Epilepsy Research最新文献

{"title":"Corrigendum to \"Emergency department utilization among adults with epilepsy: A multi-state cross-sectional analysis, 2010-2019\" [Epilepsy Res. 205 (2024) 107427].","authors":"Lidia Moura, Ioannis Karakis, David Howard","doi":"10.1016/j.eplepsyres.2025.107588","DOIUrl":"https://doi.org/10.1016/j.eplepsyres.2025.107588","url":null,"abstract":"","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":" ","pages":"107588"},"PeriodicalIF":2.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119100","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":"A systematic review of artificial intelligence techniques based on electroencephalography analysis in the diagnosis of epilepsy disorders: A clinical perspective","authors":"Seyyed Ali Zendehbad ,&nbsp;Athena Sharifi Razavi ,&nbsp;Nasim Tabrizi ,&nbsp;Zahra Sedaghat","doi":"10.1016/j.eplepsyres.2025.107582","DOIUrl":"10.1016/j.eplepsyres.2025.107582","url":null,"abstract":"<div><div>In recent years, Artificial Intelligence (AI), with a specific emphasis on attention mechanisms instead of conventional Deep Learning (DL) or Machine Learning (ML), has demonstrated significant applicability across diverse medical domains. This paper redirects its focus from general brain mapping techniques to specifically investigate the impact of AI in the field of epilepsy diagnosis, concentrating exclusively on Electroencephalography (EEG) data. While earlier studies have predominantly centered on the automatic identification and prediction of seizures using EEG records, an emerging body of research delves into the potential of AI techniques to enhance the analysis of EEG data. This systematic review offers a comprehensive overview, commencing with a concise theoretical exposition on Artificial Neural Networks (ANNs) and attention mechanisms. Subsequent sections explore the applications of AI in EEG analysis for epilepsy, covering aspects such as diagnosis, lateralization, automated lesion detection, presurgical evaluation, and the prediction of postsurgical outcomes. The discussion not only highlights the promising aspects of AI in refining clinical practices but also underscores its potential in tailoring individualized treatments for epilepsy, considering it as a network disorder. The paper concludes by addressing limitations, challenges, and proposing future directions for the application of AI in epilepsy research. While acknowledging the transformative potential of this approach, it emphasizes the necessity for greater multicenter collaboration to amass high-quality data and ensure the open accessibility of developed codes and tools. Moreover, the application of AI models in Computer-Aided Diagnosis (CAD) has exhibited significant promise in enhancing the accuracy and efficiency of epilepsy and seizure diagnosis. This integration of advanced technologies contributes to the development of robust tools for clinical decision-making and underscores the potential for AI-driven solutions in neurological healthcare.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"215 ","pages":"Article 107582"},"PeriodicalIF":2.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089964","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":"Efficacy and safety of perampanel in genetic generalized epilepsy: A retrospective, single-center study in China","authors":"Hua Li ,&nbsp;Peiqi Zhang ,&nbsp;Xiaoli Dong ,&nbsp;Yao Wang ,&nbsp;Jing Guo ,&nbsp;Yu Chen ,&nbsp;Zheng Xu","doi":"10.1016/j.eplepsyres.2025.107591","DOIUrl":"10.1016/j.eplepsyres.2025.107591","url":null,"abstract":"<div><div>Perampanel (PER) is a selective non-competitive AMPA receptor antagonist approved for treating focal and generalized seizures. However, its efficacy in genetic generalized epilepsy (GGE) has not been extensively studied in Chinese populations. This retrospective, single-center study enrolled 54 patients with GGE treated with PER between March 2021 and November 2023. To ensure data quality and minimize bias, we implemented standardized data collection procedures including: (1) systematic documentation using standardized seizure diaries, (2) regular follow-up assessments at predefined intervals, and (3) rigorous application of inclusion/exclusion criteria. Efficacy was assessed by seizure freedom rate, responder rate (≥50 % seizure reduction) and retention rate at 3, 6, 12 months and last follow-up. Safety was evaluated by monitoring adverse events. At last follow-up (mean 14 ± 4.95 months), the overall seizure freedom rate was 53.7 % and responder rate was 70.4 %. Idiopathic generalized epilepsy (IGE) patients showed better outcomes compared to non-IGE patients (seizure freedom: 63.6 % vs 10 %; responder rate: 79.5 % vs 