Epilepsy and Behavior Reports最新文献

{"title":"Severe acute respiratory distress syndrome in Dravet syndrome: Clinical cases expanding the extraneurological phenotype","authors":"R. Montero-Yéboles,&nbsp;E. de Frutos-Porras,&nbsp;E. Ulloa-Santamaría,&nbsp;M.A. García Pérez,&nbsp;M. Bueno-Campaña,&nbsp;B. Ruiz-Sáez","doi":"10.1016/j.ebr.2026.100892","DOIUrl":"10.1016/j.ebr.2026.100892","url":null,"abstract":"<div><h3>Objective</h3><div>Dravet syndrome (DS) is increasingly recognized as a multisystem disorder extending beyond epilepsy. We describe two children with genetically confirmed DS who developed recurrent, severe episodes of acute respiratory distress syndrome (ARDS), suggesting a previously underrecognized extraneurological manifestation.</div></div><div><h3>Methods</h3><div>Clinical, genetic, and pediatric intensive care data were retrospectively reviewed.</div></div><div><h3>Results</h3><div>Both patients experienced severe ARDS triggered by febrile illnesses or status epilepticus. One child developed recurrent ARDS associated with viral respiratory infections, requiring multiple pediatric intensive care unit admissions with invasive or noninvasive ventilatory support. The second patient developed life-threatening ARDS following status epilepticus, requiring prolonged mechanical ventilation and repeated veno-venous extracorporeal membrane oxygenation for refractory hypoxemia. In both cases, ARDS occurred in the absence of ongoing seizures during critical illness.</div></div><div><h3>Significance</h3><div>These cases expand the recognized extraneurological phenotype associated with SCN1A-related Dravet syndrome and suggest a potential vulnerability to severe inflammatory respiratory failure. Increased awareness of this association may have important implications for risk stratification, monitoring, and multidisciplinary management of children with DS during febrile illnesses and status epilepticus.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"35 ","pages":"Article 100892"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148951163","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":"Comparison of selective amygdalohippocampectomy and anterior temporal lobectomy for mesial temporal lobe epilepsy: a systematic review and meta-analysis","authors":"Vinícius Barone,&nbsp;Paulo Henrique Pires de Aguiar","doi":"10.1016/j.ebr.2026.100869","DOIUrl":"10.1016/j.ebr.2026.100869","url":null,"abstract":"<div><h3>Background</h3><div>Anterior temporal lobectomy (ATL) and selective amygdalohippocampectomy (SAH) are the two most widely adopted surgical approaches for drug-resistant mesial temporal lobe epilepsy (MTLE). Although both procedures target seizure control, they differ in extent of resection and potential morbidity. The relative effectiveness of ATL and SAH remains debated, particularly regarding seizure freedom, visual field deficits, and postoperative complications.</div></div><div><h3>Objective</h3><div>To systematically compare seizure freedom (Engel I) rates, Engel III-IV outcomes, visual field deficits, and postoperative complications between ATL and SAH.</div></div><div><h3>Methods</h3><div>A systematic review and <em>meta</em>-analysis were performed according to PRISMA guidelines. Searches included PubMed, Embase, Web of Science, and Scopus (1996–2023). Statistical analyses were conducted using R (version 4.3.2) with the <em>meta</em> and <em>metafor</em> packages. Random-effects or fixed-effects models were applied based on heterogeneity. Risk of bias was assessed using ROBINS-I V2. Twenty-two studies were included, totaling 2,482 patients.</div></div><div><h3>Results</h3><div>• <strong>Seizure freedom (Engel I):</strong> SAH demonstrated an <strong>8% lower chance</strong> of postoperative seizure freedom compared with ATL (RR = 0.92, 95% CI 0.87–0.97; <em>p</em> = 0.05; I² = 32%).</div><div>• <strong>Engel III–IV outcome:</strong> SAH showed a <strong>nonsignificant trend</strong> toward higher risk of poor seizure control (RR = 1.22, 95% CI 1.00–1.50; <em>p</em> &gt; 0.05; I² = 28%).</div><div>• <strong>Postoperative complications:</strong> SAH was associated with a <strong>38% lower complication risk</strong> (RR = 0.62, 95% CI 0.47–0.83; <em>p</em> &lt; 0.05; I² = 32%).