Epilepsy and Behavior Reports最新文献

{"title":"Influence of cannabis use on length of stay in patients admitted to the epilepsy monitoring unit","authors":"Oliver Hoerth ,&nbsp;Ejerzain Aniles-Renova ,&nbsp;Nan Zhang ,&nbsp;Emily Thompson ,&nbsp;Kristin A. Kirlin ,&nbsp;Joseph Drazkowski","doi":"10.1016/j.ebr.2025.100846","DOIUrl":"10.1016/j.ebr.2025.100846","url":null,"abstract":"<div><h3>Purpose</h3><div>Epilepsy affects approximately 50 million people worldwide, many of whom undergo evaluation in Epilepsy Monitoring Units (EMUs) for seizure classification, medication management, or presurgical assessment. With increasing numbers of states legalizing marijuana use, a growing number of EMU admissions involve individuals who use cannabis-based products. If cannabis users are unable to use cannabis products during their EMU admission, this may lead patients to be discharged before recording typical events. This study evaluates the impact of cannabis use on EMU outcomes, specifically length of stay (LOS) and likelihood of capturing a clinical event.</div></div><div><h3>Methods</h3><div>A retrospective chart review was conducted using a REDCap database including demographics, epilepsy risk factors, anti-seizure medication use, social history, urine drug screen results, and final diagnoses. Patients were categorized as users (self-reported use, positive urine test, or both) or non-users (negative test and no self-report). Primary outcomes in the analysis were LOS and event capture rates.</div></div><div><h3>Results</h3><div>Cannabis use was associated with a 0.9 day LOS reduction compared to non-users. Among patients admitted for spell classification, event capturability was 18.1 % higher in cannabis users. Additionally, cannabis users had increased prevalence of psychosocial comorbidities: 12.6 % reported physical abuse, 11.1 % sexual abuse, and 10.2 % mental abuse. Psychiatric diagnoses were also more prevalent; users were 18.9 % more likely to have Major Depressive Disorder and 22.1 % more likely to have Generalized Anxiety Disorder.</div></div><div><h3>Conclusions</h3><div>Cannabis use significantly affects EMU evaluation outcomes and correlates with distinct psychosocial and psychiatric profiles. These findings support a holistic approach in epilepsy patient management.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"33 ","pages":"Article 100846"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037827","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":"Feasibility and impact of virtual reality exposure therapy on epilepsy-specific anxiety: Phase 3 of the AnxEpiVR pilot clinical trial","authors":"Hannah Gabrielle Gray ,&nbsp;Danielle Tchao ,&nbsp;Samantha Lewis-Fung ,&nbsp;Glenda Carman-Gray ,&nbsp;Susanna Pardini ,&nbsp;Laurence R. Harris ,&nbsp;Lora Appel","doi":"10.1016/j.ebr.2025.100845","DOIUrl":"10.1016/j.ebr.2025.100845","url":null,"abstract":"<div><div>People with epilepsy (PwE) commonly experience interictal anxiety related to their epilepsy and seizures. However, therapeutic interventions have received minimal investigation. This study was the third phase of the “AnxEpiVR” pilot that examined the feasibility and effectiveness of a novel virtual reality exposure therapy (VR-ET) program to treat epilepsy-specific (ES) interictal anxiety in PwE. Participants (N = 5) completed the Epilepsy Anxiety Survey Instrument (EASI), Perceived Stress Scale, Igroup Presence Questionnaire, System Usability Scale, and an adapted version of the diagnostic protocol that Hingray et al. (2019) proposed. They also participated in a semi-structured interview. Participants were assigned to a personally relevant VR-ET scenario (dinner party, shopping mall, or a subway station/train). Over 12 to 14 days within a 14-day period, participants engaged in the VR-ET intervention, progressing through an individualized hierarchy of exposures. Preliminary findings suggest promising feasibility of VR-ET and high tolerability, achieving a 100% completion rate. The EASI scores showed that two of the four participants who scored above the cut-off for a probable anxiety disorder before VR-ET (brief EASI ≥ 7) scored below the cut-off after VR-ET (brief EASI &lt; 7). Subjective reports of the VR-ET’s impact supported the intervention’s potential for reducing ES-interictal anxiety. This trial represents the inaugural use of VR-ET as a potential remote intervention for ES-interictal anxiety. Moreover, these findings support the feasibility of conducting larger clinical trials to further evaluate and to validate VR-ET as a therapeutic tool for managing interictal anxiety in PwE.