Journal of Neurology, Neurosurgery, and Psychiatry最新文献

{"title":"Long-term disability trajectories in multiple sclerosis: a group-based trajectory analysis of the AusLong cohort.","authors":"Amin Zarghami, Mohammad Akhtar Hussain, Ingrid van der Mei, Steve Simpson-Yap, Anne-Louise Ponsonby, Jeanette Lechner-Scott, Simon A Broadley, Robyn M Lucas, Yuan Zhou, Xin Lin, AusLong Investigator Group, Bruce V Taylor","doi":"10.1136/jnnp-2024-333632","DOIUrl":"10.1136/jnnp-2024-333632","url":null,"abstract":"<p><strong>Background: </strong>Previous natural history studies highlighted a consistent heterogeneity of disability trajectories among individuals with primary or secondary progressive multiple sclerosis (MS). However, evidence on disability progression in relapsing onset MS is scarce.The aim of this study was to investigate heterogeneity in disability accumulation over 10 years following a first clinical diagnosis of central nervous system demyelination (FCD) and identify genetic, demographic, environmental and clinical factors associated with these trajectories.</p><p><strong>Methods: </strong>We used group-based trajectory models to measure heterogeneity in disability trajectories based on the Expanded Disability Status Scale (EDSS) in a prospectively assessed cohort of 263 participants. To capture sustained neurological impairments and avoid issues related to significant changes in EDSS associated with relapse, we did not consider EDSS points recorded within 3 months of a relapse.</p><p><strong>Results: </strong>We identified three distinct and clinically meaningful disability trajectories: No/minimal, moderate and severe. Those in the no/minimal disability trajectory showed no appreciable progression of disability (median EDSS∼1 at 10-year review) while those in the moderate and severe disability trajectories experienced disability worsening (median time to reach EDSS 4 was 9 and 7 years, respectively). Compared with the no/minimal disability trajectory, those with older age, a higher number of relapses within the first 5 years post-FCD, and a higher number of comorbidities at baseline were more likely to be in the worse disability trajectory. Surprisingly, baseline MRI and anatomical site of initial symptoms did not influence long-term outcomes.</p><p><strong>Conclusions: </strong>Those at higher risk of faster MS disability progression can be identified based on their early clinical characteristics with potential therapeutic implications for early intervention and treatment escalation.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":"424-434"},"PeriodicalIF":8.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Code ICH: reorganising stroke care for intracerebral haemorrhage.","authors":"Wendy Ziai, Issam Awad, Daniel Hanley","doi":"10.1136/jnnp-2024-334937","DOIUrl":"10.1136/jnnp-2024-334937","url":null,"abstract":"","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":"508-512"},"PeriodicalIF":8.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Huntington's disease phenocopy syndromes revisited: a clinical comparison and next-generation sequencing exploration.","authors":"Carolin Anna Maria Koriath, Fernando Guntoro, Penelope Norsworthy, Egor Dolzhenko, Michael Eberle, Davina J Hensman Moss, Michael Flower, Holger Hummerich, Anne Elizabeth Rosser, Sarah J Tabrizi, Simon Mead, Edward J Wild","doi":"10.1136/jnnp-2024-333602","DOIUrl":"10.1136/jnnp-2024-333602","url":null,"abstract":"<p><strong>Background: </strong>Genetic testing for Huntington's disease (HD) was initially usually positive but more recently the negative rate has increased: patients with negative HD tests are described as having HD phenocopy syndromes (HDPC). This study examines their clinical characteristics and investigates the genetic causes of HDPC.</p><p><strong>Methods: </strong>Clinical data from neurogenetics clinics and HDPC gene-panel data were analysed. Additionally, a subset of 50 patients with HDPC underwent whole-genome sequencing (WGS) analysed via Expansion Hunter and Ingenuity Variant Analysis.</p><p><strong>Results: </strong>HDPC prevalence was estimated at 2.3-2.9 per 100 000. No clinical discriminators between patients with HD and HDPC could be identified. In the gene-panel data, deleterious variants and potentially deleterious variants were over-represented in cases versus controls. WGS analysis identified one <i>ATXN1</i> expansion in a patient with HDPC.</p><p><strong>Conclusions: </strong>The HDPC phenotype is consistent with HD, but the genotype is distinct. Both established deleterious variants and novel potentially deleterious variants in genes related to neurodegeneration contribute to HDPC.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":"466-469"},"PeriodicalIF":8.