Epilepsy and Behavior Reports最新文献

{"title":"Caregiver burden associated with caring for individuals with tuberous sclerosis complex-associated seizures: A descriptive, non-interventional survey in Sweden","authors":"Siu Hing Lo ,&nbsp;Hanna Skrobanski ,&nbsp;Miranda Harrison ,&nbsp;Jamshaed Siddiqui ,&nbsp;Sally Bowditch","doi":"10.1016/j.ebr.2024.100737","DOIUrl":"10.1016/j.ebr.2024.100737","url":null,"abstract":"<div><div>Tuberous sclerosis complex (TSC)-associated seizures result in a significant burden for caregivers. To quantify time spent and describe activities undertaken by caregivers of individuals with TSC-associated seizures in Sweden, primary caregivers participated in a cross-sectional, non-interventional online survey. Questions comprised patient/caregiver characteristics, care provision, time, and activities associated with generalized seizures or non-seizure-related care. Twenty-three primary caregivers participated; 96 % parents, 100 % female. Median number of caregivers per individual was three. In the last month, median (interquartile range [IQR]) hours for caregiving per week was 52.0 (25.7–100.0; n = 21); median (IQR) hours for non-seizure-related care was 46.7 (20.0–93.3; n = 21) and for generalized seizure-related care was 4.7 (1.7–15.8; n = 12). Beyond the last month, hours/week of generalized seizure-related care varied from 1.9 (0–8.8) to 14.0 (0.5–77.0). Professional/paid carers contributed 99.2 (73.5–127.5) hours/week of care. Non-seizure-related care activities included assisting with routine medical care (n = 22, 96 %) and daily activities (n = 22, 96 %). Activities relating to generalized seizures included assessing the need for (n = 16, 84 %) and giving (n = 17, 89 %) rescue medication, providing physical support (n = 16, 84 %), and clearing the individual’s environment during generalized seizures (n = 13, 68 %). During generalized seizure recovery, activities included taking the individual to bed (n = 18, 95 %), emotional support (n = 14, 74 %), and managing behavioral issues (n = 14, 74 %). In Sweden, despite contributions of paid caregivers, individuals with TSC-associated seizures require substantial time from unpaid primary caregivers, including seizure- and non-seizure-related care. Generalized seizures have a considerable impact on time spent caregiving and the care activities undertaken.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"29 ","pages":"Article 100737"},"PeriodicalIF":1.8,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081539","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":"Practical Considerations for the rapid titration of VNS","authors":"Riëm El Tahry ,&nbsp;Maxine Dibué ,&nbsp;Arnaud Szmalec ,&nbsp;Roshani Patel ,&nbsp;Ryan Verner ,&nbsp;Massimiliano Boffini ,&nbsp;Firas Fahoum ,&nbsp;Michal Tzadok","doi":"10.1016/j.ebr.2024.100734","DOIUrl":"10.1016/j.ebr.2024.100734","url":null,"abstract":"<div><div>For patients with drug-resistant epilepsy who are not candidates for epilepsy surgery, Vagus nerve stimulation (VNS) is the most widely available neuromodulation option and has been available in several countries for 30 years. Given its broad availability and extended history on the market, many healthcare providers (HCPs) have developed individualized practice habits regarding the titration and dosing of VNS. This study provides novel evidence to describe the extent to which VNS management differs among providers and discusses recent literature that indicates how unique programming approaches may impact patient outcomes. In this work, practice habits regarding the titration and dosing of VNS were explored through a survey of HCPs and an examination of ongoing study data collected as part of the CORE-VNS Study. The global survey revealed significant variability in dosing and titration habits. Providers reported a wide range of initial/maximum target doses and time-to-dose, even if the population averages approximated guidance from professional societies and the manufacturer’s labeling. Variable dosing and titration were reflected in varied perception of how long it takes to realize the clinical benefits of VNS. In the CORE-VNS Study, this reported experience was represented in how different generator models were used, with users of SenTiva (and the Scheduled Programming feature) depicting faster time-to-dose than those using earlier models of VNS. Our results suggest VNS providers would benefit from continued training on the use of VNS and the use of the scheduled programming feature to enhance consistency of VNS management among providers.