Epilepsy Research最新文献

{"title":"Long-term efficacy and safety of perampanel monotherapy in patients with newly diagnosed or currently untreated recurrent focal-onset seizures: Results from the open-label extension phase of FREEDOM (Study 342)","authors":"Takamichi Yamamoto ,&nbsp;Sung Chul Lim ,&nbsp;Hirotomo Ninomiya ,&nbsp;Yuichi Kubota ,&nbsp;Won Chul Shin ,&nbsp;Dong Wook Kim ,&nbsp;Dong Jin Shin ,&nbsp;Koji Iida ,&nbsp;Taku Ochiai ,&nbsp;Risa Matsunaga ,&nbsp;Hidetaka Hiramatsu ,&nbsp;Ji Hyun Kim","doi":"10.1016/j.eplepsyres.2024.107494","DOIUrl":"10.1016/j.eplepsyres.2024.107494","url":null,"abstract":"<div><h3>Objective</h3><div>FREEDOM (Study 342; NCT03201900) assessed the long-term treatment effect of perampanel monotherapy in adolescent and adult patients (12–74 years of age) with untreated focal-onset seizures (FOS), with or without focal to bilateral tonic-clonic seizures (FBTCS).</div></div><div><h3>Methods</h3><div>In the Core Study, after a 4-week Pretreatment Phase, perampanel was up-titrated to 4 mg/day during a 6-week Titration Period followed by a 26-week Maintenance Period. Patients experiencing seizure(s) during the 4-mg/day Maintenance Period could have perampanel up-titrated to 8 mg/day over 4 weeks then could enter the 26-week 8-mg/day Maintenance Period. Patients could enter Extension to continue treatment upon the completion of the Core Study. Seizure-freedom rates, time to seizure recurrence or withdrawal since the initiation of maintenance treatment, and safety outcomes were assessed.</div></div><div><h3>Results</h3><div>In FREEDOM, 89 patients who received ≥ 1 perampanel dose were included for safety assessments (Safety Analysis Set), and 73 of them entered the 4-‍‍‍mg/day Maintenance Period (the modified Intent-to-Treat Analysis set) with 21 patients having perampanel up-titrated to 8 mg/day; 46 patients entered Extension with 38 patients completing. Overall, 42/89 (47.2 %) patients had cumulative exposure to perampanel for &gt; 52 weeks. Among patients who entered Extension, 52.2 % (n = 24/46; 95 % confidence interval [CI] 36.9, 67.1) remained seizure free for 52 weeks at perampanel 4 mg/day and 67.4 % (n = 31/46; 95 % CI 52.0, 80.5) at 4–8 mg/day. The cumulative probabilities of seizure recurrence and withdrawal at 4–8 mg/day over 52 weeks were 28.9 % (95 % CI 19.0, 42.4) and 43.8 % (95 % CI 33.4, 55.9), respectively. Treatment-emergent adverse events (TEAEs) occurred in 74/89 (83.1 %) patients, with 9/89 (10.1 %) discontinuing because of TEAEs. Dizziness occurred in 34/89 (38.2 %) patients and was the most common event.</div></div><div><h3>Conclusions</h3><div>Patients with untreated FOS (with or without FBTCS) are able to maintain seizure freedom for up to 52 weeks with perampanel monotherapy at a dose of 4–8 mg/day. The tolerability profile was manageable, and the safety profile was consistent with previous findings.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"210 ","pages":"Article 107494"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946965","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":"Significant reduction of seizure frequency in patients with drug-resistant epilepsy by vagus nerve stimulation: Systematic review and meta-analysis","authors":"Malaisamy Muniyandi ,&nbsp;Karthick Chelvanayagam ,&nbsp;Sahil Abdul Salam ,&nbsp;Sathishkumar Vadamalai ,&nbsp;Kavitha Rajsekar ,&nbsp;Rajeswari Ramachandran","doi":"10.1016/j.eplepsyres.2025.107510","DOIUrl":"10.1016/j.eplepsyres.2025.107510","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy is a major neurological disorder, typically managed with Anti-Seizure Medication (ASM). Nevertheless, a substantial 30 % of patients did not respond satisfactorily to ASMs, classifying their condition as Drug-Resistant Epilepsy (DRE). Vagus Nerve Stimulation (VNS) was recommended as a potential solution.</div></div><div><h3>Objective</h3><div>To evaluate clinical efficacy of VNS on patients with DRE in reduction of seizures through a systematic review and meta-analysis using a random effects model.</div></div><div><h3>Methods</h3><div>A systematic search was done from PubMed, ScienceDirect, Cochrane Library and Google Scholar databases on observational studies and randomized controlled trials (RCTs) for the clinical effectiveness of VNS among DRE patients. A meta-analysis was performed to obtain the pooled estimate of the clinical effectiveness of VNS in terms of seizure reduction and the odds ratio (OR) for patients achieving &gt; 50 % seizure reduction. Heterogeneity was assessed using visual inspection of forest plots and I² statistic.