Acta Epileptologica最新文献

{"title":"A decade later: a longitudinal retrospective cohort study of the clinical course of childhood-onset epilepsy in a multi-ethnic tertiary centre.","authors":"Jen Ern Tan, Juen Kiem Tan, Michelle Maryanne Tan, Zhi Xuan Ng, Zhee Yee Chan, Zi Qi Ang, Nur Arifah Mohd Khaili, Nur Liyana Rahmat, Jasmine Lee, Ching Soong Khoo, Hui Jan Tan, Sau Wei Wong","doi":"10.1186/s42494-026-00277-z","DOIUrl":"10.1186/s42494-026-00277-z","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy affects a significant proportion of people globally, with many cases beginning in childhood. However, there is a lack of longitudinal studies exploring the long-term outcomes and characteristics of childhood-onset epilepsy into adulthood. This study aimed to analyze the trajectory of childhood-onset epilepsy to identify particular characteristics and outcomes that could help guide future management.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted between June 2021 and December 2022 at adult and paediatric clinics. Participant data were obtained from medical records and corroborated through history taking during follow-up visits.</p><p><strong>Results: </strong>A total of 100 participants diagnosed with epilepsy since childhood were included. The mean age of the cohort was 23.15 (SD = 8.80) years, with a mean age at epilepsy diagnosis of 3.97 years. Focal seizures were the most prevalent type (53%), with structural causes being the predominant aetiology of epilepsy. A total of 48% of participants were identified with intellectual disabilities, 24% with learning disabilities, and 32% with behavioural difficulties. Consequently, 45% required enrollment in special education institutions. We did not observe a statistically significant difference in seizure control over the 10-year follow-up period, and no analyzed factors were significantly associated with seizure control.</p><p><strong>Conclusions: </strong>Childhood-onset epilepsy is associated with substantial long-term neurodevelopmental and psychosocial consequences. Our findings highlight the need for individualized, multidisciplinary management and clear, structured transition pathways from paediatric to adult neurology services. We outline several recommendations to enhance overall management as patients transition into adulthood.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modern generative large language models in epilepsy care: a scoping review of current applications, challenges, and future directions.","authors":"Shihao Ge, Yueqian Sun, Qun Wang","doi":"10.1186/s42494-026-00271-5","DOIUrl":"10.1186/s42494-026-00271-5","url":null,"abstract":"<p><p>Modern generative large language models (LLMs) are increasingly being evaluated in epilepsy-related clinical tasks, but the evidence remains fragmented and their safe clinical role is uncertain. We conducted a scoping review following the PRISMA-ScR framework, searching PubMed, Embase, and the Web of Science Core Collection from inception to May 2026, to map current applications of modern generative LLMs in epilepsy-related clinical contexts and identify their reported benefits, limitations, and research gaps. Eligible studies evaluated generative LLMs or generative foundation models as the primary analytical or assistive engine in clinical or clinically oriented epilepsy tasks; non-generative natural language processing, conventional machine-learning, and signal-modeling studies served as contextual comparators only. Two reviewers independently screened records and extracted data for descriptive mapping and narrative synthesis. Twenty-four studies were included. Evidence was relatively more developed for text-centered tasks, including information extraction from electronic health records, question answering, and documentation support, while applications in differential diagnosis, presurgical evaluation, prognostic assessment, and patient communication remained early-stage. Across studies, the evidence base was heterogeneous, with frequent reliance on retrospective or simulated designs, single-center data, and limited external validation, alongside persistent concerns about hallucination, bias, model opacity, and workflow integration. Current evidence suggests a limited role for cautious, clinician-supervised use of generative LLMs in selected text-heavy epilepsy tasks, particularly extraction, summarization, documentation support, and patient education, but falls short of justifying independent or routine clinical deployment. Future studies should use narrower task definitions, epilepsy-specific datasets, transparent reporting of model versions and prompt design, external validation, and explicit documentation of clinician verification workflows.