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"29 ","pages":"Article 100734"},"PeriodicalIF":1.8,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972451","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":"Heterogeneous knowledge of childhood seizures and epilepsy care in Canadian healthcare Providers: Identifying the gaps","authors":"Kregel Michelle ,&nbsp;Sherry Coulson ,&nbsp;Emily Guarasci ,&nbsp;Andrade Andrea","doi":"10.1016/j.ebr.2024.100733","DOIUrl":"10.1016/j.ebr.2024.100733","url":null,"abstract":"<div><div>Epilepsy is the most common chronic neurological condition in children. Many barriers exist in early recognition which cause delay in care and impact quality of life. Some of these children require advanced treatments which are underutilized due to lack of education, awareness and referrals. Overall, childhood epilepsy is underdiagnosed and poorly understood by non-expert providers. We investigated awareness and knowledge about epilepsy from primary care providers via the quality of their referrals. We prospectively collected and examined all epilepsy related referrals to the Paediatric Neurology Division at Children’s Hospital in London, Ontario, Canada during a six-month period. We developed a modified “epilepsy focused” scoring tool to evaluate the referrals and scored them as basic or advanced. During the study time frame 175 (82 %) referrals met the inclusion criteria. Out of these, 152 (87 %) were identified as basic and 23 (13 %) were advanced (p &lt; 0.001). Amongst the referrals that scored basic vs advanced: Family Doctors n = 49 with 40 basic (81 %) vs 9 advanced (18.3 %), Paediatric ER physicians n = 37, all 37 were basic (100 %) and Paediatricians n = 41 with 36 (87 %) basic and 5 (12 %) advanced. Our results showed significant lack of critical information in the content of epilepsy referrals coming from non-epileptologist providers, largely from the cohort of paediatric ED doctors. This reveals that knowledge and awareness of epilepsy in children remains scarce. Identifying these barriers can provide insights to develop strategies to facilitate accurate identification and rapid triage for children presenting with new onset epilepsy.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"29 ","pages":"Article 100733"},"PeriodicalIF":1.8,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980082","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 propofol and midazolam combination in managing refractory epileptic encephalopathy with spike-wave activation in sleep","authors":"Xiaorui Liu ,&nbsp;Tiejia Jiang ,&nbsp;Lu Xu ,&nbsp;Weiran Zhang ,&nbsp;Feng Gao","doi":"10.1016/j.ebr.2024.100732","DOIUrl":"10.1016/j.ebr.2024.100732","url":null,"abstract":"<div><div>We presented a 7-year-old boy with refractory Epileptic Encephalopathy with Spike-and-Wave Activation in Sleep (EE-SWAS) successfully managed with a combination of propofol and midazolam. His seizures began at age 2, initially controlled by multiple antiseizure medications (ASMs) for almost three years. At age 5, seizures recurred with electroencephalography (EEG) showing electrical status epilepticus in sleep (ESES) and a spike-wave index (SWI) of 85 %. High-dose methylprednisolone pulse therapy initially reduced the SWI to 50 %, but it relapsed to 80 % within six months. Despite further treatments, including methylprednisolone, midazolam infusion, and four combined ASMs, the SWI persisted between 75 % and 85 %, leading to progressively worsening cognitive impairment and subsequently a somnolent state with nearly continuous discharges. During hospitalization, a combination of propofol and midazolam significantly improved the condition, reducing the SWI to 50 % upon completion of the treatment period. Over a three-year follow-up, no ESES or seizures were reported, and cognitive function notably improved. Currently, there is no consensus on the treatment of ESES, which is sometimes refractory to medication and can result in partially irreversible cognitive impairment. Propofol in combination with midazolam has demonstrated effective suppression of ESES phenomena, presenting a promising treatment strategy for refractory ESES.