</div><div>• <strong>Visual field deficits (Goldmann):</strong> SAH resulted in a <strong>15% lower risk</strong> of visual field defects (RR = 0.85, 95% CI 0.73–0.99; <em>p</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>ATL provides superior seizure control compared to SAH, whereas SAH offers measurable advantages in visual and perioperative morbidity. The nonsignificant trend toward poorer seizure outcomes in SAH highlights the importance of patient selection and anatomical considerations. These findings support individualized surgical decision-making for drug-resistant MTLE, balancing seizure freedom against visual and postoperative risks.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"35 ","pages":"Article 100869"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148995340","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":"Network reprogramming after resection of occipital meningioangiomatosis: Evidence from multimodal localization and longitudinal fMRI","authors":"Changquan Wang ,&nbsp;Bin Chen ,&nbsp;Jing Hong ,&nbsp;Jiwen Xu","doi":"10.1016/j.ebr.2026.100874","DOIUrl":"10.1016/j.ebr.2026.100874","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize the epileptic network and postoperative network remodeling in a rare case of right cuneus meningioangiomatosis (MA) with electro-clinical discordance, we integrated electroencephalography (EEG), fluorodeoxyglucose positron emission tomography (FDG-PET), and resting-state fMRI (rs-fMRI).</div></div><div><h3>Methods</h3><div>A 16-year-old male with drug-resistant focal impaired-awareness seizures and a right cuneus lesion underwent preoperative multimodal evaluation. Preoperative video-EEG, magnetic resonance imaging (MRI)/computed tomography (CT), and FDG-PET were obtained; gross total resection confirmed MA. Pre- and postoperative rs-fMRI were processed in DPABI. We computed lesion-seed functional connectivity (FC), fractional amplitude of low-frequency fluctuation (fALFF), Regional homogeneity (ReHo), and weighted degree centrality (DC; <em>r</em> &gt; 0.25), then generated post–pre difference maps using Fisher z-transformed data and retained the top 5% of absolute voxel changes (cluster size &gt;50 voxels).</div></div><div><h3>Results</h3><div>Ictal EEG showed onset in the right parieto-occipital region with rapid spread to right temporal and frontal areas. FDG-PET revealed focal hypometabolism in the right cuneus and remote hypometabolism in the right mesial temporal and left central regions. Postoperatively, lesion-based FC decreased in bilateral primary sensorimotor, early visual, and superior temporal/opercular cortices, but increased in the ipsilesional dorsal occipito-parietal network. fALFF and ReHo decreased widely in peri-Rolandic and occipital regions; fALFF and DC increased in medial/superior frontal cortex and bilateral precuneus; DC decreased in inferior frontal opercular/triangular areas.</div></div><div><h3>Conclusion</h3><div>Multimodal findings localized the seizure onset to the right posterior region with widespread propagation. Postoperative rs-fMRI showed network changes consistent with partial normalization, paralleling sustained seizure freedom—though causality cannot be inferred from a single case.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"34 ","pages":"Article 100874"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of agomelatine and escitalopram in people with epilepsy and comorbid major depressive disorder: A double-blind randomized controlled trial","authors":"Mariana Fernandes ,&nbsp;Claudio Liguori ,&nbsp;Francesca Avvento ,&nbsp;Diego Lombardi ,&nbsp;Natalia Manfredi ,&nbsp;Luisa Mari ,&nbsp;Francesca Izzi ,&nbsp;Alessandro Castelli ,&nbsp;Andrea Pagano ,&nbsp;Giovanni Di Mauro ,&nbsp;Anna Teresa Giallonardo ,&nbsp;Emanuele Cerulli Irelli ,&nbsp;Carlo Di Bonaventura ,&nbsp;Andrea Romigi ,&nbsp;Nicola Biagio Mercuri ,&nbsp;Fabio Placidi","doi":"10.1016/j.ebr.2026.100872","DOIUrl":"10.1016/j.ebr.2026.100872","url":null,"abstract":"<div><div>Major depressive disorder (MDD) is the most common psychiatric comorbidity in epilepsy but is often undertreated due to concerns about antidepressant effects on seizure frequency. This study evaluated the efficacy of agomelatine versus escitalopram in people with epilepsy (PwE) and comorbid MDD, including effects on seizure frequency, sleep, cognition, and quality of life (QoL). In this double-blind, randomized, phase IV study across three centers, 64 PwE and comorbid MDD were screened, and 51 were randomized to agomelatine (25 mg) or escitalopram (10 mg). Outcome measures were Beck