Seizure-European Journal of Epilepsy最新文献

{"title":"Anatomical and functional alterations in patients with functional/dissociative seizures and posttraumatic stress disorders.","authors":"Clélia Galmiche, Louise Tyvaert, Pierre Fauvé, Cyril Husson, Emmanuelle Hologne, Wissam El-Hage, Marc Braun, Coraline Hingray, Gabriela Hossu","doi":"10.1016/j.seizure.2026.08.025","DOIUrl":"https://doi.org/10.1016/j.seizure.2026.08.025","url":null,"abstract":"<p><strong>Background: </strong>Functional/dissociative seizures (FDS) involve alterations in emotional processing, agency, self-monitoring, and motor control. Post-traumatic stress disorder (PTSD) involves brain systems related to emotional processing, salience detection, memory, and cognitive control. FDS and PTSD converge on several clinical and neurobiological dimensions-including trauma-related vulnerability, emotional processing, dissociation, and alterations involving limbic and regulatory networks-while producing markedly different clinical manifestations. However, it remains unclear which neural abnormalities reflect these shared dimensions and which may be more specifically associated with the emergence of functional seizures.</p><p><strong>Methods: </strong>The study included 25 FDS patients, 20 PTSD patients, and 23 healthy controls (HC) who underwent functional and structural 3T MRI. Functional connectivity between 12 predefined brain regions was analyzed using seed-to-voxel analysis. Cluster-based inference and Gaussian random field theory were applied with p-corrected <0.05 and p-uncorrected <0.001 thresholds. Cortical and subcortical structures, including specific hippocampal and amygdala subregions, were segmented using FreeSurfer, and volumes were expressed as mean ± SD.</p><p><strong>Results: </strong>FDS patients showed lower bilateral dentate gyrus volume (FDS: 142.75 ± 16.28, control: 157.75 ± 17.11, p-adj= 0.019) and greater left anterior cingulate cortical thickness (FDS: 2.85 ± 0.14, control: 2.75 ± 0.17, p-adj= 0.01). Compared with PTSD patients, FDS patients had lower right amygdala central nucleus (FDS: 39.81 ± 5.43, PTSD: 44.15 ± 4.15, p-adj= 0.01) and right pars orbitalis cortical thickness (FDS: 2.62 ± 0.19, PTSD: 2.75 ± 0.17, p-adj= 0.04). Hyperconnectivity was observed from the right hippocampus to the right temporoparietal junction (FDS vs. controls) and from the right insula to the orbitofrontal cortex (FDS vs. PTSD).</p><p><strong>Conclusion: </strong>Anatomical and functional alterations were observed in FDS and PTSD groups versus HC and between FDS and PTSD groups. These findings suggest both shared and disorder-specific brain alterations in FDS and PTSD.</p>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"142 ","pages":"137-145"},"PeriodicalIF":3.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurosurgical management of childhood-onset epilepsy in periventricular nodular heterotopia: A systematic review of effectiveness and outcomes.","authors":"Srishruthi Thirumalai, Dimitrios Champsas, Manuela Lo Bianco, Sergio Rinella, Evangelia Ioannidou, Aswin Chari, Martin Tisdall, Hanna Richardson, J Helen Cross, Marios Kaliakatsos","doi":"10.1016/j.seizure.2026.08.024","DOIUrl":"https://doi.org/10.1016/j.seizure.2026.08.024","url":null,"abstract":"<p><p>Epilepsy associated with periventricular nodular heterotopia (PVNH) frequently begins in childhood and often proves refractory to medication. Surgical management is challenging, as lesions are frequently deep-seated or bilateral, and seizure onset often involves networks extending beyond the heterotopic tissue itself, with the precise contribution of the nodules varying between patients. This systematic review synthesises all available evidence on neurosurgical and invasive interventions for childhood-onset PVNH-associated epilepsy, focusing on outcomes and prognostic factors. We conducted a PRISMA 2020-compliant systematic review searching PubMed/MEDLINE, Scopus, and Web of Science from inception to 13 December 2025. Eligible studies reported neurosurgical interventions in patients with MRI- or histopathology-confirmed PVNH whose epilepsy