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of epilepsy: a population-based cohort study in Denmark with comparison to Global Burden of Disease (GBD) prevalence estimates.","authors":"Jakob Christensen, Betina B Trabjerg, Ryan G Wagner, Charles R Newton, Churl-Su Kwon, Kari Modalsli Aaberg, Eugen Trinka, Samuel Wiebe, Judith Helen Cross, Håkon Magne Vegrim, Theo Vos, Jaimie Steinmetz, Julie Werenberg Dreier","doi":"10.1136/jnnp-2024-334547","DOIUrl":"10.1136/jnnp-2024-334547","url":null,"abstract":"<p><strong>Background: </strong>The Global Burden of Disease Study (GBD) produces prevalence estimates for 'idiopathic epilepsy' (ie, of unknown aetiology) and 'secondary epilepsy' (ie, with known aetiology) but does not report prevalence by underlying aetiologies for 'secondary epilepsy'.</p><p><strong>Methods: </strong>We used nationwide, population-based register data from Denmark to identify underlying causes of epilepsy and their contribution to prevalence of 'secondary epilepsy' and compared with global prevalence data from GBD 2019. We identified all persons with a hospital-based epilepsy diagnosis and a filled prescription for antiseizure medication between 1 January 2009 and 31 December 2018. Epilepsy was categorised into 'idiopathic' or 'secondary' and 'total epilepsy' as the sum of the two epilepsy categories.</p><p><strong>Results: </strong>On 31 December 2018, a total of 5 784 284 individuals (49.7% males) were living in Denmark including 40 336 with epilepsy (51.5% males). Perinatal conditions, traumatic brain injury, brain tumours and stroke were prominent underlying causes of 'secondary epilepsy'. The prevalence of 'total epilepsy' in Denmark was 697 (95% CI 691 to 704) per 100 000 population (264 (95% CI 260 to 269) for 'secondary epilepsy' and 433 (95% CI 428 to 438) for 'idiopathic epilepsy'). In the GBD 2019 Study, the prevalence of 'total epilepsy' in 2018 was 682 (95% uncertainty interval (UI) 586 to 784) per 100 000 population (359 (95% UI 324-397) for 'secondary epilepsy' and 324 (95% UI 249 to 404) for 'idiopathic epilepsy').</p><p><strong>Conclusions: </strong>Prevalence estimates of 'total epilepsy', 'idiopathic epilepsy' and 'secondary epilepsy' in Denmark align with the GBD 2019 estimates. In future studies, it is suggested to explicitly include all types of epilepsy, including 'secondary epilepsy', which is currently estimated as sequelae (consequences) of underlying diseases.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":"480-488"},"PeriodicalIF":8.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous phosphorylated-synuclein: an early diagnostic biomarker for pure autonomic failure.","authors":"Shiwen Koay, Vincenzo Provitera, Giuseppe Caporaso, Ekawat Vichayanrat, Fernanda Valerio, Annamaria Stancanelli, Ilaria Borreca, Michael P Lunn, Maria Nolano, Valeria Iodice","doi":"10.1136/jnnp-2024-334615","DOIUrl":"10.1136/jnnp-2024-334615","url":null,"abstract":"<p><strong>Background: </strong>Pure autonomic failure (PAF) presents with progressive autonomic failure without other neurological features. Atypical presentations may lead to diagnostic uncertainty. We studied whether cutaneous phosphorylated-alpha-synuclein (p-syn) could distinguish between PAF, multiple system atrophy (MSA) and non-synucleinopathy-related autonomic failure, and examined its relationship with quantitative markers of cardiovascular autonomic failure.</p><p><strong>Methods: </strong>All individuals underwent Composite Autonomic Symptom Score-31 autonomic questionnaires, cardiovascular autonomic testing and bilateral distal leg skin biopsies. We noted whether p-syn was present in nerves supplying autonomic adnexa, including sweat glands, blood vessels, arrector pili muscles, and subepidermal fibres, dermal fibres and nerve fascicles (maximum autonomic subscore 3, total p-syn score 6 for each sample, average calculated for both sides).</p><p><strong>Results: </strong>36 individuals were studied: 11 PAF, 13 MSA and 12 non-synucleinopathy-related autonomic failure. P-syn was present in 22/22 (100%) PAF biopsies, 19/26 (73%) MSA biopsies and 0/22 (0%) non-synucleinopathy biopsies. Mean total p-syn score was significantly higher in PAF compared with MSA (median 4.5 vs 1, p<0.001). Total p-syn score >3 distinguished PAF from MSA with 100% specificity and 82% sensitivity. Autonomic p-syn subscores correlated with orthostatic intolerance ratio on tilt (ρ=0.63, p=0.0004), blood pressure recovery time following Valsalva manoeuvre (r=0.44, p=0.03) and patient-reported orthostatic intolerance (ρ=0.57, p=0.006).</p><p><strong>Conclusion: </strong>Cutaneous p-syn was abundant in PAF, a predominantly peripheral alpha-synucleinopathy. It is a promising biomarker to help distinguish between PAF, MSA and non-synucleinopathy-related autonomic failure to aid early diagnosis and recruitment to future clinical trials. P-syn deposition on autonomic nerves may impair control of total peripheral resistance giving rise to symptomatic orthostatic hypotension.