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"29 ","pages":"Article 100732"},"PeriodicalIF":1.8,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898349","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 cannabidiol in patients with Lennox-Gastaut syndrome and Dravet syndrome in the UK Early Access Program: A retrospective chart review study","authors":"Christin Eltze ,&nbsp;Shaikha Alshehhi ,&nbsp;Aisha Al Ghfeli ,&nbsp;Kishan Vyas ,&nbsp;Seeta Saravanai-Prabu ,&nbsp;Gaelle Gusto ,&nbsp;Artak Khachatryan ,&nbsp;Marta Martinez ,&nbsp;Archana Desurkar","doi":"10.1016/j.ebr.2024.100731","DOIUrl":"10.1016/j.ebr.2024.100731","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate clinical outcomes from the UK Early Access Program in patients aged 2–17 years with Lennox-Gastaut syndrome (LGS) or Dravet syndrome (DS) treated with plant-derived highly purified cannabidiol (CBD; Epidyolex®; 100 mg/mL oral solution).</div></div><div><h3>Methods</h3><div>Retrospective chart review of data collected from baseline (1 month before CBD treatment initiation) until 12 months’ treatment, CBD discontinuation, death, or loss to follow up.</div></div><div><h3>Results</h3><div>At baseline, all 26 patients enrolled (LGS, <em>n =</em> 17; DS, <em>n =</em> 9; male, 73 %; mean [range] age, 11.8 [3.0–17.0] years) experienced motor seizures; 92 % were taking ≥ 1 antiseizure medication. Median (IQR) CBD dosage at 6 months (6 M; <em>n =</em> 12) was 6.0 (2.7) mg/kg/day, and 12 months (12 M; <em>n</em> = 9) 7.3 (2.1) mg/kg/day. Median (IQR) percentage change from baseline for motor seizures was − 56.7 % (60.7) at 6 M (<em>n =</em> 20), and − 60.0 % (53.3) at 12 M (<em>n =</em> 15). Patients experiencing ≥ 50 % and ≥ 75 % reduction in motor seizures were 13/20 (65 %) and 5/20 (25 %) at 6 M, respectively, and 10/15 (67 %) and 6/15 (40 %) at 12 M, respectively. Mean (SD) motor seizure-free days/month were 1.5 (4.3) at baseline (<em>n =</em> 24, missing data <em>n =</em> 2), 2.4 (6.3) at 6 M (<em>n =</em> 18), and 2.7 (5.5) at 12 M (<em>n =</em> 15). At 12 M, CBD retention for patients with follow-up data was 14/19 (74 %), whilst 7/26 (27 %) were lost to follow up. The number of patients reporting ≥ 1 adverse event of special interest (most common: gastrointestinal) was 14/20 (70 %) and 8/15 (53 %) at 6 M and 12 M, respectively.</div></div><div><h3>Conclusion</h3><div>Results demonstrate a reduction in motor seizures and a safety profile consistent with previous studies.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"29 ","pages":"Article 100731"},"PeriodicalIF":1.8,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080767","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 brain-heart connection: Value of concurrent ECG and EEG recordings in epilepsy management","authors":"Jeremy D. Slater ,&nbsp;Selim Benbadis ,&nbsp;Richard L. Verrier","doi":"10.1016/j.ebr.2024.100726","DOIUrl":"10.1016/j.ebr.2024.100726","url":null,"abstract":"<div><div>Concurrent electrocardiogram (ECG) and electroencephalogram (EEG) recording both ictally and interictally has significant value in the comprehensive management of epilepsy. This review highlights the diagnostic utility of simultaneous ECG and EEG monitoring in differentiating between epileptic and cardiac events, detecting cardiac abnormalities, and identifying autonomic dysfunction. The critical role of this combined approach to defining the mechanisms underlying cardiac morbidity and sudden cardiac death in patients with epilepsy and in guiding therapeutic interventions is underscored. The “Epileptic Heart Syndrome” is examined, illustrating how chronic epilepsy can adversely affect cardiac structure and function, leading to increased risk for interictal cardiac arrhythmias, morbidities, and mortality. The findings emphasize the need for standardized protocols for routine concurrent ECG and EEG recording in epilepsy monitoring units both ictally and interictally to ensure comprehensive patient care, improve diagnostic accuracy, and potentially reduce epilepsy-related morbidity and mortality. Future research directions are proposed to address existing gaps and to advance the technology and methodology for concurrent monitoring including wearable and computer-based monitoring systems.