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Seminars in Neurology最新文献

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Epilepsy. 癫痫。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-04-01 Epub Date: 2025-05-08 DOI: 10.1055/a-2556-8487
David B Burkholder, Elaine C Wirrell
{"title":"Epilepsy.","authors":"David B Burkholder, Elaine C Wirrell","doi":"10.1055/a-2556-8487","DOIUrl":"https://doi.org/10.1055/a-2556-8487","url":null,"abstract":"","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":"45 2","pages":"178-179"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Emerging Genetic Therapies in Epilepsy. 新兴的基因疗法（遗传和ASOs）。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-04-01 Epub Date: 2025-02-24 DOI: 10.1055/a-2544-1530
Joseph Sullivan, Veronica Hood
{"title":"Emerging Genetic Therapies in Epilepsy.","authors":"Joseph Sullivan, Veronica Hood","doi":"10.1055/a-2544-1530","DOIUrl":"10.1055/a-2544-1530","url":null,"abstract":"<p><p>Advances in next-generation sequencing have allowed for genetic characterization of many epilepsies that previously had no known cause. Although having a precise diagnosis has been very helpful for management, counseling, and prognosis, until recently true precision medicine approaches that could have disease-modifying effects have been lacking. This review will highlight how preclinical animal models of Dravet syndrome have allowed some novel gene therapy approaches to be studied and further developed such that they are now entering into the clinics.</p>","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":" ","pages":"298-302"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Disconnection Methods in the Surgical Treatment of Epilepsy. 癫痫手术治疗中的断连方法。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-04-01 Epub Date: 2025-03-10 DOI: 10.1055/a-2538-3354
Runze Yang, Goichiro Tamura, Julia Jacobs, Walter Hader
{"title":"Disconnection Methods in the Surgical Treatment of Epilepsy.","authors":"Runze Yang, Goichiro Tamura, Julia Jacobs, Walter Hader","doi":"10.1055/a-2538-3354","DOIUrl":"10.1055/a-2538-3354","url":null,"abstract":"<p><p>Disconnection procedures in epilepsy surgery have become an important tool for the management of multifocal drug-resistant epilepsy. In this chapter, we will review their indications, describe the technical procedures, and review outcome data in the literature. Among the curative approaches, anterior quadrant disconnection, posterior quadrant (PQ) disconnection, and functional hemispherectomy can be performed for patients whose epileptic focus resides in one hemisphere or one quadrant. Seizure freedom rates from these procedures range from 50 to 81% for anterior quadrant disconnections, 50 to 92% for PQ disconnections, and 43 to 93% for hemispherectomy. Although typically performed in the pediatric population, data suggest that carefully selected adult patients could also benefit from a disconnection procedure. Of the palliative approaches, corpus callosotomy has been shown to be effective for drop attacks, resulting in significant improvement in seizure frequency, severity, and quality of life. Minimally invasive alternatives to standard open corpus callosotomies with laser interstitial thermal therapy (LITT) have been proposed. Overall, surgical disconnection procedures are an effective way of treating multifocal epilepsy, with good outcomes that can improve the quality of life for these patients.</p>","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":" ","pages":"241-251"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Epilepsy Drug Pipeline: Update on Near-to-Market Therapies. 癫痫药物管线：接近上市疗法的最新进展。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-04-01 Epub Date: 2025-05-08 DOI: 10.1055/a-2580-1187
Christopher Elder, Jacob Pellinen, Samuel W Terman
{"title":"The Epilepsy Drug Pipeline: Update on Near-to-Market Therapies.","authors":"Christopher Elder, Jacob Pellinen, Samuel W Terman","doi":"10.1055/a-2580-1187","DOIUrl":"https://doi.org/10.1055/a-2580-1187","url":null,"abstract":"<p><p>Since the first antiseizure medication (ASM) was introduced in 1857, more than 30 medications have been approved by the United States Food and Drug Administration (FDA) for the treatment of epilepsy. However, limitations in efficacy and tolerability have led to one-third of patients suffering from uncontrolled seizures. Recent advances in genetics, disease modeling, high-throughput target-based and phenotype-based screening, study design, and identification of novel mechanisms of action or routes of delivery have resulted in more than 200 therapeutics currently under development in the epilepsy pipeline. This study discusses near-to-market drugs in advanced clinical development, with select drugs in earlier stages. Background regarding mechanisms, animal studies, pharmacokinetics, pharmacodynamics, efficacy, tolerability, and safety data are provided for each drug when available.</p>","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":"45 2","pages":"287-297"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of Developmental and Epileptic Encephalopathies. 发展性和癫痫性脑病的管理。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-04-01 Epub Date: 2025-02-24 DOI: 10.1055/a-2534-3267