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":"500-507"},"PeriodicalIF":8.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucagon-like peptide-1 receptor agonists for major neurocognitive disorders.","authors":"Riccardo De Giorgi, Ana Ghenciulescu, Courtney Yotter, Maxime Taquet, Ivan Koychev","doi":"10.1136/jnnp-2024-335593","DOIUrl":"https://doi.org/10.1136/jnnp-2024-335593","url":null,"abstract":"<p><p>Disease-modifying treatments for major neurocognitive disorders, including Alzheimer's disease, Parkinson's disease and other cognitive deficits, are among the main unmet needs in modern medicine. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), currently licensed for the treatment of type 2 diabetes mellitus and obesity, offer a novel, multilayered mechanism for intervention in neurodegeneration through intermediate, aetiology-agnostic pathways, likely involving metabolic, inflammatory and several other relevant neurobiological processes. In vitro and animal studies have revealed promising signals of neuroprotection, with preliminary supportive evidence emerging from recent pharmacoepidemiological investigations and clinical trials. In this article, we comprehensively review studies that investigate the impact of GLP-1RAs on the various aetiologies of cognitive impairment and dementia syndromes. Focusing on evidence from human studies, we highlight how brain energy homeostasis, neurogenesis, synaptic functioning, neuroinflammation and other cellular stress responses, pathological protein aggregates, proteostasis, cerebrovascular system and blood-brain barrier dynamics may underlie GLP-1RA putative neuroprotective effects. We then report and appraise evidence from clinical studies, including observational investigations, clinical trials and pooled analyses. Finally, we discuss current challenges and perspectives ahead for research and clinical implementation of GLP-1RAs for the care of people with major neurocognitive disorders, including their individual brain penetrance potential, the need for response biomarkers and disease stage-based indications, their possible non-specific effects on brain health, their profile in terms of adverse events and other unwanted effects, the lack of long-term data for efficacy and safety, and issues surrounding cost and availability of treatment.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neural (re)organisation of language and memory: implications for neuroplasticity and cognition.","authors":"Alena Stasenko, Erik Kaestner, Jonathan Rodriguez, Christopher Benjamin, F Scott Winstanley, Leigh Sepeta, Jessica Horsfall, Susan Y Bookheimer, Jerry J Shih, Marc A Norman, Amanda Gooding, Carrie R McDonald","doi":"10.1136/jnnp-2024-333871","DOIUrl":"10.1136/jnnp-2024-333871","url":null,"abstract":"<p><strong>Background: </strong>In the presence of neurological insult, how language and memory networks jointly reorganise provides insights into mechanisms of neuroplasticity and can inform presurgical planning. As (re)organisation is often studied within a single cognitive modality, how language and memory interact during (re)organisation in response to epilepsy and the implications for memory outcomes is less clear. We investigated (1) the rates and patterns of joint (re)organisation and (2) their associations with pre- and postsurgical memory function.</p><p><strong>Methods: </strong>Individuals with epilepsy (n=162) from three neurosurgical centres underwent the Wada procedure. We examined colateralisation patterns (ie, concordance/discordance) between language and both global and verbal memory (n=34), and associations with clinical characteristics and preoperative and postoperative memory outcomes.</p><p><strong>Results: </strong>Overall concordance between language and memory colateralisation was minimal-to-weak across both global memory and verbal memory (kappa=0.28-0.44). Discordance was primarily observed in individuals with left-lateralised language, of whom 52% and 32% showed discordance in global and verbal memory, respectively. Discordance was most pronounced in left hemisphere epilepsy and mesial temporal sclerosis. Conversely, right-lateralised language consistently predicted right-lateralised memory (95%-100%), regardless of seizure laterality or memory type. While discordance was not associated with presurgical memory function, discordance predicted superior postsurgical memory outcomes following surgery in the language-dominant hemisphere (p<0.05; η_p ²=0.30).