30 %). PER demonstrated highest efficacy in generalized tonic-clonic seizures (80.4 % responder rate), followed by myoclonic (70.8 %) and absence seizures (50 %). Among epilepsy syndromes, GTCA showed the best response (100 % responder rate), followed by JME (83.3 %). The mean effective dose was 3.86 mg/day in the seizure-free group. Treatment-emergent adverse events occurred in 18.5 % of patients, with dizziness (18.5 %) being most common, leading to discontinuation in 3.7 % of cases. PER demonstrated favorable efficacy and tolerability in Chinese patients with GGE, particularly in IGE patients and those with generalized tonic-clonic seizures. Lower doses were associated with better outcomes, suggesting careful dose titration may optimize therapeutic benefits.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"215 ","pages":"Article 107591"},"PeriodicalIF":2.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072141","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":"The construct validity of perceived disability scale in people with epilepsy","authors":"Elif Sarac ,&nbsp;Esra Yildiz","doi":"10.1016/j.eplepsyres.2025.107585","DOIUrl":"10.1016/j.eplepsyres.2025.107585","url":null,"abstract":"<div><h3>Objective</h3><div>People with epilepsy are potentially at a high risk for disability or functional impairment because of various reasons such as seizures, underlying diseases or socioeconomic inequalities. The objective of this study was designed to examine the factor structure and construct validity of Perceived Disability Scale in people with epilepsy within Turkish context.</div></div><div><h3>Methods</h3><div>Research involving “Perceived Disability Scale”, and demographic characteristics form was conducted with a group of 106 people with epilepsy. Data analyses included Exploratory and Confirmatory Factor Analysis, internal consistency reliability, ANOVAs and t-tests.</div></div><div><h3>Results</h3><div>The component analysis for the instrument yielded three factors: (1) dissatisfaction, (2) pessimism, and (3) self-disdain. The factor structure explained 68.54 % of variance and showed stronger difference with age, education, disease duration and seizure frequency.</div></div><div><h3>Conclusion</h3><div>Preliminary construct validity and reliability of the Perceived Disability Scale was supported in our context. Perceived disability in people with epilepsy significantly differed based on age, education, disease duration and seizure frequency but not gender and other demographic features. Instrument should be further used within various samples as part of clarifying epilepsy-related disability.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"215 ","pages":"Article 107585"},"PeriodicalIF":2.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946829","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":"Pragmatic strategies for improving prevention, diagnosis, and treatment of epilepsy in low- and middle-income countries","authors":"Gaurav Nepal ,&nbsp;Jayant Kumar Yadav ,&nbsp;Sunita Lamsal ,&nbsp;Rajeev Ojha","doi":"10.1016/j.eplepsyres.2025.107586","DOIUrl":"10.1016/j.eplepsyres.2025.107586","url":null,"abstract":"<div><div>Epilepsy poses a major public health challenge in low- and middle-income countries (LMICs), where prevention, diagnosis, and treatment must be tailored to local resources, infrastructure, and cultural contexts. Despite their diversity, LMICs commonly experience a pronounced urban–rural disparity in epilepsy care, with rural communities facing limited healthcare infrastructure, a shortage of specialists, and pervasive stigma. Prevention efforts should focus on modifiable risk factors. Neurocysticercosis, a leading preventable cause of epilepsy in endemic regions, can be addressed through improved sanitation, access to clean water, and timely treatment supported by low-cost diagnostics. Enhancing perinatal care, injury prevention, and stroke management is also essential to reduce epilepsy incidence. Stigma continues to hinder care. Targeted education campaigns aimed at schools, community leaders, and the general public are vital to improving awareness and reducing discrimination. Bridging diagnostic gaps requires accessible, cost-effective tools such as portable EEGs, smartphone-based seizure recordings, and mobile diagnostic applications. Integration of these technologies into community health systems, and their use by trained primary care providers and community health workers, enables earlier detection and ongoing monitoring, particularly in underserved areas. Treatment strategies should prioritize “easy-to-use,” well-tolerated medications such as levetiracetam. Improving the affordability of antiseizure medications involves promoting generic alternatives, revising patent laws, regulating drug prices, setting price ceilings for essential medicines, and enabling bulk procurement. National health insurance schemes are crucial to ensure access for low-income populations. Expanding access through home-based care by community health workers, mobile outreach clinics, telemedicine, and collaboration with traditional healers can further improve treatment adherence and outcomes. Finally, training primary care physicians in epilepsy care is essential, as they are often the first point of contact for patients in rural and resource-limited settings.