Alejandra Vasquez, Anthony L Fine
{"title":"Management of Developmental and Epileptic Encephalopathies.","authors":"Alejandra Vasquez, Anthony L Fine","doi":"10.1055/a-2534-3267","DOIUrl":"10.1055/a-2534-3267","url":null,"abstract":"<p><p>Developmental and epileptic encephalopathies (DEEs) are a group of rare, severe, early-onset epilepsies characterized by pharmacoresistance, marked electroencephalographic abnormalities, and delayed or regressive psychomotor development. DEEs are associated with poor long-term outcomes and increased mortality; however, early recognition and targeted treatment can impact neurodevelopmental outcomes and overall quality of life. Treatment with antiseizure medication is often challenging given drug resistance, chronic polypharmacy, and medication interactions. With advances in genetic testing and increased understanding of the neurobiological mechanisms of DEEs, the treatment approach is evolving and includes repurposed antiseizure medications and targeted therapies, as well as early surgical intervention in select patients. In addition to high seizure burden and neurodevelopmental delay, DEEs are associated with comorbidities affecting a range of body systems; these can include intellectual disability, psychiatric disorders, motor dysfunction, and respiratory and gastrointestinal problems. Over time, these comorbidities increase the complexity of management and have important implications on the disease burden and quality of life for both patients and their caregivers. Multidisciplinary care in DEEs is paramount. We summarize the current evidence on the management of specific DEEs, focusing on targeted therapies and optimizing outcomes.</p>","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":" ","pages":"206-220"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
General Principles of Medical Treatment. 《医疗一般原则》。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-04-01 Epub Date: 2025-04-28 DOI: 10.1055/a-2568-9482
Jordan L Clay, Julie L Youssefi, Meriem K Bensalem-Owen
{"title":"General Principles of Medical Treatment.","authors":"Jordan L Clay, Julie L Youssefi, Meriem K Bensalem-Owen","doi":"10.1055/a-2568-9482","DOIUrl":"https://doi.org/10.1055/a-2568-9482","url":null,"abstract":"<p><p>Seizures are paroxysmal neurological events that are encountered by all medical specialties. Seizures are common, with 1 in 10 people experiencing a seizure at some point in their life. Furthermore, recurring unprovoked seizures are the hallmark of the condition of epilepsy, which encompasses a spectrum of syndromes that can occur across the lifespan. Although individual seizures may be brief occurrences, they are disruptive to an individual's activities of daily living (ADLs), increase the risk of physical injury, and adversely impact the mental well-being of those who experience them. Thus, in order to provide the best management, it falls into a clinician's domain to be informed of the types of seizures along with possible provoking factors and risks of recurrence, and when to make a diagnosis of epilepsy. Attention will be given to treatment of epilepsy with medications, characteristics that may impact management, and situations that require advanced specialty care.</p>","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":"45 2","pages":"180-188"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Special Issues in Medical Management: Hormones and Pregnancy in Epilepsy. 医学管理的特殊问题：癫痫的激素和妊娠。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-04-01 Epub Date: 2025-04-03 DOI: 10.1055/a-2551-0688
Christopher M Carosella, Emily L Johnson
{"title":"Special Issues in Medical Management: Hormones and Pregnancy in Epilepsy.","authors":"Christopher M Carosella, Emily L Johnson","doi":"10.1055/a-2551-0688","DOIUrl":"10.1055/a-2551-0688","url":null,"abstract":"<p><p>The relationship between sex hormones and epilepsy involves intricate interactions that influence seizure susceptibility, reproductive health, and treatment approaches. Estrogen generally exhibits proconvulsant effects, while progesterone and its metabolite allopregnanolone have anticonvulsant properties. Variability in hormone levels during the menstrual cycle can exacerbate seizures, a phenomenon known as catamenial epilepsy. Effective management often requires a tailored combination of antiseizure medications (ASMs) and hormonal therapies. Women and others of childbearing potential face unique challenges, including higher rates of menstrual dysfunction, potential exacerbation of seizures during pregnancy, and