients was severe, with neonatal death occurring in 12/29 (41.4 %), therapeutic abortion in 5/28 (17.2 %); death occurred later in infancy in 3/29 (10.3 %), while 8/29 (31 %) presented psychomotor delay. FS may be a prenatal sign of fetal neurological impairment. Their knowledge is crucial because an early diagnosis allow an appropriate management of pregnancy, and an early anti-convulsant treatment after birth. However, in the reported cases, the prognosis was frequently poor.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"214 ","pages":"Article 107557"},"PeriodicalIF":2.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848282","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":"Seizure and cognitive outcomes of cortical long bursting responsive neurostimulation in intractable focal epilepsy","authors":"Surya Suresh ,&nbsp;Yosefa Modiano ,&nbsp;Ganne Chaitanya ,&nbsp;Vladimir Vashin ,&nbsp;Jeston Chin ,&nbsp;Sandipan Pati","doi":"10.1016/j.eplepsyres.2025.107555","DOIUrl":"10.1016/j.eplepsyres.2025.107555","url":null,"abstract":"<div><div>Responsive Neurostimulation (RNS) is an established therapy for drug-resistant epilepsies (DRE), yet conventional high-frequency stimulation delivered in short bursts (SB; 100 ms) may fail to achieve significant seizure reduction. This retrospective study evaluated the efficacy of cortical high-frequency long-burst (LB; 5000 ms) RNS therapy in 13 DRE patients who experienced less than a 50 % reduction in seizures with SB therapy. After initiating LB therapy, 55 % of patients achieved a seizure reduction of more than 50 %, with a median follow-up of 13 months. Although the number of stimulation therapies delivered per day did not significantly differ between the SB and LB paradigms, the LB RNS delivered a substantially higher charge per hour (mean 18 mC/hr vs. 0.7 mC/hr) to the epileptogenic cortex. Importantly, despite the increased charge, no cognitive decline was observed, likely due to the precise timing of the stimulation in response to epileptiform activity. These findings suggest that LB RNS may be a viable alternative for patients who do not respond to conventional RNS therapy, offering improved seizure control without compromising cognitive function. However, the increased charge raises concerns about battery life, emphasizing the need for further research on different stimulation frequencies in LB RNS. This study highlights the potential of tailored stimulation paradigms to optimize outcomes in drug-resistant epilepsy.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"214 ","pages":"Article 107555"},"PeriodicalIF":2.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143842689","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":"Evaluation and clinical characteristics of anxiety, depression, and sleep quality among adult patients with seizure clusters","authors":"Lan Mou ,&nbsp;Yuwen Zhang ,&nbsp;Chenshi Liu ,&nbsp;Ming-Ming Zhang ,&nbsp;Ting-Ting Liu ,&nbsp;Jun Liu ,&nbsp;Qi Wang ,&nbsp;Jie Liu","doi":"10.1016/j.eplepsyres.2025.107552","DOIUrl":"10.1016/j.eplepsyres.2025.107552","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to examine the clinical characteristics among seizure clusters (SCs) in adult patients with epilepsy, measure anxiety and depression symptoms, sleep quality and analyze risk factors related to these conditions while assessing their social burden.</div></div><div><h3>Methods</h3><div>The Generalized Anxiety Disorder-7 (GAD-7), the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), the Pittsburgh Sleep Quality Index (PSQI), and the Social Support Rating Scale (SSRS) were among the structured questionnaires utilized in Sichuan Provincial People's Hospital. Multivariate logistic regression analysis was conducted on the related differential indicators.</div></div><div><h3>Results</h3><div>A total of 330 adult patients with epilepsy were included. Statistically significant differences (p &lt; 0.05) were found between the patients with SCs and without groups in terms of age at first onset, etiology, semiology distribution, imaging and EEG results, therapy, and prognosis. SC patients had significantly higher GAD-7, NDDI-E, and PSQI average total scores than in the Non-Seizure Cluster (NSC) group. (p &lt; 0.001), and the distribution of related factors varying by age and daily seizure frequency. Patients with SCs had shown lower objective support, including material support, social networks, and group relationships than the control group</div></div><div><h3>Significance</h3><div>SCs are a type of clinical emergency. Patients with SCs are more susceptible to anxiety, depression, poor sleep quality and social burden, requiring proactive intervention and mental health management.</div><div>This study is registered with the Chinese Clinical Trials Registry (identifier: ChiCTR2400088157).</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"213 ","pages":"Article 107552"},"PeriodicalIF":2.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824128","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":"Treatment modifications of antiseizure medications in children due to adverse drug reactions: The parents’ perspective","authors":"Esther Meise ,&nbsp;Thilo Bertsche ,&nbsp;Sarah Jeschke ,&nbsp;Astrid Bertsche ,&nbsp;Martina P. Neininger","doi":"10.1016/j.eplepsyres.2025.107548","DOIUrl":"10.1016/j.eplepsyres.2025.107548","url":null,"abstract":"<div><h3>Background</h3><div>Adverse drug reactions (ADRs) occur frequently in the treatment with antiseizure medication (ASM). We investigated the influence of experienced ADRs on desired or actual treatment modifications in paediatric patients from the parents’ perspective.</div></div><div><h3>Methods</h3><div>We interviewed 104 parents of children with an epilepsy diagnosis in routine paediatric care at a German university hospital. The questionnaire comprised questions about current and previous experiences with ASM regarding ADRs leading to desired or actual treatment modifications.</div></div><div><h3>Results</h3><div>Of 94 parents of children with current ASM, 11/94 (12 %) desired treatment modifications because of ADRs. Of 66 parents of children with previous ASM treatment, 51/66 (77 %) reported a total of 72 actual ADR-related modifications in the past. The most frequently mentioned ADRs leading to desired or actual treatment modifications were fatigue (current: 7/94 [7 %]; previous: 23/72 [32 %]), behavioural changes (current: 6/94 [6 %]; previous: 28/72 [39 %]), and negative changes in cognitive processes (current: 3/94 [3 %]; previous: 12/72 [17 %]). In total, parents attributed ADR-related desired or actual treatment modifications to 14 different ASMs. Behavioural changes leading to desired or actual modifications were mentioned for 10/14 (71 %) ASMs, fatigue for 9/14 (64 %) ASMs, and negative changes in cognitive processes for 8/14 (57 %) ASMs.</div></div><div><h3>Conclusion</h3><div>One-in-ten parents desired to modify current ASM treatment due to ADRs, and almost two thirds reported actual ADR-related modifications of previous ASMs. As the same ADRs were reported for different ASMs, those ADRs may not be preventable through ASM variation. Thus, coping strategies are needed, particularly for the occurrence of common neurological and psychiatric ADRs.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"213 ","pages":"Article 107548"},"PeriodicalIF":2.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799263","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}