Depression Inventory-II (BDI-II), Hamilton Depression Rating Scale (HDRS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), QoL in Epilepsy Inventory-31, Mental Deterioration Battery, and seizure frequency. Depression scores did not differ between groups, although both groups improved over time. No significant between-group differences were found for QoL or cognitive performance. However, QoL improved significantly only in the escitalopram group. After correction for multiple comparisons, verbal memory improved significantly only in the agomelatine group, whereas the cognitive changes observed with escitalopram did not remain significant after correction. No significant differences in seizure frequency, PSQI, or ESS scores were observed in either group. Adverse events were mild to moderate (7.8%), and no serious adverse event occurred. In conclusion, agomelatine and escitalopram improved depressive symptoms in PwE, without worsening seizure frequency, sleep, or daytime alertness. Escitalopram showed a more consistent pattern of benefit on mood and QoL, whereas cognitive effects were limited after correction for multiple testing. Larger studies are needed to confirm these findings.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"34 ","pages":"Article 100872"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Vagus nerve stimulation in super-refractory status epilepticus: Delayed seizure control and focal cortical knife-blade atrophy","authors":"Ario Parak ,&nbsp;Alexander Holzhausen ,&nbsp;Susanne Pirker ,&nbsp;Gregor Kasprian ,&nbsp;Eugen Trinka ,&nbsp;Walter Pirker","doi":"10.1016/j.ebr.2026.100871","DOIUrl":"10.1016/j.ebr.2026.100871","url":null,"abstract":"<div><div>Super-refractory status epilepticus (SRSE), defined as seizure activity persisting &gt; 24 h despite anesthetic treatment, remains a therapeutic challenge with high morbidity and mortality. We report a 42-year-old man with Crohn’s disease who developed SRSE following a right posterior cerebral artery infarction. Despite treatment with multiple antiseizure medications, immunotherapy, intravenous anesthetics, and barbiturate coma, seizures persisted for 80 days. A vagus nerve stimulator (VNS) was implanted on day 57 after status epilepticus onset. Clinical improvement began within days, and complete cessation of clonic seizures occurred 23 days after implantation, allowing withdrawal of anesthetic agents. The patient was discharged with mild residual deficits and achieved good long-term functional recovery. Follow-up MRI revealed progressive focal atrophy of the right postcentral gyrus, correlating with cortical sensory deficits.</div><div>This case highlights that VNS may contribute to seizure termination in SRSE even when implanted late, although clinical effects may be delayed. It also illustrates that prolonged SRSE can lead to focal cortical atrophy beyond the mesial temporal lobe.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"34 ","pages":"Article 100871"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal changes in developmental trajectory following early hemispherotomy in early infantile developmental and epileptic encephalopathy","authors":"Tetsuya Ueda ,&nbsp;Hiroharu Suzuki ,&nbsp;Takumi Mitsuhashi ,&nbsp;Kazuki Nishioka ,&nbsp;Kazuki Nomura ,&nbsp;Takato Akiba ,&nbsp;Shimpei Matsuda ,&nbsp;Ayuko Igarashi ,&nbsp;Hidenori Sugano ,&nbsp;Yuri Urabe ,&nbsp;Eri Inaba ,&nbsp;Yasushi Iimura ,&nbsp;Akihide Kondo","doi":"10.1016/j.ebr.2026.100875","DOIUrl":"10.1016/j.ebr.2026.100875","url":null,"abstract":"<div><div>Early infantile developmental and epileptic encephalopathy (EIDEE) associated with extensive unilateral structural abnormalities is frequently characterized by drug-resistance and poor developmental outcomes. Although epilepsy surgery is recognized as a treatment option, the optimal timing of intervention in early infancy and detailed longitudinal postoperative developmental trajectories remain insufficiently characterized.