</div></div><div><h3>Results</h3><div>A total of 1023 articles were retrieved from the electronic search. After removing duplicates, non-relevance and non-availability of efficacy data, 28 articles were included in the final analysis. Of these, 9 are RCTs and 19 are observational studies. The pooled estimate of &gt; 50 % seizure reduction was 0.46 (95 % CI: 0.40–0.51) and the pooled estimate of the OR comparing &gt; 50 % vs ≤ 50 % seizure reduction was 0.76 (95 % CI: 0.44–1.29).</div></div><div><h3>Conclusion</h3><div>Our meta-analysis showed that 46 % of DRE patients have experienced ≥ 50 % seizure reduction with VNS treatment. It should be considered in patients in whom ASM has failed or who continue to experience seizures after medication.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"210 ","pages":"Article 107510"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983106","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":"Daily executive functioning in adults with pediatric hemispherectomy","authors":"Cory E. Kowalski ,&nbsp;Warren S. Brown ,&nbsp;Anne A.T. Nolty ,&nbsp;Amanda Panos ,&nbsp;Monika Jones ,&nbsp;Lynn K. Paul","doi":"10.1016/j.eplepsyres.2025.107509","DOIUrl":"10.1016/j.eplepsyres.2025.107509","url":null,"abstract":"<div><h3>Background and aims</h3><div>For young children with intractable epilepsy caused by congenital abnormalities or acquired cortical lesions, pediatric hemispherectomy surgery (pHS) may offer the only path to seizure remediation. Although some sensory and motor outcomes of pHS are highly predictable, the long-term cognitive and functional sequelae of pHS are far more variable. With the aim of identifying potential post-pHS intervention targets, the current study examined daily executive functioning and self-awareness in adults with pHS and broadly intact cognitive outcomes (indicated by average or above performance on intelligence tests).</div></div><div><h3>Methods</h3><div>This study used self- and informant-ratings on the Behavior Rating Inventory of Executive Functioning, Adult Version (BRIEF-A) everyday executive functioning in to evaluate adaptive behavior in 16 adults with pHS and Full-Scale IQ (FSIQ) of 77 or greater. Self- and informant-report results were compared to the normative sample, as was the proportion of participants with self vs. informant discrepancy scores of &gt; 1 standard deviation.</div></div><div><h3>Results</h3><div>Both participants and informants reported each participants’ behaviors and executive functioning were largely commensurate with average range from test norms. On average, participants with pHS rated themselves as stronger than their peers at Self-Monitoring, possibly suggesting compensatory attention to issues surrounding their sensory-motor disabilities (e.g., hemiplegia and hemianopsia). Informant- and self-reports were generally consistent, with the exception of an elevated number of participants whose self-ratings indicated less impairment than informant-ratings on the Initiate subscale.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that following pHS, adults with average (or higher) general cognition also exhibit daily executive functioning broadly commensurate with their peers, with the possible exceptions of elevated self-monitoring and greater likelihood of overestimating their initiation (compared to informant ratings).</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"210 ","pages":"Article 107509"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002576","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":"Effects of MeCP2 on chronic seizures and cognitive function in mice with temporal lobe epilepsy","authors":"Yu Chen ,&nbsp;Shu-Nan Yang ,&nbsp;Guan-Ling Fu ,&nbsp;Xiao-Xuan Liu ,&nbsp;Xin-Li Xiao ,&nbsp;Xiao-Lin Wu ,&nbsp;Feng Wu ,&nbsp;Yan-Bing Ma ,&nbsp;Sheng-Feng Ji ,&nbsp;Jin-Song Zhou ,&nbsp;Jian-Xin Liu","doi":"10.1016/j.eplepsyres.2025.107512","DOIUrl":"10.1016/j.eplepsyres.2025.107512","url":null,"abstract":"<div><div>Mutations in methyl CpG binding protein 2 (MeCP2) are linked to Rett syndrome, in which epilepsy is one of the most well-described disorders. However, little is known about the specific role of MeCP2 during epileptogenesis. Our previous study has demonstrated that MeCP2 has a unique control on the development of mossy fiber sprouting (MFS) in the epileptic hippocampus. This study aimed to (1) examine whether MeCP2 affects spontaneous recurrent seizures (SRSs) and cognitive deficits in mice with pilocarpine-induced epilepsy, and (2) profile MeCP2’s downstream molecular events. In the dentate gyrus (DG), we found that over-expression or suppression of MeCP2 significantly reduced or increased the frequency, duration, and number of stage 5 seizures of SRSs during the chronic stage after the SE. Over-expression of MeCP2 improved cognitive deficits in TLE mice, while exacerbated cognitive performances were observed following MeCP2 knockdown. Chromatin immunoprecipitation sequencing (ChIP-seq) and RNA-sequence analyses revealed that MeCP2-targeted genes have far‑reaching impacts on the pathophysiological events during epileptogenesis, including neuron differentiation, neurogenesis, axon guidance, and so on.