Epilepsy Research最新文献

{"title":"Periodic limb movements among persons with epilepsy: A retrospective polysomnographic study","authors":"Manav Jain , Laurel Charlesworth , Helen Driver , Gavin P. Winston , Lysa Boissé Lomax , Garima Shukla","doi":"10.1016/j.eplepsyres.2025.107662","DOIUrl":"10.1016/j.eplepsyres.2025.107662","url":null,"abstract":"<div><h3>Introduction</h3><div>Persons with epilepsy (PWE) frequently contend with disrupted sleep related to multiple seizure related as well as other factors like medications and comorbidities. Such disturbances often lead to fragmented sleep, which can adversely affect quality of life and compromise seizure management. Previous</div><div>Although previous research has addressed conditions like sleep apnea and insomnia among PWE, less attention has been paid to periodic limb movements (PLMs), a requirement for diagnosis of the periodic limb movement disorder and also commonly observed in restless legs syndrome (RLS) as well as other conditions. This study aims to determine the prevalence and specific features of PLMs in PWE and to explore how these movements correlate with objective sleep measurements.</div></div><div><h3>Methods</h3><div>This investigation employed a retrospective chart review of consecutive adult patients diagnosed with epilepsy who underwent polysomnography at a tertiary-care sleep laboratory over a ten-year span. The control group consisted of individuals evaluated for possible obstructive sleep apnea, who were matched to cases based on age, sex, and the severity of sleep apnea. Patient records were initially identified using keywords related to “epilepsy” or “seizures.” Epilepsy diagnosis was confirmed through detailed chart review, which also yielded clinical details likety duration of epilepsy, seizure classification, and antiseizure medication usage. Sleep parameters such as sleep efficiency, spontaneous arousal index, periodic limb movement index, periodic limb movement with arousal index, and apnea-hypopnea index were extracted from archived polysomnography reports. The subsequent analysis was carried out using descriptive statistical methods using RStudio version 4.4.1.</div></div><div><h3>Results</h3><div>A total of 152 relevant patient records were found in the database. Of these, 61 patients with epilepsy (mean age 41.4 ± 17.2 years, including 31 females) met the inclusion criteria and were matched with 61 patients suspected for OSA. Within the epilepsy cohort, 43 patients experienced focal-onset epilepsy while 16 had generalized epilepsy. 25 patients were prescribed two or more antiseizure medications, and 12 were categorized as medically refractory. PLMs were detected in 23 % of patients with epilepsy compared to 26 % in the control group, with mean PLMI values of 6.1 ± 16.8 and 8.8 ± 20.7, respectively. The PLMAI was also similar between the two groups (0.5 ± 1.0 vs. 1.1 ± 2.4). Other sleep parameters, including the mean AHI (16.0 ± 20.0 in the epilepsy group vs. 19.7 ± 19.4 in the control group), did not exhibit significant differences between groups. Within the epilepsy cohort, the only factor linked to the presence of periodic limb movements was older age, with no observed association with seizure type, number of antiseizure medications, or seizure control.</div></div><div><h3>Conclusions</h3><div>PLMs are a","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107662"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085185","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":"Attention-deficit/hyperactivity disorder in adults with epilepsy: Preliminary prevalence and associated factors in a Czech sample","authors":"Karin Daniele ,&nbsp;Jaroslava Raudenská ,&nbsp;Alena Javůrková","doi":"10.1016/j.eplepsyres.2025.107645","DOIUrl":"10.1016/j.eplepsyres.2025.107645","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigated the prevalence of Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms in Czech adult people with epilepsy (PWE) and examined factors potentially contributing to the co-occurrence of these two conditions. Although previous research has consistently reported elevated rates of ADHD in epilepsy populations, data from adult samples in Czech Republic remain limited.