increased risks associated with hormonal contraception and menopause. Careful ASM selection is critical to ensure maternal and fetal safety, with lamotrigine, levetiracetam, and oxcarbazepine being preferred options. Postpartum ASM adjustments and breastfeeding considerations are also essential for optimizing outcomes. Emerging research highlights the impact of hormonal interactions in transgender individuals undergoing gender-affirming therapies. For transwomen, estrogen could heighten seizure risk. Close monitoring and collaboration between health care providers are crucial for personalized care. The complex interplay between hormones and epilepsy underscores the need for ongoing research and individualized approaches to optimize seizure control and address the unique reproductive health needs of people with epilepsy.</p>","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":" ","pages":"198-205"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Unique Surgical Challenges in Early Life Epilepsy. 早期癫痫的独特手术挑战。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-04-01 Epub Date: 2025-02-13 DOI: 10.1055/a-2519-2923
Michael Scott Perry, Daniel Hansen
{"title":"Unique Surgical Challenges in Early Life Epilepsy.","authors":"Michael Scott Perry, Daniel Hansen","doi":"10.1055/a-2519-2923","DOIUrl":"10.1055/a-2519-2923","url":null,"abstract":"<p><p>The incidence of epilepsy is highest at the extremes of age. Drug resistance is present in approximately one-third of people with epilepsy but occurs at higher than average rates in children with seizure onset before age 3 years, owing to a variety of etiologies unique to this age group. Epilepsy surgery is an effective therapeutic option for drug-resistant epilepsy but is vastly underutilized. Epilepsy surgery in children under age 3 comes with distinct clinical challenges related to brain anatomy, evolving developmental maturation, and limitations of evaluation and surgical strategies. However, epilepsy surgery can lead to seizure freedom or significant seizure reduction in this age group. Early seizure control may have a significant positive impact on long-term cognitive development, making urgency of surgical referral of immense importance. This review highlights available evidence on the safety and efficacy of epilepsy surgery in early-life epilepsy, identifying barriers to surgical therapy, describing utilization of available evaluation and surgical strategies, and examining risks and benefits of earlier surgical consideration in this vulnerable population.</p>","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":" ","pages":"264-274"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pediatric Epilepsy Management: Special Considerations. 小儿癫痫的独特管理注意事项。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-04-01 Epub Date: 2025-02-04 DOI: 10.1055/a-2531-3610
Katherine Nickels, Charuta Joshi
{"title":"Pediatric Epilepsy Management: Special Considerations.","authors":"Katherine Nickels, Charuta Joshi","doi":"10.1055/a-2531-3610","DOIUrl":"10.1055/a-2531-3610","url":null,"abstract":"<p><p>While pediatric epilepsy shares some features with adult epilepsy, the growing and developing brain during childhood is associated with differences in epilepsy etiologies, syndromes, comorbidities, management, and outcomes. We must also consider the long-term effects of epilepsy and treatments. This section highlights unique considerations for pediatric epilepsy. These include pediatric onset electroclinical syndromes that commonly resolve prior to adulthood, treatment duration of self-limited pediatric epilepsy syndromes, pediatric-onset epilepsy with etiology-specific treatment, and therapies used more commonly in the pediatric population. In addition, pediatric-onset epilepsy is associated with a higher risk for developmental, psychiatric, and behavioral comorbidities in a bidirectional fashion. Family dynamics are affected by a child with epilepsy, and transitioning to the adult clinic is a particular challenge for this population. Finally, there are special issues that occur in pediatric epilepsy, including the lack of pediatric FDA approvals for newly available therapies and the need for sedation for investigations.</p>","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":" ","pages":"189-197"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
David Burkholder, MD, and Elaine Wirrell, MD. 大卫·伯克霍尔德，医学博士和伊莱恩·威雷尔，医学博士。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-04-01 Epub Date: 2025-05-08 DOI: 10.1055/a-2566-0796
David M Greer
{"title":"David Burkholder, MD, and Elaine Wirrell, MD.","authors":"David M Greer","doi":"10.1055/a-2566-0796","DOIUrl":"https://doi.org/10.1055/a-2566-0796","url":null,"abstract":"","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":"45 2","pages":"177"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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