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"215 ","pages":"Article 107586"},"PeriodicalIF":2.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143929431","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":"Efficacy of transcutaneous vagus nerve stimulation (t-VNS) in treating drug-resistant epilepsy: A systematic review and meta-analysis","authors":"Seraj Makkawi ,&nbsp;Ghadah Y. Alsamiri ,&nbsp;Mumen H. Halabi ,&nbsp;Jawad I. Bukhari ,&nbsp;Feras Alharbi ,&nbsp;Fay N. Alnafisi ,&nbsp;Alanoud K. Alaslab ,&nbsp;Abdulrahman E. Alghamdi ,&nbsp;Amal M. Bamehriz ,&nbsp;Madihah Alhubayshi ,&nbsp;Ali Alanazi","doi":"10.1016/j.eplepsyres.2025.107583","DOIUrl":"10.1016/j.eplepsyres.2025.107583","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy is a disease that affects over 50 million people globally. It poses significant challenges, especially for those with drug-resistant forms. This study aims to evaluate the efficacy of transcutaneous vagus nerve stimulation (t-VNS) in treating drug-resistant epilepsy by conducting a systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>We adhered to PRISMA guidelines and registered the study with PROSPERO. Randomized clinical trials (RCTs) focusing on t-VNS for patients aged 14 and above with drug-resistant epilepsy were included. PubMed, Elsevier, CENTRAL, and Web of Science databases were searched up to December 2023. Data extraction and risk of bias assessment were independently conducted by two reviewers, with discrepancies resolved by a third.</div></div><div><h3>Results</h3><div>Out of 2782 studies identified, four RCTs involving 417 subjects were included. The meta-analysis revealed that t-VNS significantly reduced seizure frequency at various time points, notably at 8, 12, 16, and 52 weeks. However, no significant difference in responder rates between the t-VNS and control groups was found. Quality of life improvements were observed in some studies, while adverse effects were generally mild and transient.</div></div><div><h3>Conclusion</h3><div>t-VNS has a favorable safety profile to reduce seizure frequency in drug-resistant epilepsy. Despite these positive findings, variations in study methodologies and a high risk of bias necessitate further high-quality research to confirm these results and better integrate t-VNS into clinical practice.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"215 ","pages":"Article 107583"},"PeriodicalIF":2.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942674","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":"Addressing the gap: SUDEP knowledge and communication among patients and neurologists","authors":"Yasmeena Abdelall Kozaa ,&nbsp;Youstina Mohsen ,&nbsp;Mohammad T. Abuawwad ,&nbsp;Mohamed Saad Rakab ,&nbsp;Ahmed R.A. Moustafa ,&nbsp;Mohamed Arafa Shady ,&nbsp;Mohammed Bakr Alsehili ,&nbsp;Mohamed Ragab ElDessouki ,&nbsp;Hend Salama Abo Helow ,&nbsp;Nada Mahmoud Abdelkarim ,&nbsp;Mohammad J.J. Taha ,&nbsp;Osama Ahmed Elshafei","doi":"10.1016/j.eplepsyres.2025.107584","DOIUrl":"10.1016/j.eplepsyres.2025.107584","url":null,"abstract":"<div><h3>Objectives</h3><div>Sudden unexpected death in epilepsy (SUDEP) is a major cause of mortality in epilepsy. Effective management of SUDEP risk depends on a solid understanding of SUDEP and its associated risk factors. This study evaluates the perspectives of both patients and neurologists on SUDEP discussion.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted at Mansoura University Hospital in Egypt, involving 173 adult epilepsy patients and 26 neurologists. Patients completed structured, in-person surveys assessing their awareness of SUDEP and preferences for receiving related information. Neurologists were surveyed regarding their knowledge of SUDEP risk factors, frequency of SUDEP discussions, and perceived barriers. Data analysis included descriptive statistics, Chi-square tests, and binary logistic regression.