</div></div><div><h3>Methods</h3><div>Fifty-six adults with epilepsy completed validated self-report questionnaires assessing ADHD symptoms (ASRS), anxiety (GAD-2), and depression (NDDIE-2). Epilepsy-related clinical factors, such as seizure frequency, anti-seizure medication (ASM), type of epilepsy and epilepsy duration, were also analyzed in relation to ADHD symptoms.</div></div><div><h3>Results</h3><div>A high prevalence of ADHD symptoms n = 25 (44.6 %) was found in the sample. No significant associations were observed between ADHD symptoms and epilepsy-related variables or depressive symptoms, but a regression model of clinical and sociodemographic variables can explain 34.2 % of the variance in ASRS scores (Adj. R² = 0.342), with only anxiety emerging as a significant predictor (β = 0.517, SE = 0.50, t = 3.23, p = .003).</div></div><div><h3>Conclusion</h3><div>These preliminary findings suggest a possible link between epilepsy and ADHD, which may be further explored in future research through shared emotional or neurobiological mechanisms. The results underscore the need for integrated screening approaches and further research into the co-occurrence of epilepsy and ADHD in adult populations.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107645"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018503","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":"Electrographic seizures on responsive neurostimulation: An early and objective measure of response to cenobamate","authors":"Sami Aboumatar ,&nbsp;Jay R. Gavvala ,&nbsp;Zeenat Jaisani ,&nbsp;Ruben Kuzniecky ,&nbsp;Michael Privitera ,&nbsp;Madeline Ring ,&nbsp;William E. Rosenfeld ,&nbsp;Jacob Pellinen","doi":"10.1016/j.eplepsyres.2025.107647","DOIUrl":"10.1016/j.eplepsyres.2025.107647","url":null,"abstract":"<div><h3>Objectives</h3><div>Responsive neurostimulation (RNS) electrocorticographic (ECoG) data may have a role in objectively assessing the efficacy of add-on antiseizure medications (ASMs). This retrospective, multicenter, observational, 24-week study is the first to report the effects of cenobamate on RNS-detected events (RDE).</div></div><div><h3>Methods</h3><div>Patients included adults (≥18 years) with a history of recurrent focal seizures and implanted RNS who initiated adjunctive cenobamate ≥ 3 months after RNS implant between 4/1/20–12/15/23 and who received ≥ 2 weeks of cenobamate (≥50 mg/day). RDE (“long episodes,” “long episodes with saturation,” and “saturation”) obtained from the NeuroPace Patient Data Management System were reviewed to select only electrographic seizures (ESs) based on electrographic ictal patterns. RDEs and ESs were counted during the 8-week baseline period, every 2 weeks for 12 weeks after starting cenobamate, and at study end. The main outcome was percent change from baseline to the end of the 16-week treatment period (12 + weeks) for overall ESs, ESs ≥ 50 seconds, and ESs &lt; 50 seconds. Patient-reported clinical seizure frequency was recorded when available.</div></div><div><h3>Results</h3><div>Thirty-seven patients (mean age 36.7 years) were included. Median cenobamate dose was 150 mg/day (range, 50–250 mg/day). There was a significant median percent reduction from baseline to the end of cenobamate treatment in ESs (94.4 %; p &lt; 0.0001), ESs ≥ 50 s (100.0 %; p &lt; 0.0001), and ESs &lt; 50 s (100.0 %; p &lt; 0.0001). Among patients with available seizure data (n = 24), median percent reduction in clinical seizures per 28 days from baseline to end of treatment was 72.2 % (p &lt; 0.0001). Adverse events were reported in 27 % (10/37) of patients; dizziness, fatigue, and sleepiness were most reported.</div></div><div><h3>Significance</h3><div>Patients with uncontrolled seizures after RNS had a significant reduction in ESs and clinically reported seizures during adjunctive cenobamate treatment. Results from this analysis support the potential use of RNS ECoG data as an objective measure to supplement clinical data when determining cenobamate efficacy and may provide a strategy for monitoring responses to ASMs more generally in this population.</div></div><div><h3>Data Availability</h3><div>The data for the analyses described in this paper are available by request from the corresponding author or from SK Life Science, Inc., the company sponsoring the clinical development of cenobamate for the treatment of focal epilepsy.