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"28 ","pages":"Article 100726"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663852","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":"Association of oxcarbazepine concentration with seizure frequency in pregnant women with epilepsy","authors":"Lin-yan Wei ,&nbsp;Zheng-yan-ran Xu ,&nbsp;Zhen-zhen Lai ,&nbsp;Na Dong ,&nbsp;Yi-wen Sang ,&nbsp;Yi Guo","doi":"10.1016/j.ebr.2023.100640","DOIUrl":"https://doi.org/10.1016/j.ebr.2023.100640","url":null,"abstract":"<div><p>The management of epilepsy during pregnancy presents particular challenges for neurologists worldwide. Currently, there are no clear recommendations for oxcarbazepine (OXC) specific target concentration during pregnancy. We conducted this retrospective observational cohort study on pregnant women with epilepsy (WWE) who received OXC monotherapy or polytherapy, at the epilepsy outpatient clinic of a tertiary hospital in eastern China. Sixteen pregnancies of 16 WWE were split into the seizure-free group or the non-seizure-free group, according to whether they had been seizure free for more than one year prior to conception or not. There was a significantly decrease in OXC concentration throughout pregnancy, as indicated by the concentration/dose ratio and the ratio of target concentration (RTC). The second trimester of pregnancy was the period when seizure deterioration occurred the most, particularly in the non-seizure-free group. Lower RTC_OXC was identified to be a risk factor for increasing seizure frequency in both the total group and the non-seizure-free group in both univariate and multivariate analysis, with a threshold of 0.575 for differentiating patients at high-risk and low-risk for seizure deterioration. In conclusion, this study suggested an OXC concentration threshold of 0.575 during pregnancy for assisting neurologists in OXC drug monitoring and dose adaptation.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"25 ","pages":"Article 100640"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589986423000588/pdfft?md5=387d86b8fb65ba786124714f69496015&pid=1-s2.0-S2589986423000588-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139108100","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":"Insights into epileptic aphasia: Intracranial recordings in a child with a left insular ganglioglioma","authors":"Mitchell Steinschneider ,&nbsp;Ariane E. Rhone ,&nbsp;Peter N. Taylor ,&nbsp;Kirill V. Nourski ,&nbsp;Brian J Dlouhy ,&nbsp;Matthew A. Howard III","doi":"10.1016/j.ebr.2024.100715","DOIUrl":"10.1016/j.ebr.2024.100715","url":null,"abstract":"<div><div>Intracranial EEG was recorded during a dialog-based task in a 16-year-old boy with a left insular ganglioglioma, medically intractable epilepsy, epileptic foci in auditory cortex on the lateral superior temporal gyrus (STG) and language deficiencies. Performance of the task was highly erratic, characterized by rapid cycling between providing correct answers, incorrect answers and failure to respond. There was no relationship between performance and the degree of concurrent epileptic activity in auditory cortex. High gamma activity in core auditory cortex (posterior medial Heschl’s gyrus, HGPM) was markedly diminished during listening and, with two exceptions, was less than activity from 17 control subjects. The two exceptions also had seizure onset zones in perisylvian cortex. Responses during listening were of smaller amplitude than those occurring during speaking, a pattern opposite that typically seen in the left HGPM. Within HGPM, lateral STG and pars opercularis of the inferior frontal gyrus, high gamma activity while listening was greatest when questions were correctly answered and least when the subject failed to respond. Alpha activity preceding utterances was lowest in pars opercularis when the subject failed to respond. Comparisons between resting state activity in another cohort of controls and the subject were most disparate in HGPM. Alpha activity during performance of the task was greatest in the mid-anterior cingulate when the subject failed to respond, suggesting dysfunction beyond the speech network and into the salience network. Multiple abnormalities noted in this patient paralleled those seen in epileptic aphasia and Rolandic epilepsy.