</div></div><div><h3>Results</h3><div>Among patients, 84 % had never heard of SUDEP; however, 92 % expressed a desire to be informed, with 75 % preferring detailed information from a neurologist. Neurologists demonstrated limited knowledge, with only 27 % correctly identifying key SUDEP risk factors. Additionally, 65 % rarely or never discussed SUDEP with patients, citing concerns about inducing anxiety and impacting quality of life. Knowledge level among neurologists was not significantly associated with the frequency of SUDEP discussions.</div></div><div><h3>Conclusion</h3><div>This study identifies a major gap in SUDEP awareness among patients and neurologists, with patients expressing a strong preference for information despite limited discussions by clinicians. Targeted educational initiatives are needed to bridge this communication gap. As the first study from the MENA region to assess both perspectives, it also contributes a unique sociocultural understanding to global SUDEP research.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"215 ","pages":"Article 107584"},"PeriodicalIF":2.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143922104","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":"Phenobarbital versus valproate for generalized convulsive status epilepticus in adults. An updated systematic review and meta-analysis","authors":"Umair Ul Haq ,&nbsp;Neha Majeed ,&nbsp;Nisha Kumari ,&nbsp;Anushe Saleh ,&nbsp;Amna Tariq ,&nbsp;Saad Masood ,&nbsp;Junaid Imran ,&nbsp;Safa Siddique Ali ansari ,&nbsp;Hamzah Naushad Siddiqui ,&nbsp;Muhammad Wasey Arshad ,&nbsp;Muhammad Aamir ,&nbsp;Abdul Rehman Shah Syed ,&nbsp;Satesh Kumar ,&nbsp;Mahima Khatri ,&nbsp;Maria Rasheed","doi":"10.1016/j.eplepsyres.2025.107571","DOIUrl":"10.1016/j.eplepsyres.2025.107571","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Status epilepticus (SE) is a neurological emergency with significant mortality and morbidity with generalized convulsive SE (GCSE) being the most prevalent. A meta-analysis reported an overall mortality rate of 15.9 % in adults and 3.6 % in children, with variations based on etiology, age, and treatment response. We compare phenobarbital with valproate for the treatment of GCSE.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. An electronic search was performed on PubMed, Embase, and Cochrane from inception to March 2025. In addition, unpublished clinical trials were searched for on the \"ClinicalTrials.gov\" website. Three authors independently screened the titles and abstracts of all retrieved articles and removed those not fulfilling the inclusion criteria. We only included randomized controlled trials (RCTs) in our meta-analysis.</div></div><div><h3>Results</h3><div>After screening 3706 articles, seven studies were selected for inclusion after removing the duplicates, and assessing the titles and abstracts. The meta-analysis involved a total pool of 475 participants divided into two groups: 232 patients in the Phenobarbital group, and 243 patients in the Valproate group. The use of Phenobarbital was associated with a more effective control of GSCE compared to Valproate (RR = 1.20, 95 % CI 1.04–1.39, P = 0.01, I2 =80 %), however phenobarbital group were more likely to experience adverse effects (RR = 2.49, 95 % CI 1.53–4.04, P = 0.002, I2 = 0 %) than valproate group.</div></div><div><h3>Conclusion</h3><div>In conclusion, phenobarbital is more successful than valproate at controlling GSCE, although phenobarbital group showed more negative adverse effects.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"215 ","pages":"Article 107571"},"PeriodicalIF":2.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143931583","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":"Anatomical-electroclinical phenotypes and SEEG-defined network patterns in pure insular lobe epilepsy: A study of 20 cases","authors":"Jun Zhuang ,&nbsp;Lingxia Fei ,&nbsp;Hua Li ,&nbsp;Kaihui Li ,&nbsp;Qinghua Tan ,&nbsp;Shaochun Li ,&nbsp;Junxi Chen ,&nbsp;Meiling Cai","doi":"10.1016/j.eplepsyres.2025.107558","DOIUrl":"10.1016/j.eplepsyres.2025.107558","url":null,"abstract":"<div><h3>Objective</h3><div>Insular epilepsy poses significant diagnostic challenges due to its distinctive anatomical location and heterogeneous clinical manifestations. This study aims to develop a comprehensive classification system based on anatomo-electro-clinical features through stereoelectroencephalography (SEEG) analysis. The research seeks to elucidate the specific correspondence between clinical phenotypes and ictal electro-anatomical propagation patterns, investigate the network dynamics underlying various clinical phenotypes, and establish a theoretical framework for the precise diagnosis and personalized treatment of insular epilepsy.