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"33 ","pages":"Article 100845"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077865","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":"Do generalized epilepsies exhibit more attentional or executive disorders?","authors":"Bertille Lacour ,&nbsp;Vincent Heintz ,&nbsp;Natacha Forthoffer ,&nbsp;Serge Chassagnon ,&nbsp;Alain Jager ,&nbsp;Louis Maillard ,&nbsp;Helene Brissart","doi":"10.1016/j.ebr.2025.100843","DOIUrl":"10.1016/j.ebr.2025.100843","url":null,"abstract":"<div><div>This study aimed to characterize attentional and executive dysfunctions in patients with genetic generalized epilepsies (GGE), using specific and validated neuropsychological tools. Secondary objectives included estimating the prevalence of cognitive impairments and exploring potential clinical and psychosocial determinants. A total of 69 adult patients with GGE were enrolled in this multicentric observational study. Participants completed screening questionnaires for anxiety and depression and underwent a battery of neuropsychological tests assessing four attentional components (alertness, sustained, selective, and divided attention), executive functions (flexibility, inhibition, verbal initiation and auditory working memory). Attentional and executive impairments were highly prevalent, affecting approximately 60–64 % of the cohort. Divided attention was the most frequently impaired attentional component (44.93 %), while mental flexibility was the most commonly affected executive function (39.68 %). Selective and sustained attention were relatively preserved. Working memory manipulation was impaired in 17.4 % of patients. Cognitive performance was weakly influenced by clinical and psychosocial factors. Anxiety or depression was associated with poorer divided attention, epilepsy duration with lower selective attention, and education and number of anti-seizure medications with better performance across selective, sustained, and executive attention domains. These findings highlight the need for targeted neuropsychological assessments in GGE, prioritizing divided attention and flexibility. Since divided attention reflects both attentional control and working memory interventions focusing on working memory may offer greater clinic utility. Given the scarcity of studies on cognition rehabilitation in epilepsy, further research is needed, particularly on divided attention as a potential cognitive remediation target.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"33 ","pages":"Article 100843"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349209","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":"The role of cannabis in epilepsy illustrated by two case reports","authors":"Santiago Philibert-Rosas ,&nbsp;Cameron J. Brace ,&nbsp;Sanaa Semia ,&nbsp;Barry E. Gidal ,&nbsp;Bradley T. Nix ,&nbsp;Anne F. Josiah ,&nbsp;Melanie Boly ,&nbsp;Aaron F. Struck","doi":"10.1016/j.ebr.2025.100804","DOIUrl":"10.1016/j.ebr.2025.100804","url":null,"abstract":"<div><div>Cannabis use is increasingly prevalent among individuals with epilepsy, yet its impact on seizure control remains poorly understood. While cannabidiol (CBD) has demonstrated antiseizure properties and gained FDA approval for specific epileptic syndromes, tetrahydrocannabinol (THC), the primary psychoactive compound in cannabis, may alter neuronal excitability and potentially exacerbate seizure activity. We present two illustrative case reports of male patients with focal epilepsy and chronic cannabis use who underwent treatment with antiseizure medications and responsive neurostimulation (RNS). In both cases, cannabis use was temporally associated with breakthrough seizures and poor seizure control. These cases highlight the complex and multifactorial relationship between cannabis use and seizure outcomes, including potential pharmacokinetic interactions with antiseizure medications (ASM) and the possibility that cannabis may blunt the neuromodulation effects of RNS. Given the retrospective data and limited detail on cannabis use, these findings should be interpreted with caution. As cannabis use rises among individuals with epilepsy, further research is needed to clarify its potential effects on seizures and treatment response, including neuromodulation.