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107647"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003869","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":"Deep brain stimulation of the anterior nucleus of the thalamus in animal models of mesial temporal lobe epilepsy: A literature review","authors":"Emma Acerbo ,&nbsp;Thomas Eggers ,&nbsp;Alejandra M. Fernandez ,&nbsp;Robert E. Gross ,&nbsp;Claire-Anne Gutekunst","doi":"10.1016/j.eplepsyres.2025.107670","DOIUrl":"10.1016/j.eplepsyres.2025.107670","url":null,"abstract":"<div><div>Epilepsy affects approximately 1 % of the global population, presenting as a complex and heterogeneous disorder characterized by spontaneous, recurrent seizures. Focal onset seizures comprise half of all epilepsy cases. Mesial temporal lobe epilepsy (MTLE), the most prevalent form of focal seizures in adults, originates in the temporal lobe and is challenging to manage with standard antiseizure medications. Deep brain stimulation (DBS) targeting the anterior nucleus of the thalamus (ANT) has emerged as a therapeutic option for drug-resistant cases. Although clinical effects are well documented, pre-clinical research remains limited. To date, only 28 studies have been published, mostly in rodents and few in primates and sheep. This narrative review examines the anatomical organization of the ANT across human, rodent, and non-human primate models and synthesizes findings from the preclinical studies investigating ANT-DBS in experimental MTLE animal models. Collectively, these studies demonstrate an approximate 50 % reduction in seizure frequency, mirroring recent clinical outcomes. However, the majority of studies have focused on high-frequency stimulation (&gt;100 Hz), with few exploring multiple stimulation frequencies. Additionally, outcomes from intermittent ON/OFF stimulation were inconclusive or showed worsening effects in two out of three studies. Thus, several crucial parameters, including stimulation frequency, pattern, and other variables remain inadequately explored in preclinical MTLE models yet hold potential to enhance therapeutic efficacy and patient outcomes.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107670"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265974","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":"Perceptions of health disparities among neurologists treating Black patients with epilepsy: A survey study in the United States","authors":"Ima Ebong ,&nbsp;Pam Eads ,&nbsp;Georgette Charles","doi":"10.1016/j.eplepsyres.2025.107637","DOIUrl":"10.1016/j.eplepsyres.2025.107637","url":null,"abstract":"<div><h3>Objective</h3><div>Many factors influence patients’ experience with epilepsy, including inequities based on socially defined race and ethnicity. We sought to better understand factors contributing to health disparities in Black people living with epilepsy (PWE), as perceived by neurologists, and the value of programs to help healthcare providers (HCPs) reduce these disparities.</div></div><div><h3>Methods</h3><div>An online, blinded, cross-sectional survey was administered to neurologists (November 8–18, 2022) whose population of PWE included ≥ 20 % of Black individuals and who had managed ≥ 10 PWE in the last 30 days. Questions assessed recognition of health disparities in PWE and the value of HCP-focused programs to address disparities. Statistical comparisons were performed by practice setting (academic vs. community).</div></div><div><h3>Results</h3><div>Of 101 neurologists, 48.5 % and 51.5 % worked in academic and community settings, respectively, 2.0 % of all neurologists were Black, and 28.3 % of neurologists’ patients were Black. Situations most commonly having a major/severe negative health impact were ‘inconsistent treatment adherence/compliance’ and ‘have significant comorbidities’ in all PWE, and ‘missed appointments’ and ‘mistrust in the healthcare system’ in Black PWE. In total, 27.7 % of neurologists (42.9 % academic vs. 13.5 % community-based; p &lt; 0.05) completely agreed that racism is a social determinant of health (SDOH). HCP-focused programs were generally considered as somewhat/very important to improve outcomes in Black PWE.</div></div><div><h3>Conclusions</h3><div>Fewer than a third of neurologists completely agreed that racism is an SDOH, variably suggesting no perceived differences in their patient populations (leading to disagreement) or providing evidence of implicit/unconscious bias. Increasing neurologists' participation in HCP-focused programs may help counter health disparities in Black PWE, or at a minimum improve awareness that disparities exist.