began before age 18, with outcomes reported using Engel or ILAE classification. Two reviewers independently screened and extracted data. Methodological quality was appraised using GRADE. Findings were synthesised narratively due to the inherent heterogeneity of the included studies. Thirty studies comprising 134 patients met our inclusion criteria. Excellent outcomes, defined as seizure freedom or auras only, were achieved in 50.7% (n = 68), with 76.9% (n = 103) experiencing meaningful benefit, defined as at least a 50% reduction in seizure frequency. Outcomes were better in unilateral than bilateral PVNH (75.9%vs 33.8%, p < 0.001) and with complete rather than incomplete nodule removal (72.9%vs 25.0%, p < 0.001). Permanent morbidity was 10.4% (n = 14), predominantly visual field deficits. Invasive EEG-guided approaches can achieve seizure freedom in around half of children with PVNH-related epilepsy, with outcomes strongly predicted by laterality. As with all subgroup comparisons in this review, reported p-values reflect effect size across pooled retrospective cohorts rather than formal hypothesis testing. Minimally invasive ablation appears effective and safe, while neuromodulation offers palliation where curative treatment is not feasible. Evidence remains limited by retrospective study designs and small sample sizes, and prospective multicentre data are needed.</p>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"142 ","pages":"104-117"},"PeriodicalIF":3.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of MR guided-laser interstitial thermal therapy versus resective surgery for MRI-positive focal cortical dysplasia type II and tuberous sclerosis complex: A systematic review and meta-analysis.","authors":"Yuxin Wang, Yuchen Tai, Tinghong Liu, Shuli Liang","doi":"10.1016/j.seizure.2026.08.021","DOIUrl":"https://doi.org/10.1016/j.seizure.2026.08.021","url":null,"abstract":"<p><strong>Background: </strong>Focal cortical dysplasia type II (FCD II) and tuberous sclerosis complex (TSC) are two major structural causes of drug-resistant epilepsy. While the effectiveness of surgical resection in controlling seizures is well-established, the comparative efficacy and safety profile of magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) has not been thoroughly investigated.</p><p><strong>Objective: </strong>To compare the efficacy and safety of MRgLITT with resective surgery in patients with MRI-positive FCD II and TSC.</p><p><strong>Design: </strong>A systematic review and meta-analysis was conducted with all available randomized clinical trials and observational studies.</p><p><strong>Materials and methods: </strong>A systematic literature search was conducted across four databases: PubMed, Web of Science, the Cochrane Library, and Embase. Study quality was assessed with the ROBINS-I V2 tool. The primary outcome was the postoperative seizure freedom rate, and the secondary outcome was the complication rate.</p><p><strong>Results: </strong>Overall, 36 studies were included, comprising 25 on resective surgery (1220 patients) and 13 on MRgLITT (87 patients), with two studies reporting data on both surgical modalities. No significant difference was observed in seizure freedom rates between MRgLITT and resective surgery for the combined FCD II/TSC group (0.72 vs. 0.71, P = 0.838), the FCD II-only (0.74 vs. 0.85, P = 0.065), and the TSC-only (0.50 vs. 0.59, P = 0.510), respectively. Surgery age-based subgroup (<18 vs. ≥18 years) analysis also revealed no significant difference in seizure freedom. Similarly, in the combined FCD II/TSC group, complication rates did not differ significantly between MRgLITT and resective surgery (P = 0.469).</p><p><strong>Conclusion: </strong>Both resective surgery and MRgLITT are effective treatment options for epilepsy caused by MRI-positive FCD II and TSC, demonstrating comparable efficacy in seizure control and safety. Postoperative seizure outcomes were not influenced by patient age group.</p>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"142 ","pages":"121-130"},"PeriodicalIF":3.