</div><div>We report a male infant with EIDEE due to extensive unilateral hemispheric malformation who underwent hemispherotomy at four months of age for persistent epileptic spasms with a suppression–burst pattern. The patient achieved sustained seizure freedom over five years and discontinued antiseizure medications two years postoperatively. Longitudinal developmental assessments showed continued acquisition of cognitive, language, and motor skills. Raw developmental measures increased steadily over time, whereas age-normed standardized scores remained below age-adjusted norms, indicating a gradual shift in developmental trajectory rather than normalization within the expected range. This case suggests that early consideration of surgical intervention may be associated with a favorable developmental trajectory in selected infants with EIDEE due to congenital structural abnormalities, particularly when drug-resistance is anticipated. Further investigation is needed to define optimal timing and patient selection.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"34 ","pages":"Article 100875"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative EEG morphology predicts early Antiseizure medication response in newly diagnosed epilepsy: A prospective cohort study","authors":"Segvan M.S. Kucher,&nbsp;Mohammed Aziz Sulaiman","doi":"10.1016/j.ebr.2026.100877","DOIUrl":"10.1016/j.ebr.2026.100877","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy is a complex neurological disorder with diverse electroclinical characteristics. While diagnosis is guided by the ILAE 2025 classification, the prognostic value of specific interictal epileptiform discharge (IED) morphologies for initial antiseizure medication (ASM) selection remains incompletely characterized.</div></div><div><h3>Objective</h3><div>To determine whether qualitative EEG characteristics at diagnosis predict early ASM responsiveness across six major epilepsy syndromes.</div></div><div><h3>Methods</h3><div>In this prospective cohort study, 150 newly diagnosed, drug-naïve patients (25 per syndrome) including Focal Epilepsy, FBTCS, BECTS, CAE, GGE, and JME underwent standardized baseline EEG with activation procedures. ASMs were prescribed according to routine clinical practice. Follow-up clinical evaluation and EEG were performed at 3 months. The primary outcome was EEG normalization; secondary outcomes included ≥50% seizure reduction and seizure freedom.</div></div><div><h3>Results</h3><div>EEG normalization rates varied significantly across syndromes, ranging from 76% in CAE to 20% in FBTCS. Qualitative IED morphology was associated with normalization (<em>p</em> &lt; 0.01). Patients achieving EEG normalization at 3 months were significantly more likely to be seizure free (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>In well-defined electroclinical syndromes, qualitative IED morphology appears to provide additional prognostic information regarding early ASM response. These findings suggest that EEG morphology may complement syndrome-based assessment and that variability in spike and sharp-wave morphology may reflect underlying electrophysiological heterogeneity extending beyond fixed syndrome labels, supporting further investigation using standardized morphology analysis in larger, controlled studies.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"34 ","pages":"Article 100877"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world Data on Adult Status Epilepticus from Latin America: Clinical Characteristics and Outcomes in a Mexican Tertiary Center","authors":"Irene Gómez-Oropeza ,&nbsp;María F. Castelo-Pablos ,&nbsp;Iracema Santizo-Nanduca ,&nbsp;Irving Fuentes-Calvo ,&nbsp;Daniela Deustúa-Hernández ,&nbsp;Oscar Esquivel-Zapata ,&nbsp;Salvador Martínez-Medina ,&nbsp;Mariana Peschard-Franco ,&nbsp;Pilar Robles-Lomelin ,&nbsp;Iris E. Martínez-Juárez ,&nbsp;Ashuin Kammar- García ,&nbsp;Claudia Cervera-Martínez ,&nbsp;Valeria I. Bravo-Osorno ,&nbsp;Gabriel Manrique-Gutierrez ,&nbsp;Erika Palacios Rosas ,&nbsp;Juan C López-Hernández ,&nbsp;Raúl Anwar García Santos ,&nbsp;Raúl Medina-Rioja ,&nbsp;Sonia I Mejia-Peréz ,&nbsp;Elma Paredes-Aragón","doi":"10.1016/j.ebr.2026.100854","DOIUrl":"10.1016/j.ebr.2026.100854","url":null,"abstract":"<div><h3>Background</h3><div>Status epilepticus is a life-threatening emergency in neurology practice. Latin America faces a disproportionate epilepsy burden; little data is available on this population type.</div></div><div><h3>Objective</h3><div>To describe the clinical characteristics, treatment approaches, and functional outcomes of adult patients with SE in a tertiary neurological center in Mexico City.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study involving 103 adult patients diagnosed with SE from 2020 to 2024. Functional outcomes were measured using the modified Rankin Scale (mRS), with scores 0–2 classified as favorable. Severity was assessed with the STESS. Chi-square, Mann–Whitney U tests, and logistic regression were used to identify variables related to outcomes.