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107637"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829607","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":"Ganaxolone in Epilepsy: Insights into a Neurosteroid-Based Therapy","authors":"Giovanni Battista Dell’Isola ,&nbsp;Margherita Siciliano ,&nbsp;Gianluca D’Onofrio ,&nbsp;Pietro Ferrara ,&nbsp;Pasquale Striano ,&nbsp;Marco Carotenuto ,&nbsp;Alberto Verrotti","doi":"10.1016/j.eplepsyres.2025.107669","DOIUrl":"10.1016/j.eplepsyres.2025.107669","url":null,"abstract":"<div><div>Neurological and neuropsychiatric disorders, particularly drug-resistant epilepsies and rare genetic syndromes such as CDKL5 deficiency disorder, pose significant therapeutic challenges. Ganaxolone (GNX), a synthetic neurosteroid and positive allosteric modulator of GABA-A receptors, has emerged as a promising treatment option due to its unique pharmacological properties. This review explores GNX's pharmacokinetic profile, preclinical evidence, and clinical applications. Preclinical studies have demonstrated its efficacy in reducing seizure frequency and severity across various epilepsy models, including amygdala kindling and status epilepticus, as well as its neuroprotective effects in hypoxic-ischemic encephalopathy. Clinical trials have confirmed GNX's benefits, particularly in CDD, where it significantly reduces seizure frequency, leading to its FDA and EMA approval. Additionally, GNX has shown potential in focal epilepsy, status epilepticus, and other drug-resistant epilepsies, although with variable results. Beyond epilepsy, GNX's modulation of GABAergic signaling suggests potential applications in neuropsychiatric conditions. Its favorable safety profile further supports its therapeutic value.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107669"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205979","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":"Exploring metabolic biomarkers and pathways in pharmacoresistant epilepsy: A systematic review","authors":"Zheng-Dong Lim ,&nbsp;Nur Asyiqin Syafiqa Abdullah ,&nbsp;Kheng-Seang Lim ,&nbsp;Paul Chi-Lui Ho ,&nbsp;Alina Arulsamy ,&nbsp;Si-Lei Fong ,&nbsp;Hui-Yin Yow","doi":"10.1016/j.eplepsyres.2025.107656","DOIUrl":"10.1016/j.eplepsyres.2025.107656","url":null,"abstract":"<div><div>Drug-resistant epilepsy (DRE) is characterized by the failure to attain sustained seizure freedom despite adequate trials of two antiseizure medication (ASM) regimens that are well tolerated and appropriately chosen and administered, either as monotherapies or in combination. Despite being a cornerstone of epilepsy treatment, ASMs are ineffective in achieving seizure remission in nearly one-third of patients, who are consequently classified as having DRE. This systematic review aims to determine potential metabolic biomarkers and pathways linked to DRE, which could inform personalized treatment and optimize therapeutic outcomes. A comprehensive search of databases, namely Medline, Web of Science and the Cochrane Central Register of Controlled Trials (CENTRAL) based on predefined inclusion and exclusion criteria yielded 29 eligible studies after full-text screening. The risk of bias from these studies was reviewed using the Office of Health Assessment and Translation (OHAT) risk of bias rating tool. Key information, including study groups, sample size, model types, and main findings were tabulated. Several metabolites were identified, including amino acids (glycine, glutamate, isoleucine), organic acids (lactate), and glucose, which may serve as potential biomarkers for DRE. MetaboAnalyst 6.0 pathway analysis identified the alanine, aspartate and glutamate metabolism, as well as phenylalanine, tyrosine and tryptophan biosynthesis pathways, emerged with significant impact score (≥0.5, p &lt; 0.05). The findings highlight the promising role of these metabolites and pathways as predictive biomarkers for DRE and potential therapeutic targets for novel drug development.