</div></div><div><h3>Methods</h3><div>This single-center retrospective case series included 20 patients with pure insular epilepsy confirmed by stereoelectroencephalography (SEEG) who were treated at Guangdong Sanjiu Brain Hospital between January 2015 and July 2024. The cohort comprised 12 males and 8 females with a mean age of 14.25 ± 9.8 years. All patients underwent individualized SEEG electrode implantation (mean 12.5 ± 2.3 electrodes per patient), comprehensively covering all insular subregions (anterior and posterior insula) and key brain areas in potential propagation pathways. A standardized protocol was employed for systematic analysis of: (1) ictal onset zone localization and electro-anatomical propagation patterns; (2) ictal semiology and clinical phenotype analysis based on video-SEEG recordings; and (3) surgical strategies, pathological findings, and outcome assessment (Engel classification, with follow-up periods ranging from 6 months to 8 years).</div></div><div><h3>Results</h3><div>The study identified five characteristic clinical phenotypes: the BATS phenotype (35.0 %), tonic-hypermotor phenotype (25.0 %), hypermotor-autonomic phenotype (25.0 %), pure sensory phenotype (10.0 %), and pure autonomic phenotype (5.0 %). These phenotypes demonstrated specific correspondence with six distinct SEEG propagation patterns. Posterior insular epilepsy (70.0 %) preferentially propagated through sensorimotor networks, whereas anterior insular epilepsy (30.0 %) primarily spread via limbic system networks. Focal cortical dysplasia was the predominant pathological finding (94.7 %). All surgical patients (n = 19) achieved Engel Ia outcome, with follow-up periods ranging from 6 months to 8 years.</div></div><div><h3>Conclusion</h3><div>This study established an anatomo-electro-clinical classification system for insular epilepsy and elucidated the specific correspondence between clinical phenotypes and neuronal network propagation patterns. This correspondence reflects the characteristic propagation of epileptic activity through pre-existing functional connectivity networks, providing a theoretical foundation for the precise diagnosis and personalized treatment of insular epilepsy.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"215 ","pages":"Article 107558"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904353","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":"A retrospective analysis of pediatric patients on a ketogenic diet: A comparison of inpatient versus outpatient diet initiations","authors":"Chelsey Stillman ,&nbsp;Kelly Knupp ,&nbsp;Jennifer Oliver ,&nbsp;Alison Conley ,&nbsp;Kaitlyn Kennedy ,&nbsp;Lori Silveira ,&nbsp;Charuta Joshi","doi":"10.1016/j.eplepsyres.2025.107556","DOIUrl":"10.1016/j.eplepsyres.2025.107556","url":null,"abstract":"<div><h3>Introduction</h3><div>Ketogenic diet therapies are effective therapies for drug-resistant epilepsy. Conventional initiation of the ketogenic diet occurs via inpatient (IP) admission to a hospital. The COVID19 pandemic forced changes to practices allowing for comparison between inpatient (IP) and outpatient (OP) initiations. Our aim was to evaluate differences between IP and OP initiations including laboratory results, seizure reduction and communications with patients.</div></div><div><h3>Methods</h3><div>This is a retrospective chart review of patients initiated on a ketogenic diet (modified Atkins [MAD] or classic ketogenic [CKD]) between 2007 and 2022. We compared variables such as demographic data, communications, lab values, seizure counts, IP or OP initiation, presence of a gastrostomy tube (g-tube), and diet type.</div></div><div><h3>Results</h3><div>Of the 157 total subjects, 139 subjects initiated CKD and 18 subjects initiated MAD. 39 initiated OP and 118 initiated IP. The odds of a 50 % reduction in seizures at 65 days post initiation increased four times for IP initiation after adjusting for the impact of serum beta hydroxybutyrate (BHB). This difference was no longer present at 196 days post initiation. Number of communications between diet initiation and the first visit post initiation were similar for IP and OP. G-tube presence or absence did not impact outcomes.</div></div><div><h3>Conclusion</h3><div>IP initiation resulted in better seizure control at the first visit post initiation. CKD was the only variable associated with increased communications. Since seizure improvement rates were similar at 196 days, a gradual approach with lower CKD ratios may be considered. G-tube presence had no impact on outcomes and should be weighted less when considering admission.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"214 ","pages":"Article 107556"},"PeriodicalIF":2.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894853","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}