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A treatable cause of developmental and epileptic encephalopathy: Cerebral folate deficiency in a young child.","authors":"Sangeetha Yoganathan, Haya S AlFaris, Sayoni Roy Chowdhury, Andrea LeBlanc-Millar, Lyndsey McRae, Puneet Jain, Carolina Gorodetsky","doi":"10.1016/j.seizure.2026.08.013","DOIUrl":"https://doi.org/10.1016/j.seizure.2026.08.013","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"142 ","pages":"146-149"},"PeriodicalIF":3.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term trends and regional inequalities in epilepsy of genetic/unknown cause in Europe (1990-2023): A data analysis of the global burden of disease study.","authors":"Francesco Brigo, Simona Lattanzi, Eugen Trinka, Johan Zelano","doi":"10.1016/j.seizure.2026.08.018","DOIUrl":"https://doi.org/10.1016/j.seizure.2026.08.018","url":null,"abstract":"<p><strong>Background: </strong>In Global Burden of Disease (GBD) framework, idiopathic epilepsy corresponds to epilepsy of genetic/unknown cause, encompassing cases without identifiable etiologies. Despite major health-system changes across Europe, long-term, regionally disaggregated assessments of its burden remain limited.</p><p><strong>Methods: </strong>Using GBD 2023 estimates, we analysed age-standardized Disability‑Adjusted Life Years (DALYs), Years of Life Lost (YLL), and Years Lived with Disability (YLD) rates for epilepsy of genetic/unknown cause across Central, Eastern, and Western Europe from 1990 to 2023. We applied log-linear models with cluster-robust inference, assessed linearity using polynomial terms, estimated annual percentage changes (EAPCs), evaluated sex- and area-specific differences through interaction models and Benjamini-Hochberg-adjusted pairwise contrasts, and decomposed long-term changes into mortality and disability components using Shapley-style averages.</p><p><strong>Results: </strong>The overall burden decreased across Europe, but temporal trends differed considerably between macroareas. Linearity checks supported a log-linear specification, and diagnostic analyses identified no influential observations. Sex-specific slopes did not differ significantly for any outcome, whereas strong heterogeneity emerged across macroareas: Eastern Europe showed the steepest declines, while Western Europe showed largely stable or less favourable trends. Area-year interactions showed evidence of heterogeneity, and pairwise contrasts confirmed robust differences. In decomposition analyses, YLL and YLD components contributed to reductions in DALYs.</p><p><strong>Conclusion: </strong>The overall burden of epilepsy of genetic/unknown cause decreased across Europe from 1990 to 2023, but trends differed substantially between macroareas, with Eastern Europe experiencing the most rapid improvements. These findings provide a coherent epidemiological foundation for future research and policy aimed at reducing regional disparities in epilepsy outcomes.</p>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"142 ","pages":"131-136"},"PeriodicalIF":3.1,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel SEMA6B splice-site variant (c.1680-2A>G) causes incompletely penetrant epilepsy via diverse aberrant transcripts.","authors":"Shuyao Zhu, Jin Wang, Zemin Luo, Ping Zhou, Dan Tang, Fangyi Long, Hui Zhu, Lan Zeng, Fu Xiong, Xiaocheng Nie, Ai Cheng, Guohui Zhang, Weixin Liu","doi":"10.1016/j.seizure.2026.08.015","DOIUrl":"https://doi.org/10.1016/j.seizure.2026.08.015","url":null,"abstract":"<p><strong>Background: </strong>While truncating variants in the SEMA6B gene are an established cause of Progressive Myoclonus Epilepsy-1(EPM11), the pathogenic mechanisms of non-last-exon splicing variants, particularly those underlying the frequent yet elusive phenomenon of incomplete penetrance, remain a critical knowledge gap. Elucidating these mechanisms is essential for accurate molecular diagnosis and genetic counseling METHODS: We combined whole-exome sequencing in a proband, familial co-segregation analysis, and an in vitro minigene splicing assay in HEK-293T cells to characterize a novel candidate variant. Long-term clinical follow-up assessed phenotypic trajectory.