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":"Functional evaluation of a rat model of KCNT1-related epilepsy","authors":"Nana Liu ,&nbsp;Zehong Lin ,&nbsp;Huifang Song ,&nbsp;Aojie Cai ,&nbsp;Xiao Li ,&nbsp;Junjiao Zhang ,&nbsp;Di Chang ,&nbsp;Taoyun Ji ,&nbsp;Ye Wu ,&nbsp;Zhuo Huang ,&nbsp;Yuwu Jiang ,&nbsp;Kai Gao","doi":"10.1016/j.eplepsyres.2025.107589","DOIUrl":"10.1016/j.eplepsyres.2025.107589","url":null,"abstract":"<div><h3>Objective</h3><div><em>KCNT1</em> encodes a sodium-activated potassium channel, and its variant can lead to refractory epilepsy. The resistance to antiseizure medication in <em>KCNT1</em> variant–related epilepsy suggests the presence of complex gene regulation. Our goal is to clarify the pathogenicity of a <em>KCNT1</em> variant associated with epilepsy.</div></div><div><h3>Methods</h3><div>Here, we intended to characterize the pathogenicity of the <em>Kcnt1</em>-269 variant (c.805 G &gt; A, c.807 G &gt; C, p.G269S; corresponding to c.862 G &gt; A, p.G288S in human) <em>in vitro</em> and <em>in vivo</em>, and to analyze the transcriptome of the rat cerebral cortex through RNA sequencing.</div></div><div><h3>Results</h3><div>Our study revealed that homozygous <em>Kcnt1</em>-269 variant rats showed excessive neuroexcitability in CA1 pyramidal neurons, including enhanced neuronal action potential amplitudes, decreased action potential thresholds, and increased neuronal firing numbers. Homozygous and heterozygous <em>Kcnt1</em>-269 variant rats had high frequency of evoked action potential under different step currents. The cumulative dose of pentetrazol required to induce epileptic seizures in homozygous <em>Kcnt1</em>-269 variant rats was significantly lower compared with wild-type rats. Transcriptome analysis of the cerebral cortex identified 190 upregulated and 149 downregulated genes in heterozygous <em>Kcnt1</em>-269 variant rats compared with wild-type rats. Functional enrichment analysis revealed that \"nucleolus,\" \"neuropeptide signaling pathway,\" \"dendrite,\" and \"protein binding\" were the most prominent Gene Ontology terms, while \"neuroactive ligand–receptor interaction\" was one of the most significant Kyoto Encyclopedia of Genes and Genomes terms.</div></div><div><h3>Conclusion</h3><div>Our findings elucidate the epileptogenicity of the <em>Kcnt1</em>-269 variant in rats and may provide new insights into the pathways associated with <em>Kcnt1</em> variant–related epilepsy through transcriptome analysis.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"216 ","pages":"Article 107589"},"PeriodicalIF":2.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194445","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":"Clinical efficacy of lacosamide monotherapy in children with focal epilepsy and comorbid depression and its impact on peripheral blood interleukin-6 and serotonin expression","authors":"Rui Li ,&nbsp;Runlu Geng ,&nbsp;Xiaoqing Xu ,&nbsp;Chu Wang ,&nbsp;Yichen Tao ,&nbsp;Yuanyuan Dai","doi":"10.1016/j.eplepsyres.2025.107587","DOIUrl":"10.1016/j.eplepsyres.2025.107587","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the clinical efficacy of lacosamide monotherapy in adolescents with focal epilepsy and comorbid depression and its effects on peripheral blood interleukin-6 (IL-6) and serotonin (5-HT) levels.</div></div><div><h3>Methods</h3><div>A total of 116 adolescents (12–18 years) newly diagnosed with focal epilepsy and depression between June 2022 and December 2023 were randomly assigned to the lacosamide group (n = 53) and the oxcarbazepine group (n = 63). The treatment duration ranged from 6 to 12 months. Outcomes included epilepsy control rates, the Hamilton Depression Scale (HAMD) scores, peripheral IL-6 and 5-HT levels and adverse drug reactions.</div></div><div><h3>Results</h3><div>After 6 months, epilepsy control in the lacosamide group reached 64.71 %, comparable to the oxcarbazepine group (<em>P</em> &lt; 0.05). At 12 months, the lacosamide group achieved a higher control rate than the oxcarbazepine group (89.13 % vs 73.02 %, <em>P</em> &lt; 0.05). Both groups showed no baseline differences in the HAMD scores, IL-6 and 5-HT levels. In the lacosamide group, the HAMD scores and IL-6 levels decreased, whereas 5-HT levels increased significantly at 6 and 12 months compared with baseline (<em>P</em> &lt; 0.05). The incidence of adverse reactions in the lacosamide group was 15.09 %, which was lower than that in the oxcarbazepine group (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Lacosamide monotherapy effectively controls seizures and alleviates depressive symptoms in adolescents with focal epilepsy and depression. These benefits may be associated with decreased IL-6 and increased 5-HT levels. Lacosamide also demonstrated a favourable safety profile.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"216 ","pages":"Article 107587"},"PeriodicalIF":2.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212974","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}