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and neurophysiology study of 17 children with epileptic negative myoclonus.","authors":"Lin Zhang, Tao Xu, Miao Jing, Jingbo Ma, Mingxia Sun, Ying Hua, Hongwei Tang, Yanping Wang","doi":"10.1186/s42494-026-00273-3","DOIUrl":"https://doi.org/10.1186/s42494-026-00273-3","url":null,"abstract":"<p><strong>Background: </strong>Epileptic negative myoclonus (ENM) is a clinically underrecognized seizure type, and systematic data on its clinical manifestations and optimal management strategies in pediatric populations remain scarce. This case series aimed to describe the clinical manifestations, neurophysiological patterns, and therapeutic outcomes in pediatric ENM.</p><p><strong>Methods: </strong>A retrospective descriptive analysis was conducted on 17 ENM patients diagnosed at Wuxi Children's Hospital between October 2017 and June 2024. Clinical data, electroencephalogram (EEG) findings, and treatment responses were systematically evaluated.</p><p><strong>Results: </strong>The cohort showed a marked female predominance (female-to-male ratio of 12:5). All cases exhibited upper-limb ENM, with contralateral central-parietal epileptiform discharges observed in ictal EEG. Two patients presented additional lower-limb ENM accompanied by midline discharges. Clinically, ENM manifested as the initial symptom in five cases (29.4%), including two with isolated ENM. Therapeutic outcomes varied: among four non-electrical status epilepticus during sleep (ESES) patients, antiseizure medications (ASMs) achieved symptom control, including one case of oxcarbazepine (OXC)-associated ENM that resolved after transition to valproate (VPA). Of 13 ESES-positive patients, three responded to ASMs alone, while nine received methylprednisolone pulse therapy (MPT), and one surgical candidate with focal cortical dysplasia (FCD) type IIa achieved post-resection remission. Among the nine children treated with MPT: four showed a good response; four relapsed upon steroid withdrawal; and one responded well to ketogenic diet (KD) therapy.</p><p><strong>Conclusions: </strong>ENM can manifest as the initial or sole epilepsy symptom in children. The marked female predominance in this cohort suggests that sex-related factors may play an important role in the expression or underlying mechanisms of ENM. Additionally, a correlation was found between the EEG discharge patterns and the specific limb regions involved. Regarding treatment, OXC may exacerbate ENM, necessitating cautious use. Steroid therapy should be considered for ESES cases unresponsive to ASMs. Refractory ENM with ESES warrants evaluation for structural abnormalities, particularly cortical dysplasia. Early EEG and neuroimaging improve diagnostic accuracy, while combined therapies-ASMs, immunomodulation, KD, or surgery-optimize outcomes. These findings highlight ENM's diagnostic intricacy and the need for individualized management.</p><p><strong>Clinical trial registration: </strong>Not applicable.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vagus nerve stimulation as an add-on therapy in patients with epilepsy: a prospective, multicenter, real-world study in China.","authors":"Chenyang Zhao, Enhui Zhang, Hesheng Zhang, Raowei Yan, Zhijun Le, Yujie Chen, Wenyu Liu, Weixi Xiong, Xintong Wu, Dong Zhou","doi":"10.1186/s42494-026-00272-4","DOIUrl":"10.1186/s42494-026-00272-4","url":null,"abstract":"<p><strong>Background: </strong>Vagus nerve stimulation (VNS) has been proven as an effective and safe adjunct therapy for epilepsy, but real-world evidence is limited. This study aimed to evaluate outcomes of VNS and its cumulative effect through a prospective, multicenter, real-world survey in China, with dynamic follow-up.</p><p><strong>Methods: </strong>A total of 83 sites in China participated and 124 epilepsy patients enrolled. Visits were scheduled at 1, 3, 6, 9, and 12 months after VNS. Primary outcomes included seizure response rate (≥ 50% frequency reduction) and seizure-free rate. Secondary outcomes assessed changes in the 31-item Quality of Life in Epilepsy Inventory (QOILE-31) score, overall anti-seizure medication (ASM) load, and adverse events.</p><p><strong>Results: </strong>The responder rates were 35.5%, 41.6%, 62.2%, 64.2%, and 76.6% at 1, 3, 6, 9, and 12 months after VNS, respectively. Seizure-free rates were 2.4%, 2.7%, 9.2%, 8.6%, and 10.9% at 1, 3, 6, 9, and 12 months, respectively. No significant differences were observed in overall ASM load between baseline and any follow-up visit. Significant improvements were noted in QOLIE-31 from baseline to each follow-up visit, with mean (± SD) score improvements as follows: 1 month (2.93 ± 8.65), 3 months (4.27 ± 9.84), 6 months (4.69 ± 11.5), 9 months (6.68 ± 12.5), and 12 months (9.32 ± 13.8). A significant trend toward improved seizure outcomes and change in quality of life was observed with longer treatment durations. Adverse events occurred in 34 patients (27.4%).