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107656"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044611","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":"Astrocytic and microglial phenotypes in focal cortical dysplasia","authors":"Aditi Goyal ,&nbsp;Shilpa Rao ,&nbsp;Mariamma Philip ,&nbsp;A. Arivazhagan ,&nbsp;Jitender Saini ,&nbsp;LG Vishwanathan ,&nbsp;Ajay Asranna ,&nbsp;Raghavendra K ,&nbsp;RC Mundlamuri ,&nbsp;Nishanth Sadashiva ,&nbsp;RD Bharath ,&nbsp;Karthik K ,&nbsp;Sandhya M ,&nbsp;Malla Bhaskara Rao ,&nbsp;Sanjib Sinha ,&nbsp;Anita Mahadevan","doi":"10.1016/j.eplepsyres.2025.107663","DOIUrl":"10.1016/j.eplepsyres.2025.107663","url":null,"abstract":"<div><h3>Background</h3><div>Focal cortical dysplasia (FCD) is a common cause of focal epilepsy, however pathophysiology of epileptogenesis in FCD remains unresolved. Emerging evidence suggests that dysfunctional astrocytes are key players in epilepsy. Recently two phenotypes of astrocytes (A1/A2) and microglia (M1/M2) have been described in neurological diseases with neuroinflammatory and neuroprotective roles. We investigated astrocytic (A1/A2) and microglial (M1/M2) phenotypes in FCD and their role in epileptogenesis.</div></div><div><h3>Material and Methods</h3><div>Histologically confirmed cases of surgically resected FCD IIa (n = 10) and FCD IIb (n = 10) and age and region-matched post-mortem controls (n = 4) were evaluated by immunohistochemistry using C3d and GBP2 (A1-astrocytic markers), pSTAT3 (A2-astrocytes), CD14 (M1-microglia) and CD163 (M2-microglia), caspase 3 (for apoptosis) and phosphorylated-Tau and phosphorylated-neurofilament (for neuronal degeneration). Semi-quantitative assessment for glial phenotypes were correlated with clinical parameters.</div></div><div><h3>Results</h3><div>Compared to the control group, in FCDIIa, pSTAT3 + A2-astrocytes (mean-44.1 cells/mm²) predominated in absence of C3d/GBP2 + A1-astrocytes. In FCDIIb, A2-astrocytes were significantly higher than A1 (p-value=0.04) [A1 (C3d-15.79 cells/mm²; GBP2–13.67 cells/mm²); A2 (pSTAT3–78.24 cells/mm²)]. Balloon cells in FCDIIb strongly labelled with C3d and GBP2 (A1-phenotype). In both FCDIIa and IIb, pSTAT3 + A2 astrocytes were localised to subpial zone. Increase in both inflammatory CD14 + M1 and reparative CD163 + M2 microglia in perivascular region, was seen in the dysplastic cortex in both FCD IIa (M1- 11.9/mm², M2- 12.4 cells/mm²) and FCD IIb (M1–27.9/mm², M2–18.7/mm²) with M1 &gt;M2 in FCD IIb, though not statistically significant (p-value&gt;0.05). Mean densities of astrocytes (A1, A2) and microglia (M1, M2) did not correlate with any of the clinical parameters. Caspase 3 labelled reactive astrocytes and oligodendrocytes and occasional dysmorphic neurons in both, and BC in FCDIIb.</div></div><div><h3>Conclusions</h3><div>This is the first study examining astrocytic and microglial phenotypes in FCD IIa and IIb. Identification of specific astrocytic and microglial phenotypes offers novel therapeutic targets for modulation of epileptogenesis, especially in drug resistant epilepsy.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107663"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085068","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 and EEG characteristics of sleep-related hypermotor epilepsy in children","authors":"Xinru Tan ,&nbsp;Hailang Liu ,&nbsp;Yan Li ,&nbsp;Qiaoling Hu ,&nbsp;Lisi Yan ,&nbsp;Jin Chen ,&nbsp;Siqi Hong ,&nbsp;Li Jiang","doi":"10.1016/j.eplepsyres.2025.107664","DOIUrl":"10.1016/j.eplepsyres.2025.107664","url":null,"abstract":"<div><h3>Background</h3><div>Sleep-related hypermotor epilepsy (SHE) is a focal epilepsy with nocturnal hypermotor seizures. Although SHE was redefined in 2014, comprehensive pediatric studies are still lacking for this disorder. To address this need, here we describe the clinical and electroencephalography (EEG) characteristics of children with SHE.</div></div><div><h3>Methods</h3><div>We retrospectively enrolled pediatric patients with SHE diagnosis who were hospitalized at our institution from August 1, 2021, to August 31, 2023.</div></div><div><h3>Results</h3><div>Among the 47 patients, 31.9 % and 42.6 % manifested as SP2 and SP3, respectively. A total of 57.4 % of the patients showed a focal discharge as diagnosed by interictal EEG, 36.2 % showed multifocal discharges, and 6.4 % did not have discharge. Ictal EEG revealed that 66.0 % of patients presented with frontal lobe onset, 10.6 % with temporal lobe onset, and 23.4 % with unknown onset. Further, 36.2 % of patients had a structural etiology, approximately 80 % of those patients had focal cortical dysplasia. Finally, 23 patients were diagnosed with refractory epilepsy, and 15 of them underwent surgery.