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"210 ","pages":"Article 107512"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028333","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":"Tenets of timing: An evidence based comprehensive review on time-lag in the management of pediatric status epilepticus and its effect on clinical outcomes","authors":"Vaibhav R. Suryawanshi ,&nbsp;Kavita Srivastava ,&nbsp;Asavari Raut ,&nbsp;Bhakti Sarangi","doi":"10.1016/j.eplepsyres.2025.107518","DOIUrl":"10.1016/j.eplepsyres.2025.107518","url":null,"abstract":"<div><div>Pediatric status epilepticus (SE) is a life-threatening, time-sensitive neurological emergency. The adequate treatment of pediatric patients with SE is challenging, especially when the principles of time are considered. Various clinical trials and studies [especially one of the most important randomized controlled trials of the present time, ‘ESETT (Established Status Epilepticus Treatment Trial)’] compared the effectiveness of 3 antiseizure medications (ASMs) in patients with SE, providing robust evidence for clinical practice. Meticulous analysis of care delivery is an essential component as far as optimal management of pediatric SE is concerned. We performed an evidence-based comprehensive review on documented non-compliance and deviations from standard-treatment guidelines (STGs), focusing on time-elapsed from pediatric SE onset to ASM administration and escalation to subsequent classes. We have found significant gaps in real-world clinical practice. A literature review and a pooled-analysis of 12 studies on pediatric SE showed prehospital time to SE treatment was 29.5 minutes. Time to EMS arrival and hospital admission was 23 minutes and 48 minutes, respectively. Time-elapsed from SE onset to first-line ASM administration was 25.5 minutes, compared to evidence-based guidelines recommended time of 5–10 minutes. Similar delays were also observed in second- and third-line ASM administration. We have reviewed the factors affecting time-delays and impact on clinical outcomes. This review also highlights quality-improvement avenues that may help in improvising time for SE treatment and associated outcomes in pediatrics.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"210 ","pages":"Article 107518"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104484","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":"Early-phase EEG power spectrum analysis may differentiate acute encephalopathy with biphasic seizures and late reduced diffusion from prolonged febrile seizures","authors":"Eri Ogawa ,&nbsp;Yuri Sakaguchi ,&nbsp;Tetsuji Kaneko ,&nbsp;Osamu Saito ,&nbsp;Sahoko Miyama","doi":"10.1016/j.eplepsyres.2025.107515","DOIUrl":"10.1016/j.eplepsyres.2025.107515","url":null,"abstract":"<div><h3>Background</h3><div>Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is clinically characterized by biphasic seizures associated with mild to severe neurological sequelae and is the most common subtype of acute encephalopathy in Japan, accounting for around 30 % of cases. The present study retrospectively analyzed the utility of electroencephalography (EEG) in determining the optimal method of diagnosing AESD at the early stage.</div></div><div><h3>Methods</h3><div>This study explores early power value differences to differentiate acute encephalopathy from prolonged febrile seizure (FS). The subjects were patients aged six months to four years who had received intensive care for febrile status epilepticus and had a continuous EEG record up to 24 h after seizure onset. Power spectrum analysis of consecutive, 30-minute recordings at two-hour intervals were conducted, and the power values (alpha, beta, delta, theta waves) were compared between AESD group and FS group.</div></div><div><h3>Results</h3><div>Eight patients with AESD and 69 patients with FS were identified retrospectively. The emergence of delta waves in the frontal region was significantly higher in the AESD group at six to ten hours after onset. The emergence of beta waves across all the regions was lower in the AESD group from six hours after seizure onset.</div></div><div><h3>Conclusions</h3><div>Frequency analysis of EEG in the early period after febrile status epilepticus onset demonstrated a significant difference between the AESD and FS groups. Delta wave power values in the frontal region at six to ten hours after onset might be useful for the early differentiation of AESD from FS.