</div></div><div><h3>Results</h3><div>The median patient age was 36 (IQR 18–79), with 50.5% of patients being female. Most had a prior diagnosis of epilepsy (80.6%). Convulsive SE (74.8%) and acute symptomatic etiologies (70.9%) were predominant. Infections were the leading cause among acute symptomatic cases (35%). Refractory SE occurred in 41.7% of cases, and 14.6% progressed to super-refractory SE. Favorable outcomes were significantly associated with prior epilepsy (p = 0.032), and SE subtype (p = 0.003). Multivariate analysis confirmed prior epilepsy as an independent predictor of good outcome (OR = 0.65, 95% CI 0.48–0.87; p = 0.004).</div></div><div><h3>Conclusions</h3><div>This study offers the most extensive characterization of SE in a Mexican center. Infectious etiologies dominate the clinical landscape, with functional outcome linked to baseline epilepsy history and SE subtype.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"33 ","pages":"Article 100854"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duolingo-induced seizures in GAD65 IgG associated autoimmune epilepsy","authors":"Reece M. Hass ,&nbsp;Divyanshu Dubey ,&nbsp;Jamie J. Van Gompel ,&nbsp;Jeffrey W. Britton ,&nbsp;Kelsey M. Smith","doi":"10.1016/j.ebr.2026.100848","DOIUrl":"10.1016/j.ebr.2026.100848","url":null,"abstract":"<div><div>Autoimmune etiologies of seizures have been increasingly recognized with the discovery of novel autoantibodies to cell surface and intracellular antigens. GAD65 neurologic autoimmunity has been associated with stiff person syndrome, cerebellar ataxia, and chronic focal epilepsy, usually of temporal regional origin. While musicogenic reflex seizures have been described in multiple GAD65 IgG seropositive patients, non-musicogenic acoustic reflex seizures have not been described. We present a case of a patient with GAD65 antibody associated epilepsy with a long-standing history of right temporal seizures who developed left temporal reflex seizures triggered by a specific character and language while using the language learning app, Duolingo™.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"33 ","pages":"Article 100848"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bloodletting as a harmful and misguided first-aid response to seizures in sub-saharan Africa: a case-based review","authors":"Gloire Chubaka Magala ,&nbsp;Jamiilah Neve Nchare ,&nbsp;Abel Christian Tanoh ,&nbsp;Cedric Segla Achi Agbo-Panzo ,&nbsp;Axel Toa Bi ,&nbsp;Constance Yapo-Ehounoud ,&nbsp;Mariam Doumbia-Ouattara ,&nbsp;Évelyne Aka-Anghui Diarra ,&nbsp;Berthe Assi","doi":"10.1016/j.ebr.2026.100851","DOIUrl":"10.1016/j.ebr.2026.100851","url":null,"abstract":"<div><div>Epileptic seizures are common neurological events whose sociocultural interpretations have long been linked to supernatural causes or biomagico-symbolic beliefs. Depending on the region, blood may be regarded as the cause, seat, vector of evil, or even a therapeutic agent. These misconceptions continue to influence treatment choices in rural communities and large urban centers, leading to unnecessary or harmful first-aid measures. To date, the use of bloodletting as an inappropriate first-aid intervention has not been documented in sub-Saharan Africa.</div><div>We report an unprecedented event that occurred in a suburban area of a large West African city, involving a 42-year-old man who presented with inaugural generalized tonic seizures, symptomatic of a lobar intracerebral hemorrhage. In response to these seizures, members of the surrounding community performed bloodletting by making deep incisions on the soles of both feet, believing that “letting the blood flow” would stop the convulsions. These inappropriate traditional practices have led to hemorrhagic, ulceronecrotic, and superinfected lesions, compromising the patient’s prognosis.</div><div>This case highlights the severe impact of magico-biological misconceptions on seizure management in West Africa and emphasizes the urgent need for culturally tailored public health education, leveraging digital tools to deliver personalized awareness to communities and patients.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"33 ","pages":"Article 100851"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}