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"28 ","pages":"Article 100715"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427178","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":"Infantile epileptic spasms syndrome in a child with lissencephaly associated with de novo PAFAH1B1 variant and coincidental CMV infection","authors":"Nga Ying Eng ,&nbsp;Duyu A. Nie","doi":"10.1016/j.ebr.2024.100664","DOIUrl":"https://doi.org/10.1016/j.ebr.2024.100664","url":null,"abstract":"<div><p>Type 1 lissencephaly is a brain malformation characterized by agyria and pachygyria and is known to be caused by congenital infections and genetic variations. Here we present a case of a 4-month-old female with new onset infantile epileptic spasms syndrome (IESS) with initial etiology concerned for congenital cytomegalovirus (cCMV) due to a positive urine CMV PCR and maternal viral syndrome during pregnancy. Her brain MRI was significant for type 1 lissencephaly without other radiographical features of cCMV. The patient initially responded to high dose Prednisolone but had relapse of spasms at 9-month-old and required an ACTH course. She later developed generalized tonic seizures and focal impaired awareness seizures. Subsequent whole exome sequencing (WES) trio revealed a <em>de novo PAFAH1B1</em> (c.405G &gt; A, p.W135*) heterozygous nonsense variant which is pathogenic and thus solved the diagnostic puzzle. This case demonstrates that the absence of cCMV stigmata should raise concern for alternative etiology in cases of lissencephaly and the importance of genetic evaluation for subsequent management and family counseling.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"26 ","pages":"Article 100664"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589986424000212/pdfft?md5=1220c6197b604e9809304ee778099735&pid=1-s2.0-S2589986424000212-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140536776","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":"Ketogenic dietary therapy utilization in Kenya: A qualitative exploration of dietitian’s perceptions","authors":"Pauline Samia ,&nbsp;Violet Naanyu ,&nbsp;J Helen Cross ,&nbsp;Richard Idro ,&nbsp;Paul Boon ,&nbsp;Jo Wilmshurst ,&nbsp;Stanley Luchters","doi":"10.1016/j.ebr.2024.100661","DOIUrl":"https://doi.org/10.1016/j.ebr.2024.100661","url":null,"abstract":"<div><p>This study utilized a qualitative design to explore dietitians’ perceptions regarding Ketogenic Diet Therapy (KDT) for patients with drug-resistant epilepsy in Kenya. Dietitians from Kenya were selected and consented. Audio-recorded interviews were conducted, followed by thematic analysis of verbatim transcripts to identify recurring patterns. The study enrolled 18 dietitians, fourteen of whom correctly described their understanding of KDT for managing drug-resistant epilepsy. There was a lack of confidence in their capacity to initiate the KDT with all expressing the need for further training and facilitation. Only one dietitian reported having initiated and maintained KDT. There was an overall positive view regarding KDT and willingness to implement KDT for patients with drug-resistant epilepsy. Dietitians expressed concerns regarding the availability of national policies, inadequate staffing to support families who require KDT, and the cost of implementing this intervention. Dietitians expressed interest in virtual training to enhance their understanding of KDT. Dietitians in Kenya are mostly aware of KDT utilization for the management of drug-resistant epilepsy. However, they cited poor capability and various barriers to implementation. There is a need for policies to facilitate KDT as a treatment option for the benefit of patients with drug-resistant epilepsy.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"26 ","pages":"Article 100661"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589986424000182/pdfft?md5=80074b66045b0b853da40c30d958bb19&pid=1-s2.0-S2589986424000182-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140187975","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}