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"32 ","pages":"Article 100804"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580568","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":"Electroceuticals for Motherhood: Utility of responsive neurostimulation and Proactive antiseizure medication management in two pregnancies","authors":"Aisha Abdulrazaq ,&nbsp;Dorothee Kasteleijn ,&nbsp;Thomas Henry ,&nbsp;Sandipan Pati","doi":"10.1016/j.ebr.2025.100838","DOIUrl":"10.1016/j.ebr.2025.100838","url":null,"abstract":"<div><div>Females with drug-resistant epilepsy (DRE) face unique challenges in balancing seizure control with the teratogenic risks of anti-seizure medications (ASMs) during pregnancy. This case study highlights the use of responsive neurostimulation (RNS) as an electroneuromodulatory strategy to enable safer pregnancies by reducing ASM burden while maintaining seizure control. A 25-year-old woman with bilateral limbic epilepsy secondary to autoimmune encephalitis underwent RNS implantation targeting the hippocampi. Over a multi-year preconception planning period, RNS optimization allowed for tapering of high-risk ASMs and stabilization of seizure frequency. Across two pregnancies, neuromodulation enabled stable epilepsy control and reduced reliance on polytherapy, despite pharmacokinetic ASM variability. Both pregnancies resulted in healthy infants with no major congenital anomalies, despite episodes of breakthrough seizures. This case underscores the transformative potential of RNS in the reproductive care of women with DRE—not only by improving maternal safety but also by reducing fetal exposure to teratogenic drugs. As the first report to demonstrate how RNS can facilitate pregnancy planning with details on how ASM was minimized and complex therapeutic monitoring, this study sets the stage for integrating electroneuromodulation into preconception counselling and epilepsy management for women of childbearing age.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"32 ","pages":"Article 100838"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145568492","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":"Early detection of antiseizure medication inefficacy using an implantable continuous EEG system and a personalized model: a case study","authors":"A. Reynolds ,&nbsp;A. Lai ,&nbsp;D.B. Grayden ,&nbsp;M.J. Cook ,&nbsp;A. Peterson","doi":"10.1016/j.ebr.2025.100829","DOIUrl":"10.1016/j.ebr.2025.100829","url":null,"abstract":"<div><div>Evaluating anti-seizure medication (ASM) efficacy can be limited by inaccurate seizure diaries and periodic fluctuations in seizure frequency, known as seizure cycles. These limitations may prolong monitoring of ineffective treatments. This study explores implantable continuous EEG monitoring (iCEM™) with Epiminder’s Minder® system and timeseries modelling to improve efficacy assessments.</div><div>This retrospective case study examines a 49-year-old female with drug-resistant focal epilepsy with iCEM (Nov. 2019). The participant maintained a seizure diary and was followed-up for 3 years. ASMs were changed in Aug.-Oct. 2020. A personalised autoregressive model incorporating interictal epileptiform discharge cycles to project 3-monthly seizure rates was trained and validated on post-drug data then tested on four held-out datasets (two pre-drug and two post-drug). The Kruskal-Wallis test assessed model performance between drug periods (α = 0.05).</div><div>Only 37 % of seizures were reported. Post-drug, diary-reported seizures increased while detected seizures decreased, but both remained within normal seizure rate variability. ASM inefficacy was addressed after 3 years. The autoregressive model mean squared error post-drug was 0.17 and 0.13 seizures per day over 3-months², which were significantly different from pre-drug (0.49 and 0.58 seizures per day over 3-months², <span><math><mi>H</mi></math></span>=336.82, p = 2.44exp.^-89), suggesting the model could recognise when an altered drug regimen affected seizure rate and interictal epileptiform discharges.</div><div>Seizures identified using iCEM combined with an individualised model may be able to distinguish drug-induced changes in seizure rate from normal variability. This proof-of-concept study offers useful information towards the development of methods that can support early treatment assessments, potentially shortening the time to find an optimal therapy.