</p><p><strong>Conclusions: </strong>VNS is an effective and safe adjunctive treatment for epilepsy, reducing seizure frequency and significantly improving quality of life, with a cumulative effect over time.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical application of artificial intelligence technology in epilepsy.","authors":"Qi Ren, Yan Zhang, Xiaohong Deng, Meng Fu, Xia Li, Luyao Wang, Xianpeng Chen, Yu Yang, Jinfeng Zhang","doi":"10.1186/s42494-026-00268-0","DOIUrl":"10.1186/s42494-026-00268-0","url":null,"abstract":"<p><p>Epilepsy is a prevalent neurological disorder, and its inherent complexity and significant interindividual variability pose substantial challenges for clinical diagnosis and treatment. Against this backdrop, the rapid development of artificial intelligence (AI) technology is driving a historic paradigm shift in the field of epilepsy diagnosis and management. This review analyses the application of AI in four core domains of epilepsy clinical practice: early diagnosis, accurate seizure prediction, individualized treatment, and long-term disease management. The primary objectives of this review are to delineate the current status of the clinical application of AI in epilepsy, clarify emerging future trends, and ultimately provide practical references and actionable insights for clinical practitioners.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of electroencephalographic changes after hemispheric disconnection surgery in patients with drug-resistant epilepsy.","authors":"Xinghua Cui, Zaifen Gao, Shuhua Chen, Lu Liu, Jianguo Shi, Guifu Geng, Xiuli Zhan","doi":"10.1186/s42494-026-00269-z","DOIUrl":"10.1186/s42494-026-00269-z","url":null,"abstract":"<p><strong>Background: </strong>Hemispheric disconnection surgery is a safe and effective therapeutic modality for drug-resistant epilepsy (DRE) secondary to hemispheric or multilobar lesions, while the dynamic evolutionary characteristics of postoperative electroencephalogram (EEG) and its clinical prognostic value remain unclear with no relevant systematic follow-up reports currently available. This study aims to retrospectively analyze EEG changes following hemispheric disconnection surgery in patients with DRE and to assess their clinical significance.</p><p><strong>Methods: </strong>We enrolled patients with DRE who underwent hemispheric disconnection surgery. EEG data were collected preoperatively and at 3 months, 1 year, and 2 years postoperatively. We analyzed EEG characteristics (including background activity and interictal and ictal patterns) at each time point and evaluated their correlation with prognosis.</p><p><strong>Results: </strong>Sixteen patients met the inclusion criteria; 14 (87.5%) had no seizure recurrence within the 2-year follow-up period. EEG analysis at postoperative time points showed that: (1) The EEG background activity on the ipsilateral side was dominated by slow waves and low-voltage activity. The proportion of low-voltage background activity gradually increased within 1 year, and slow waves became the predominant pattern thereafter. While, the contralateral background activity normalized within 1 year. (2) Epileptiform discharges on the ipsilateral side initially increased then decreased, accompanied by a reversible burst-suppression-like pattern. Epileptiform discharges on the contralateral side gradually decreased and disappeared in most patients (8/11, 72.7%). (3) In this study, seizure recurrence occurred in 2 patients, which was associated with incomplete disconnection and complications. Seizures were subsequently controlled after reoperation. (4) No postoperative EEG features were significantly correlated with prognosis (all P > 0.05).</p><p><strong>Conclusions: </strong>Following hemispheric disconnection, dynamic alterations are observed in bilateral EEG recordings. A postoperative burst-suppression-like pattern is commonly observed on the ipsilateral side. In this small-sample study, no significant association was found between postoperative EEG characteristics and prognosis.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of oxcarbazepine in treating focal epilepsy based on resting-state EEG functional connectivity and power spectral analyses.","authors":"Shupeng Cheng, Wenkang Li, Jing Ning, Yingfan Wang, Rong Rong, Xiaoshan Wang","doi":"10.1186/s42494-026-00270-6","DOIUrl":"10.1186/s42494-026-00270-6","url":null,"abstract":"<p><strong>Background: </strong>Objective electroencephalography (EEG)-based biomarkers are needed to assess oxcarbazepine (OXC) response in patients with focal epilepsy. This study aimed to identify resting-state EEG biomarkers associated with oxcarbazepine efficacy in focal epilepsy using power spectral and functional connectivity analyses.