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"210 ","pages":"Article 107515"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058518","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":"SEEG guided mapping of primary motor cortex in children with epilepsy","authors":"Sonali Singh ,&nbsp;Karim Mithani ,&nbsp;Ayako Ochi ,&nbsp;Hiroshi Otsubo ,&nbsp;Rohit Sharma ,&nbsp;Suvasini Sharma ,&nbsp;Lauren Sham ,&nbsp;Shelly Weiss ,&nbsp;George M. Ibrahim ,&nbsp;Elizabeth Donner ,&nbsp;Puneet Jain","doi":"10.1016/j.eplepsyres.2025.107517","DOIUrl":"10.1016/j.eplepsyres.2025.107517","url":null,"abstract":"<div><h3>Background</h3><div>Direct cortical electrical stimulation remains the gold standard for delineation of the primary motor cortex in patients with drug-resistant epilepsy (DRE) undergoing epilepsy surgery evaluation</div></div><div><h3>Objective</h3><div>This study aimed to explore the efficacy and safety of functional motor mapping through Stereo-EEG (SEEG) electrode contacts in children with DRE at our institute.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis of children who underwent SEEG evaluation and functional cortical mapping via bipolar electrical stimulation at our institution between July 2020 and June 2024. Detailed clinical, radiological and neurophysiological variable were extracted; qualitative and quantitative variables were summarized using appropriate descriptive statistics.</div></div><div><h3>Results</h3><div>A total of 29 patients underwent functional cortical motor mapping via SEEG with the mean age of 12.5 years (standard deviation, 4.1). Stimulation was performed using 50 Hz bipolar electrical stimulation. Succesful motor mapping was reported in 28 patients (96.6 %). The median lowest current threshold for a motor response was 2 mA. The spectrum of motor responses reported included: tonic/dystonic (26), clonic (6), and jerk/jitteriness (1). Afterdischarges were noted in 14 patients (48.3 %) and seizures were seen in 5 patients (17.2 %).</div></div><div><h3>Conclusions</h3><div>SEEG guided electrical stimulation of motor cortex is feasible and safe for functional cortical mapping in children with epilepsy.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"210 ","pages":"Article 107517"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064696","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":"Neuromodulation Strategies in Lennox‐Gastaut Syndrome: Practical Clinical Guidance from the Pediatric Epilepsy Research Consortium","authors":"Debopam Samanta ,&nbsp;Gewalin Aungaroon ,&nbsp;Anthony L. Fine ,&nbsp;Cemal Karakas ,&nbsp;Michelle Y. Chiu ,&nbsp;Puneet Jain ,&nbsp;Syndi Seinfeld ,&nbsp;Juliet K. Knowles ,&nbsp;Ismail S. Mohamed ,&nbsp;Carl E. Stafstrom ,&nbsp;Tracy Dixon-Salazar ,&nbsp;Anup D. Patel ,&nbsp;Sonam Bhalla ,&nbsp;Cynthia Guadalupe Keator ,&nbsp;Jorge Vidaurre ,&nbsp;Aaron E.L. Warren ,&nbsp;Renée A. Shellhaas ,&nbsp;M. Scott Perry","doi":"10.1016/j.eplepsyres.2024.107499","DOIUrl":"10.1016/j.eplepsyres.2024.107499","url":null,"abstract":"<div><div>Lennox-Gastaut syndrome (LGS) is a severe developmental and epileptic encephalopathy characterized by multiple drug-resistant seizure types, cognitive impairment, and distinctive electroencephalographic patterns. Neuromodulation techniques, including vagus nerve stimulation (VNS), deep brain stimulation (DBS), and responsive neurostimulation (RNS), have emerged as important treatment options for patients with LGS who do not respond adequately to antiseizure medications. This review, developed with input from the Pediatric Epilepsy Research Consortium (PERC) LGS Special Interest Group, provides practical guidance for clinicians on the use of these neuromodulation approaches in patients with LGS. We discuss patient selection criteria, expected seizure and non-seizure outcomes, potential complications, and device management considerations for each technique. The review also covers initiation and titration strategies, ongoing care requirements, and emerging data on combining multiple neuromodulation modalities. While all three approaches can reduce seizure frequency in patients with LGS, with commonly reported responder rates ranging from 50 % to 60 %, their impacts on cognition, behavior and quality of life are more variable. Careful patient selection, individualized programming, and long-term follow-up are essential to optimize outcomes with neuromodulation in this challenging patient population. Further research is needed to identify optimal candidates, determine the ideal timing during patients’ clinical course to consider neuromodulation, develop standardized outcome measures, and evaluate the comparative effectiveness and cost-effectiveness of different neuromodulation techniques for LGS.