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"32 ","pages":"Article 100829"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157439","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":"Significant seizure frequency reduction in a patient with refractory bitemporal epilepsy following transition from high-frequency to low-frequency responsive neurostimulation","authors":"Stacey Kim ,&nbsp;Christel Benny ,&nbsp;Alan Salim ,&nbsp;Charles Liu ,&nbsp;Brian Lee ,&nbsp;Hari Prasad Kunhi Veedu","doi":"10.1016/j.ebr.2025.100822","DOIUrl":"10.1016/j.ebr.2025.100822","url":null,"abstract":"<div><div>While many patients treated with Responsive Neurostimulation (RNS) experience a significant reduction in seizures, poor responders to traditional high frequency stimulation (HFS) may experience a meaningful reduction in seizure frequency when switched to low frequency stimulation (LFS). This case report presents a patient who developed post-traumatic pharmacoresistant bitemporal epilepsy and underwent unsuccessful treatments, including antiseizure polytherapy and implantation of a vagus nerve stimulator (VNS). Due to ongoing seizures, the patient underwent RNS System implantation with bilateral hippocampal depth electrodes. Prior to RNS implantation, the patient experienced a median frequency of 6.5 seizures per month. At traditional HFS settings applied for 30 months, the patient experienced a 31 % reduction from baseline. After switching to LFS for 8 months, the patient experienced an 85 % reduction. HFS delivered 6.02 min per day, compared to 113.77 min per day with LFS. This patient experienced a substantial and meaningful reduction in seizure frequency after switching to LFS, suggesting that LFS may be an effective alternative for RNS patients who do not have a satisfactory seizure reduction to traditional HFS. Furthermore, this case report highlights the importance of collaboration between academic medical centers with public safety net hospitals in delivering advanced epilepsy care to people in underserved communities.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"32 ","pages":"Article 100822"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144841364","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":"EPIDEP: Prevalence of undiagnosed depression in an epilepsy outpatient clinic","authors":"Alejandro Fernández-Cabrera ,&nbsp;Paula Santamaría-Montero ,&nbsp;Jesús García-de Soto ,&nbsp;Antía Figueira-Gómez ,&nbsp;Martín Rodríguez-Botana ,&nbsp;Benigno Pérez-Regojo ,&nbsp;Robustiano Pego-Reigosa","doi":"10.1016/j.ebr.2025.100819","DOIUrl":"10.1016/j.ebr.2025.100819","url":null,"abstract":"<div><div>Epilepsy and depression frequently coexist, with depressive symptoms affecting up to 50 % of patients, particularly those with drug-resistant epilepsy (DRE). Underdetection of depression in general neurology settings can worsen seizure control, treatment adherence, and overall prognosis. This study aimed to characterize the prevalence of undiagnosed depression in epilepsy outpatients and to evaluate the Neurological Disorders Depression Inventory for Epilepsy (NDDIE) as a screening tool, as well as the impact of early SSRI treatment. In a single-center, observational, non-interventional, prospective design, 82 consenting adults (mean age 50.8 ± 23 years; 59.8 % female) with diagnosed epilepsy (focal, idiopathic generalized, or unknown onset) and no prior psychiatric history or antidepressant use were enrolled over one year. Participants completed the NDDIE at baseline; those screening positive (score &gt; 13) began SSRI therapy and were referred to psychiatry for diagnostic confirmation. Repeat NDDIE assessments occurred at three months. Of 82 patients, 35 (42.7 %) screened positive on NDDIE and 24 (29.3 % overall) were confirmed depressed by psychiatry (κ = 0.71). Baseline mean NDDIE was 12.17 ± 5.46, decreasing to 10.78 ± 4.36 at three months across all participants (Δ = 1.39; p &lt; 0.05). In treated patients (n = 35), NDDIE fell from 17.83 ± 2.74 to 14.74 ± 3.48 (Δ = 3.09; p &lt; 0.001). Patients with DRE (n = 10) had higher baseline scores than non-DRE (19.40 ± 1.96 vs 11.00 ± 5.40; p &lt; 0.05) and those on ≥ 2 anti-seizure medications (ASM) scored higher than monotherapy (17.52 ± 4.08 vs 9.82 ± 4.20; p &lt; 0.001). Patients &gt; 60 years had lower scores than younger patients (10.68 ± 4.58 vs 13.23 ± 5.82; p &lt; 0.05). No sex or epilepsy type differences were significant. Depression is common and underdiagnosed in epilepsy outpatients, especially among those with DRE or on multiple ASMs. The NDDIE demonstrates good agreement with psychiatric diagnosis and detects clinically meaningful improvements following early SSRI treatment. Systematic depression screening using NDDIE in neurology clinics is recommended to identify and treat comorbid depression, potentially improving quality of life and seizure outcomes.