</p><p><strong>Conclusions: </strong>When language dominance is atypical, memory tends to colateralise. However, when language remains typical, concordance with memory is weak, particularly for left hemisphere seizure onset. An interhemispheric shift in language may trigger a shift in memory, possibly to maintain efficient communication between medial temporal and neocortical language networks. In contrast, memory appears able to reorganise in isolation, with discordance predicting better postsurgical memory outcomes without detriment to presurgical function. Our findings support the continued need for separate presurgical mapping of language and memory lateralisation, particularly in the case of typical language dominance and left hemisphere seizures.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":"489-499"},"PeriodicalIF":8.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurotoxic complications of chimeric antigen receptor (CAR) T-cell therapy.","authors":"Frederick W Vonberg, Imran Malik, Maeve O'Reilly, Harpreet Hyare, Aisling S Carr, Claire Roddie","doi":"10.1136/jnnp-2024-333924","DOIUrl":"https://doi.org/10.1136/jnnp-2024-333924","url":null,"abstract":"<p><p>Chimeric antigen receptor (CAR) T-cell therapy has revolutionised the treatment of haematological malignancies and has demonstrated efficacy in early trials for solid tumours, neurological and rheumatological autoimmune diseases. However, CAR-T is complicated in some patients by neurotoxicity syndromes including immune-effector cell-associated neurotoxicity syndrome, and the more recently described movement and neurocognitive treatment-emergent adverse events, and tumour inflammation-associated neurotoxicity. These neurotoxic syndromes remain poorly understood and are associated with significant morbidity and mortality. A multidisciplinary approach, including neurologists, haematologists and oncologists, is critical for the diagnosis and management of CAR-T neurotoxicity. This approach will be of increasing importance as the use of CAR-T expands, its applications increase and as novel neurotoxic syndromes emerge.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seizures in pregnancy and child outcomes.","authors":"Kimford J Meador","doi":"10.1136/jnnp-2025-335945","DOIUrl":"https://doi.org/10.1136/jnnp-2025-335945","url":null,"abstract":"","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of seizure control during pregnancy with adverse offspring outcomes in women with epilepsy.","authors":"Yutong Fu, Fanfan Shi, Leihao Sha, Weihong Lin, Ying Ma, Hua Yan, Pei Wang, Jiajia Fang, Qun Huang, Fang Chen, Xiaoyi Li, Yun Li, Changqing Liu, Qingxia Kong, Hua Huang, Qi Zhang, Rong Mei, Yuan Wu, Shixu He, Yanbing Han, Hua Zhang, Bo Xiao, Kuiyun Wang, Zhanghui Peng, Xi Zhu, Jian Wang, Xunyi Wu, Yanmei Zhu, Ting Wu, Xuelian He, Haizhi Guo, Ming Yu, Min Zhong, Qing Zhang, Xiangshu Hu, Yan Su, Mei Zou, Jian Zhou, Yaqing Liu, Bozhong Pu, Chonglun Guo, Qin Feng, Jing Gao, Wanhui Lin, Torbjörn Tomson, Lei Chen","doi":"10.1136/jnnp-2024-335751","DOIUrl":"https://doi.org/10.1136/jnnp-2024-335751","url":null,"abstract":"<p><strong>Background: </strong>Information on fetal risks with maternal seizures during pregnancy is scarce. This study investigates seizure control during pregnancy and fetal risks associated with maternal seizures in different stages of pregnancy among pregnant women with epilepsy (PWWE).</p><p><strong>Methods: </strong>The nested case-control study enrolled PWWE between 2009 and 2023 in China. Information was obtained on maternal seizures, antiseizure medication (ASM), folic acid supplementation and pregnancy outcomes. The primary outcome was composite including major congenital malformations (MCMs), neurodevelopmental delay, low birth weight (LBW) and fetal death. Univariate and multivariate logistic regression analyses were conducted to adjust for ASM effects and other confounders.</p><p><strong>Results: </strong>Among 1110 pregnancies from 934 PWWE included, 56.6% experienced seizures. Seizure deterioration during pregnancy compared with prepregnancy was observed in 25.9% of pregnancies, while 20.9% experienced worsening seizures from the first to second or third trimesters. Seizures (adjusted OR (aOR) 1.472, 95% CI 1.024 to 2.137), particularly status epilepticus (aOR 2.906, 95% CI 1.364 to 5.93), generalised tonic-clonic seizures (aOR 1.581, 95% CI 1.066 to 2.354) and seizure deterioration (aOR 1.829, 95% CI 1.233 to 2.69) were associated with composite adverse outcomes. Specifically, seizures occurring (aOR 2.324, 95% CI 1.320 to 4.084) or deteriorating (aOR 2.396, 95% CI 1.471 to 3.866) during second and third trimesters were associated with the risk of LBW. No significant association was found between seizures and MCMs.</p><p><strong>Conclusions: </strong>While nearly half of PWWE remain seizure-free during pregnancy, those who do experience seizures face increased risks of adverse offspring outcomes. For PWWE, every effort should be made to optimise seizure control in order to minimise risks to both mother and child.</p><p><strong>Trial registration number: </strong>ChiCTR2100046318.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}