</p><p><strong>Methods: </strong>In this retrospective cohort study, 27 drug-naïve patients with focal epilepsy underwent resting-state EEG before treatment and approximately 1 year after initiating OXC monotherapy. Nineteen 10-20 system electrodes were recorded at 256/512 Hz, and preprocessed (resampling, detrending, 50 Hz notch, 0.5-70 Hz band-pass, independent component analysis [ICA] artifact removal). Relative power spectral density (rPSD) was estimated via Welch's method (5 s windows, 50% overlap). Functional connectivity (FC) was quantified by amplitude envelope correlation with correction (AEC-C) within canonical bands, yielding 19×19 matrices. Group comparisons used nonparametric tests with Benjamini-Hochberg false discovery rate (FDR) correction for rPSD and network-based statistic (NBS) for FC (5,000 permutations; initial thresholds t = 2.787, P < 0.01, and t = 3.725, P < 0.001). Clinical outcomes were classified as seizure-free (SF) or not seizure-free (NSF) at 6-24 months after OXC initiation.</p><p><strong>Results: </strong>Baseline clinical characteristics did not differ between groups. At the on-treatment follow-up EEG, the NSF group exhibited significantly higher θ-band rPSD at multiple frontal-central electrodes (Fp1, Fp2, F3, F4, C3, C4, F7, F8, Fz, Cz) after FDR correction. FC analysis showed stronger δ-band connectivity in the NSF group across frontal-central nodes at P < 0.01; under the stricter threshold (P < 0.001), a robust edge between P3 and F7 remained significantly stronger in the NSF group. No significant between-group differences were observed in other frequency bands after correction.</p><p><strong>Conclusions: </strong>These findings suggest that the response to oxcarbazepine in focal epilepsy is linked to differential regulation of slow-frequency brain networks. Persistent low-frequency synchronization reflects ongoing network instability and reduced treatment efficacy, whereas attenuation of pathological slow-wave activity indicates effective network stabilization. These band-limited spectral and network features are promising EEG features associated with treatment response to OXC.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of quantitative electroencephalography in evaluating epilepsy treatment.","authors":"Jingjing Qiu, Yixia Chen, Zhiyuan Ning, Bing Zhang, Bo Shen, Yuying Zhao, Ying Liu","doi":"10.1186/s42494-026-00267-1","DOIUrl":"10.1186/s42494-026-00267-1","url":null,"abstract":"<p><p>Because quantitative electroencephalography (QEEG) presents objective, data-driven measurements of brain activity with better performance than conventional EEG, it has become more popular for evaluating therapeutic response in epilepsy. Data from over 160 English-language papers on the use of QEEG in the evaluation of epilepsy treatment that were published up to March 2026 were assessed in this review. This review includes anti-seizure medications (ASMs), long-term EEG monitoring, neuromodulation methods such as vagus nerve stimulation (VNS), epilepsy surgery and epileptogenic zone identification, and new models using AI. Instead of providing a methodical or completely reproducible synthesis, this review concentrates on critically evaluating methodological trends, translational significance, and current limitations in various applications. The significant differences in patients' demographics, EEG acquisition methods, analytical approaches, and clinical goals caused difficulties in a thorough systematic review or meta-analysis. However, a qualitative review of the literature showed recurrent QEEG patterns associated with treatment response, areas of conflicting evidence, and the translational readiness of different metrics. Studies frequently find correlations between changes in spectral power, functional connectivity (FC), and epileptiform activity indices (EAI) and clinical outcomes. However, the reproducibility and robustness of these correlations greatly vary depending on treatment modality and methodological environment. Hence, the potential of QEEG in directing customized treatments is limited by the lack of standardized procedures, normative databases, and prospective validation. All things considered, it appears most promise for long-term therapy tracking and, in certain situations, for enhancing conventional clinical evaluation. This review emphasizes the necessity of thorough studies that prioritize practical application, clinical interpretability, and repeatability. Additionally, it highlights the current limitations and therapeutic potential of QEEG-based treatment evaluation.