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"32 ","pages":"Article 100819"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144826650","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":"Upward eye deviation as a precursor to epileptic spasms: A case successfully treated with early corpus callosotomy without adrenocorticotropic hormone therapy","authors":"Yasushi Iimura ,&nbsp;Hiroharu Suzuki ,&nbsp;Takumi Mitsuhashi ,&nbsp;Tetsuya Ueda ,&nbsp;Kazuki Nishioka ,&nbsp;Kazuki Nomura ,&nbsp;Shimpei Abe ,&nbsp;Takato Akiba ,&nbsp;Shimpei Matsuda ,&nbsp;Hidenori Sugano ,&nbsp;Akihide Kondo","doi":"10.1016/j.ebr.2025.100818","DOIUrl":"10.1016/j.ebr.2025.100818","url":null,"abstract":"<div><div>Infantile epileptic spasms syndrome is characterized by epileptic spasms (ES), neurodevelopmental regression, and variable electroclinical features. Early recognition and prompt treatment are crucial for improving outcomes; however, subtle ictal manifestations are often overlooked by caregivers. We describe a male infant who exhibited repeated upward eye deviation beginning at 5 months of age, preceding the onset of typical ES. Prolonged scalp video electroencephalography (EEG) monitoring captured both isolated upward eye deviation and typical ES preceded by upward eye deviation. Despite the introduction of two antiseizure medications, ES persisted. Given the absence of lateralizing findings on neuroimaging and the presence of bilaterally synchronous ictal discharges on EEG, corpus callosotomy (CC) was performed at 7 months of age without prior adrenocorticotropic hormone (ACTH) therapy, in accordance with parental preference. The patient has remained seizure free for 1 year and 3 months postoperatively, with age-appropriate neurodevelopmental scores on the Vineland Adaptive Behavior Scales, Second Edition. This case highlights the importance of identifying subtle signs, such as upward eye deviation, as potential early ictal precursors in ES. CC may represent a viable first-line treatment in selected cases.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"32 ","pages":"Article 100818"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810213","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":"Long-term efficacy and safety of perampanel in patients aged 60 years and older with focal seizures: Post hoc analysis of phase III open-label extension studies stratified by enzyme-inducing anti-seizure medication use","authors":"Rohit Marawar ,&nbsp;Ilo E. Leppik ,&nbsp;Robert T. Wechsler ,&nbsp;Anna Patten ,&nbsp;Leock Y. Ngo","doi":"10.1016/j.ebr.2025.100833","DOIUrl":"10.1016/j.ebr.2025.100833","url":null,"abstract":"<div><h3>Objective</h3><div>Examine long-term findings from two Phase III open-label extension (OLEx) studies of adjunctive perampanel in patients aged ≥60 years experiencing focal seizures (FS), with/without focal to bilateral tonic-clonic seizures (FBTCS), with/without enzyme-inducing anti-seizure medications (EIASMs). Methods: Study 307 (NCT00735397) included a Conversion Period (16 weeks; blinded) and a Maintenance Period (256 weeks). Study 335 OLEx (NCT01618695) included Pre-conversion (4 weeks), Conversion (6 weeks), and Maintenance Periods (≥46 weeks). Perampanel (2–12 mg/day) was given alongside 1–3 concomitant ASMs, of which ≤2 (Study 307) and ≤1 (Study 335) were EIASMs. Efficacy and safety outcomes were analyzed. Results: Seventy-one patients aged ≥60 years were included in the Full and Safety Analysis Sets. Over 4 years, seizure frequency decreased regardless of EIASM use; seizure-freedom rates for FS were 0.0 % (n = 0/71) for Year 1, 2.6 % (n = 1/38) Year 2, 5.3 % (n = 1/19) Year 3, and 0.0 % (n = 0/14) Year 4. For FBTCS, these rates were 26.3 % (n = 5/19) for Year 1, 22.2 % (n = 2/9) Year 2, 40.0 % (n = 2/5) Year 3, and 0.0 % (n = 0/4) Year 4. The 90 % responder rates were ≥14.0 % for FS and ≥40.0 % for FBTCS. Incidence of treatment-emergent adverse events (TEAEs) was highest during Year 1 (87.3 % [n = 62/71]) but decreased across Years 2–4 (47.4 %–60.4 %). The most commonly reported TEAE during Years 1/2 was dizziness (47.9 % [n = 34/71] and 12.5 % [n = 6/48], respectively) and during Years 3/4 was fall (15.8 % [n = 3/19] and 14.3 % [n = 2/14]). Significance: Adjunctive perampanel conferred long-term seizure control in older patients with epilepsy; safety was aligned with established perampanel safety profile.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"32 ","pages":"Article 100833"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361959","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}