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"210 ","pages":"Article 107499"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946967","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":"Twenty-four-hour pattern of children with febrile seizures presenting to a United States Pediatric Emergency Department","authors":"Ami P. Shah ,&nbsp;Michael H. Smolensky ,&nbsp;Linda Sackett-Lundeen ,&nbsp;Shahab Haghayegh ,&nbsp;Aishah Najam ,&nbsp;David Slattery","doi":"10.1016/j.eplepsyres.2025.107508","DOIUrl":"10.1016/j.eplepsyres.2025.107508","url":null,"abstract":"<div><h3>Background</h3><div>Febrile seizure (FS) is the most common convulsive disorder in children. Understanding its time-of-day pattern can provide insight into mechanisms and prevention.</div></div><div><h3>Purpose</h3><div>We explored clock-time variation of FS presentations of children to a US pediatric emergency department (PED) in comparison to two control cohorts: one (<em>n</em> = 5719) like-aged children presenting solely with fever, i.e., temperature &gt; 100.4 °F/38°C, and one of children (<em>n</em> = 103,806) presenting for any medical emergency.</div></div><div><h3>Methods</h3><div>Electronic medical records covering a 58-month span were searched for clock time of arrivals to the PED, with data assessed either by chi-square or Cosinor analyses to test for temporal variation and derive descriptive parameters.</div></div><div><h3>Major findings</h3><div>Presentation of the 84 FS cases exhibited a time–of-day difference (<em>p</em> = .038), being 5-fold higher between 16:00–19:59 h than 08:00–11:59 h. Presentations of both control groups additionally exhibited such difference, with peak numbers between 16:00 and 19:59 h. Fever intensity of cases tended to be greater by 0.58 °F (<em>p</em> &gt; .10) in those attending the PED between 16:00–23:59 h than 00:00–07:59 h. The control group of children solely with fever showed (<em>p</em> &lt; .0001) time-of-day variation in body temperature, with the difference between presentations of highest and lowest temperature, respectively at ∼21:40 and ∼09:40 h, of 0.4 °F.</div></div><div><h3>Novelty of findings</h3><div>This is the first study to report time-of-day variation in FS of American children, which is like that reported in children of other countries. The peak number of presentations for FS corresponds in time both with that for fever without seizure and that for any medical emergency, and, additionally, fever intensity of fever controls.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"210 ","pages":"Article 107508"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002579","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 of pediatric drug-resistant generalized epilepsy with responsive neurostimulation of the centromedian nucleus of the thalamus: A case series of seven patients","authors":"Mikaela E. Speakes ,&nbsp;Kiersten Reznik-Schaefer ,&nbsp;Ruba Al-Ramadhani ,&nbsp;Luis D. Fernandez ,&nbsp;Jasmine L. Hect ,&nbsp;Taylor J. Abel ,&nbsp;William P. Welch","doi":"10.1016/j.eplepsyres.2025.107516","DOIUrl":"10.1016/j.eplepsyres.2025.107516","url":null,"abstract":"<div><h3>Purpose</h3><div>Responsive neurostimulation of the centromedian nucleus of the thalamus (CM RNS) is being investigated for treatment of drug-resistant generalized epilepsy with promising results. The aim of this study is to report outcomes of seven patients with pediatric-onset drug-resistant generalized epilepsy, including both genetic generalized epilepsy (GGE) and Lennox-Gastaut syndrome (LGS), who underwent treatment with bilateral CM RNS.</div></div><div><h3>Methods</h3><div>A retrospective chart review was performed for patients with drug-resistant generalized epilepsy who underwent treatment with bilateral CM RNS at Children’s Hospital of Pittsburgh from 2020 to 2022. Improvement in seizure frequency was obtained through patient and/or caregiver reports on standardized patient questionnaires. The primary outcome measure was percent improvement in seizure frequency at time of last follow-up appointment compared to baseline seizure frequency.</div></div><div><h3>Results</h3><div>Five of the seven patients (71 %) had an average 50 % or greater improvement in seizure frequency among seizure types including four of the five patients (80 %) with GGE and one of the two patients (50 %) with LGS. There were no serious adverse events including post-operative infection, stroke, or device malfunction/migration.</div></div><div><h3>Conclusion</h3><div>This data, along with other recent studies, suggests that CM RNS can improve seizure frequency in pediatric-onset drug-resistant generalized epilepsy, but larger systematic studies with longer follow-up times and standardized outcome measures are needed to determine long-term effectiveness and optimal patient selection for thalamic RNS.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"210 ","pages":"Article 107516"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046063","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}