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and factors associated with intellectual impairment in children with epilepsy in two national referral hospitals in Uganda.","authors":"Anita Arinda, Molly McVoy, Joan Abaatyo, Mark Kaddumukasa, Martha Sajatovic, Elly Katabira","doi":"10.1186/s42494-026-00265-3","DOIUrl":"10.1186/s42494-026-00265-3","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy is a common neurological condition in children and is often associated with intellectual impairment. However, there is limited information on the intellectual impairment among children with epilepsy in Uganda. This study assessed the prevalence and associated factors of intellectual impairment among children and adolescents with epilepsy attending two national referral hospitals in Uganda.</p><p><strong>Methods: </strong>This cross-sectional study included children and adolescents aged 5 to 17 years who had a diagnosis of epilepsy. Intellectual functioning was assessed using the Raven's Progressive Matrices. Logistic regression analysis was performed to determine demographic and clinical factors associated with intellectual impairment.</p><p><strong>Results: </strong>Of 386 participants, 34.7% had intellectual impairment. Older age (adjusted odds ratio [aOR] = 6.94, P = 0.001), being in a special needs school (aOR = 14.50, P = 0.016), not being in school (aOR = 26.01, P < 0.001), delayed speech (aOR = 3.26, P = 0.030), and anti-seizure medication polypharmacy (aOR = 3.08, P = 0.020) were positively associated with intellectual impairment, while adolescent-onset epilepsy (aOR = 0.05, P = 0.030) was negatively associated.</p><p><strong>Conclusions: </strong>Intellectual impairment is common among Ugandan children and adolescents with epilepsy and is associated with older age, school non-attendance, special-needs school placement, delayed speech, and anti-seizure medication polypharmacy. These findings underscore the need for routine assessment of intellectual functioning and targeted interventions, including academic support, speech therapy, and optimization of treatment regimens.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13321425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Taenia solium development and host interactions in neurocysticercosis: a narrative mini review on mechanistic pathways to epileptogenesis.","authors":"Franck Katembo Sikakulya, Hervé Monka Lekuya, Larry Kasereka Kamabu, Mathieu Katembo Manzekele, Eric Ochen, Fatuma Djuma Sonia, Jeannot Munihire Baanitse, Furaha Nzanzu Blaise Pascal, Rishi A Shah, Shitu Hauwa Balarabe, Olivier Kambere Kavulikirwa, David Kitya, Malcolm K Jones","doi":"10.1186/s42494-026-00261-7","DOIUrl":"10.1186/s42494-026-00261-7","url":null,"abstract":"<p><p>Neurocysticercosis (NCC), a central nervous system infection caused by the larval stage of Taenia solium, remains a leading cause of acquired epilepsy in endemic regions. Mounting evidence indicates that seizure development in NCC is not solely driven by host inflammatory responses but reflects complex, dynamic interactions between parasite development, host neuroimmune processes, and neuronal network remodeling. This narrative mini-review integrates experimental and clinical data to demonstrate that T. solium larvae actively shape the cerebral microenvironment through stage-specific immune modulation, blood-brain barrier disruption, and the release of neuroactive excretory-secretory products. During cyst degeneration, parasite antigens and excitatory amino acids drive microglial and astrocytic activation, amplify glutamatergic signaling, and destabilize inhibitory neurotransmission, collectively reducing seizure thresholds. These acute events are followed by chronic structural alterations, including perilesional gliosis, synaptic reorganization, and persistent network hyperexcitability, particularly around parenchymal and calcified lesions that serve as enduring epileptogenic foci. Integrating parasite developmental biology with neuroimmune and neuroexcitatory mechanisms, this review reconceptualizes NCC epileptogenesis as an active, multilevel dialogue between parasite, host, and neuron, rather than a passive, inflammation-driven consequence of infection. This integrated mechanistic framework highlights opportunities for biomarker discovery and therapeutic strategies that look beyond mere parasite eradication to address sustained neural dysfunction. It further underscores the critical need for One Health-oriented interventions to disrupt the T. solium transmission cycle and alleviate the long-term burden of NCC-associated epilepsy.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13231682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}