</p><p><strong>Results: </strong>We identified a novel heterozygous donor splice-site variant NM_032108.4 (SEMA6B): c.1680-2A>G segregating with autosomal dominant EPM1in a family exhibiting marked incomplete penetrance. The minigene assay demonstrated that this single variant drives the production of three distinct aberrant transcripts (exon 16 skipping, intron 15 retention, and partial exon 16 deletion), confirming its strong splice-disrupting effect. Notably, effective anti-seizure medication was associated with improved neurodevelopmental outcomes.</p><p><strong>Conclusion: </strong>This study provides the first functional validation of the c.1680-2A>G variant, demonstrating that complex transcript heterogeneity from a single splice-site mutation is a key molecular feature. Our findings propose a plausible link between this heterogeneity and the observed incomplete penetrance, thereby refining the genetic architecture of SEMA6B-related disorders and underscoring the necessity of functional assays for the interpretation of splicing variants.</p>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"142 ","pages":"150-157"},"PeriodicalIF":3.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remarkable seizure reduction with trofinetide treatment in an adult with Rett syndrome: A case report.","authors":"Semihan Adegbite, Pooneh Memar Ardestani, Maromi Nei","doi":"10.1016/j.seizure.2026.08.016","DOIUrl":"https://doi.org/10.1016/j.seizure.2026.08.016","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"142 ","pages":"118-120"},"PeriodicalIF":3.1,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjunctive transcranial DC stimulation in the management of refractory drug-resistant focal epilepsy in POLG mitochondrial disease: A case series.","authors":"Katrin A Bangel, Yi Ng, Albert Lim, Naomi J P Thomas, Stephan R Jaiser, H Ming Lai, Gráinne S Gorman, Rhys R Thomas, Douglass M Turnbull, Venkateswaran Ramesh, Andrew M Schaefer, Robert McFarland, Mark R Baker","doi":"10.1016/j.seizure.2026.05.009","DOIUrl":"https://doi.org/10.1016/j.seizure.2026.05.009","url":null,"abstract":"<p><strong>Background: </strong>Pathogenic POLG variants produce an age-related progressive multi-system mitochondrial disorder, with neurologic manifestations that include focal onset seizures, stroke-like episodes, cerebellar ataxia, sensory neuronopathy, complex ophthalmoplegia and myopathy. Focal onset status epilepticus or epilepsia partialis continua (EPC) frequently occurs in patients with paediatric and early adulthood onset disease.</p><p><strong>Methods: </strong>Between 2014 and 2020, we treated 15 episodes of drug-refractory focal epileptic status (epilepsia partialis continua) in 5 patients with POLG-related mitochondrial disease with cathodal transcranial direct current stimulation (tDCS). Here we describe the management of each episode of EPC, including the application of tDCS.</p><p><strong>Results: </strong>Transcranial DCS, delivered for 20 min at 2 mA, once daily (minimum 3 days; maximum 14 days), as an adjunct to optimal standard medical care, was associated with a significant reduction (93% of episodes after 4.3 sessions) or a cessation of seizures (63% of episodes after 8.4 sessions). No major side effects of tDCS were noted.</p><p><strong>Conclusion: </strong>Our findings support further exploration of tDCS as a potential adjunctive therapy for complex neurological challenges in mitochondrial disorders.</p>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148177159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cenobamate: A comprehensive review","authors":"David G Vossler ,&nbsp;Raman Sankar","doi":"10.1016/j.seizure.2026.04.011","DOIUrl":"10.1016/j.seizure.2026.04.011","url":null,"abstract":"<div><div>This article provides a review of cenobamate’s (CNB’s) pharmacology, mechanisms of action, efficacy, safety, and seizure/epilepsy types treated. CNB is an antiseizure medication approved in the U.S. in 2019 for treatment of adults with focal (partial-onset) seizures. Preclinical data indicated CNB had a broad spectrum of antiseizure