</div></div><div><h3>Conclusions</h3><div>Patients mainly presented as SP3 and SP2. The focal discharges detected by interictal EEG accounted for approximately 57.4 % and the frontal lobe onset detected by ictal EEG accounted for approximately 66 %. Structural etiology (mainly focal cortical dysplasia) accounted for approximately 33 %, and surgery was an effective treatment for these patients.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107664"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079941","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":"Outcomes of surgically and non-surgically managed temporal encephalocoeles in the context of drug-resistant temporal lobe epilepsy: A retrospective single-centre case series","authors":"Anca-Mihaela Vasilica ,&nbsp;Jasneet Kaur Dhaliwal ,&nbsp;Debayan Dasgupta ,&nbsp;Aswin Chari ,&nbsp;Sachit Shah ,&nbsp;Dermot Mallon ,&nbsp;Jane de Tisi ,&nbsp;Anna Miserocchi ,&nbsp;Andrew W. McEvoy ,&nbsp;John S. Duncan","doi":"10.1016/j.eplepsyres.2025.107643","DOIUrl":"10.1016/j.eplepsyres.2025.107643","url":null,"abstract":"<div><h3>Introduction</h3><div>Temporal encephalocoeles are a recognised cause of drug-resistant temporal lobe epilepsy (TLE), with uncertain associations to epileptogenesis and an unclear optimal management approach. Operative management, particularly resective temporal lobe surgery, has been proposed, but outcomes and decision-making criteria remain debated. This study aims to evaluate the outcomes of surgically and non-surgically managed patients with temporal encephalocoeles in the context of drug-resistant TLE, focusing on seizure freedom rates, postoperative complications and factors influencing management decisions.</div></div><div><h3>Methods</h3><div>A retrospective, single-centre study was conducted based on all adult TLE patients with temporal encephalocoeles encountered between March 2017 and August 2023. Patients were classified into three groups: those discussed at an epilepsy surgery multidisciplinary team (MDT) meeting and managed surgically (surgical group), those discussed at an MDT and managed non-surgically (non-surgical group) and those radiologically identified by reporting neuroradiologists but not discussed at MDT (radiologically diagnosed group). Clinical, electrophysiological, radiological and surgical data were compared across the groups, including radiological features of raised intracranial pressure (ICP) that have been postulated as a cause for temporal encephaloceles.</div></div><div><h3>Results</h3><div>We included 24 adult patients with temporal encephalocoeles: eight in the surgical group, eight in the non-surgical group and eight in the radiologically diagnosed group. The mean age at diagnosis was 39.3 ± 13.6 years and clinical features were comparable across groups. Operative management was decided by an experienced epilepsy surgery MDT, involving resection of the anterior temporal pole with (4/8, 50 %) or without (50 %) mesial temporal structures, resulted in a seizure freedom rate of 87.5 %. In contrast, no patient in the non-surgical or radiologically diagnosed groups achieved seizure freedom (0 %). Postoperative complications included one patient who developed hydrocephalus and required a ventriculoperitoneal shunt, and another who developed a pseudomeningocoele. Radiological markers of raised ICP were broadly similar across the groups, with the exception of increased optic nerve sheath diameter in the non-surgical group (p = 0.032).</div></div><div><h3>Conclusion</h3><div>Our study demonstrates that excellent post-operative outcomes are achievable with temporal lobe resections. A standardised presurgical evaluation pathway and management protocol are essential to ensure timely identification of temporal encephalocoeles on imaging, facilitating preoperative planning and optimising surgical outcomes. CSF hydrodynamic disturbances may occur after surgery for encephaloceles and individualised evaluation is therefore crucial to select the most appropriate management approach.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107643"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908470","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}