activity in rodent models of generalized and focal seizures. CNB has two mechanisms of action that may contribute additively or synergistically to powerfully counter the development of the paroxysmal depolarizing shift in neurons: selective inhibition of persistent sodium currents (I_NaP), sparing transient sodium currents, and augmentation of GABA-mediated tonic currents. In 3 randomized, placebo-controlled trials in adults with focal seizures, median 28-day seizure frequency reductions ranged from 36.0%-100% at CNB doses of 100-400 mg/day. During the maintenance phases of these trials, CNB at higher doses demonstrated 100% seizure-free rates in 21.0%-52.4% of patients. In a recent randomized, controlled study of patients aged 12-65 years with primary generalized tonic-clonic seizures, the seizure-free rates with CNB and with placebo were 43% and 20%, respectively (<em>p</em>=0.0034). Since CNB’s approval in multiple countries, many open-label extension, postmarketing, and observational studies have been published for patients with focal epilepsy and other epilepsy types, and remarkably high seizure freedom rates have been consistently reported. Seizure-free rates reported are also very high among treatment-resistant patients, but many studies report even higher rates in patients with milder or shorter-duration epilepsy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"138 ","pages":"Pages 185-197"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147799218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 vaccine hesitancy among people with epilepsy: an updated systematic review and meta-analysis","authors":"Iris Bucker Froes Menin ,&nbsp;Adriano da Costa Dias ,&nbsp;Maria Inês da Rosa ,&nbsp;Tamy Colonetti ,&nbsp;Antonio José Grande","doi":"10.1016/j.seizure.2026.04.007","DOIUrl":"10.1016/j.seizure.2026.04.007","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically review and meta-analyze COVID-19 vaccine hesitancy among individuals with epilepsy.</div></div><div><h3>Methods</h3><div>Following PRISMA 2020 guidelines, we searched Cochrane CENTRAL, MEDLINE, EMBASE, CINAHL, LILACS, PsycINFO databases, and grey literature through February 6, 2026. We included studies addressing COVID-19 vaccination hesitancy in adults with epilepsy, with no date or language restrictions. Two reviewers independently screened articles, extracted data, and assessed quality using the Newcastle-Ottawa Scale (NOS). Meta-analyses were conducted using random-effects models, with heterogeneity assessed using I² statistics. The certainty of evidence was evaluated using the GRADE criteria.</div></div><div><h3>Results</h3><div>Fourteen studies comprising 4230 participants were included. Overall vaccination willingness was 51.7% (95% CI: 36.6–68.8%, I²=98%). Among unvaccinated individuals, 44.2% (95% CI: 26.6–61.8%, I²=95%) expressed willingness to be vaccinated. Well-controlled epilepsy was associated with higher vaccination rates (OR 1.91, 95% CI: 1.49–2.46, I²=0%). Conversely, frequent seizures (daily/weekly) were associated with lower vaccination likelihood (OR 0.52, 95% CI: 0.35–0.76, I²=0%). The primary reasons for vaccine hesitancy were fear of seizure worsening (23.8–88.5% across studies) and concerns about side effects (13.0–53.0%). Methodological quality was generally poor, with only one study rated as \"satisfactory\" using NOS criteria. GRADE assessment indicated very low certainty of evidence due to serious risk of bias, inconsistency, and imprecision.</div></div><div><h3>Conclusions</h3><div>COVID-19 vaccine hesitancy remains present in people with epilepsy, primarily driven by concerns about seizure exacerbation. Individuals with well-controlled epilepsy show higher vaccination acceptance. Healthcare providers should address specific concerns about seizure control while emphasizing vaccine safety data. High-quality prospective studies using validated instruments are recommended.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"138 ","pages":"Pages 198-211"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147799220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}