Seizure-European Journal of Epilepsy最新文献

{"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}

{"title":"Phenotype and genotype of AKT3-related disorders","authors":"Shimin Zhang ,&nbsp;Qinrui Li ,&nbsp;Zhao Xu ,&nbsp;Jiong Qin ,&nbsp;Zhixian Yang ,&nbsp;Yue Niu","doi":"10.1016/j.seizure.2026.04.021","DOIUrl":"10.1016/j.seizure.2026.04.021","url":null,"abstract":"<div><h3>Objectives</h3><div>To systematically define and elucidate the relationship between clinical manifestations and genetic features of somatic and germline <em>AKT3</em> variants.</div></div><div><h3>Methods</h3><div>We collected clinical data, MRI and EEG data from five Chinese children with <em>AKT3</em> variants. Furthermore, we systematically reviewed published literature on <em>AKT3</em> variants.</div></div><div><h3>Results</h3><div>Five patients with germline <em>AKT3</em> variants were identified in the present study. Combined with 68 previously reported cases, a total of 74 patients have been documented to date, including 28 with somatic variants, 36 with germline single-nucleotide variants (SNVs), 4 with germline duplications, and 6 with germline pure <em>AKT3</em> deletions. Among patients with somatic variants, early-onset seizures were observed in 96.4%, with drug resistance epilepsy reported in 96.1%. Brain MRI abnormalities were detected in 96.4% of cases, most commonly focal cortical dysplasia and hemimegalencephaly. In patients with germline SNVs, developmental delay and megalencephaly were the most frequent manifestations, followed by seizures. Cranial MRI findings were heterogeneous, with megalencephaly accompanied by polymicrogyria representing the most common pattern, followed by isolated megalencephaly without cortical dysplasia and combined megalencephaly, polymicrogyria, and periventricular nodular heterotopia. Patients with germline <em>AKT3</em> duplications exhibited phenotypes broadly similar to those with germline SNVs. In contrast, individuals with germline pure <em>AKT3</em> deletions typically presented with microcephaly and developmental delay, without distinctive MRI abnormalities. Most germline variants were missense changes. The somatic variant E17K and the germline variant R465W exhibited as mutational hotspots.</div></div><div><h3>Interpretation</h3><div>Our study presented five cases with germline <em>AKT3</em> variants and expanded the understanding of genotype-phenotype correlations. Patients harboring somatic variants predominantly presented with early-onset seizures and demonstrated focal cortical dysplasia (FCD) or hemimegalencephaly (HME) on brain MRI. In contrast, individuals with SNVs or duplications most commonly exhibited neurodevelopmental delay, megalencephaly and seizures. Patients with germline <em>AKT3</em> deletions were characterized by microcephaly and developmental delay. Notably, phenotypic heterogeneity was observed even among patients carrying identical variants,</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"138 ","pages":"Pages 147-156"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787278","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 novel antiseizure medications as adjunctive treatment of focal epilepsy: An updated network meta-analysis","authors":"Zhijun Le,&nbsp;Zhujing Ou,&nbsp;Raowei Yan,&nbsp;Hesheng Zhang,&nbsp;Jiayu Mi,&nbsp;Yuzhen Baima,&nbsp;Dong Zhou,&nbsp;Xintong Wu","doi":"10.1016/j.seizure.2026.04.013","DOIUrl":"10.1016/j.seizure.2026.04.013","url":null,"abstract":"<div><h3>Objective</h3><div>Antiseizure medications (ASMs) are the cornerstone of epilepsy treatment. However, evidence on direct comparison of ASMs is lacking. This network meta-analysis evaluated the comparative efficacy and safety of approved and investigational add-on third-generation ASMs for focal epilepsy in adolescents and adults.</div></div><div><h3>Methods</h3><div>Data were retrieved through an extensive literature search of PubMed, Embase, Cochrane Library, and ClinicalTrial.gov databases from inception through August 2025. Findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline (CRD420251180027). Primary efficacy outcomes were ≥50 % and 100 % responder rates at 12-weeks maintenance duration. Secondary outcomes were corresponding responder rates at 8-weeks maintenance duration. Tolerability was assessed as retention rate. Treatment-emergent adverse events (TEAEs) and TEAEs leading to treatment discontinuation were the safety outcomes.</div></div><div><h3>Results</h3><div>The literature search retrieved 345 studies, of which 35 studies were included. All ASMs showed significantly higher responder rates compared with placebo. Significantly higher 100 % responder rate was observed with cenobamate (CNB; 400mg/d: Risk ratio [RR] 15; 95 % CI, 7.0-39; 200mg/d: RR 8.7; 95 % CI, 3.9-22) at a maintenance duration of 12 weeks and 8 weeks (400mg/d: RR 15; 95 % CI, 7.0-41; 200mg/d: RR 8.6; 95 % CI, 4.0-24). All ASMs showed a patient retention rate comparable with placebo. For overall TEAEs, brivaracetam (BRV; 50mg/d) and BRV ranked the lowest for individual and pooled doses, respectively; placebo ranked the highest in both cases. For TEAEs leading to treatment discontinuation, CNB ranked lower than the placebo.</div></div><div><h3>Significance</h3><div>All approved and investigational ASMs were effective add-on treatments for focal epilepsy, with CNB demonstrating the greatest likelihood of achieving seizure freedom.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"138 ","pages":"Pages 167-184"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787303","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":"Retrospective observational study of treatment and referral pathways of patients with epilepsy in Germany","authors":"Nils G. Margraf ,&nbsp;Adam Strzelczyk ,&nbsp;Karel Kostev ,&nbsp;Sergio R. Pérez Rosal ,&nbsp;Benedikt Greshake ,&nbsp;Felix von Podewils ,&nbsp;Thomas Mayer ,&nbsp;Andreas Schulze-Bonhage","doi":"10.1016/j.seizure.2026.04.001","DOIUrl":"10.1016/j.seizure.2026.04.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Epilepsy is one of the most common chronic neurological disorders. Epilepsy treatment is supported and managed through clinical practice guidelines which aim to improve patient care by educating and supporting prescribers. This is achieved through presenting unbiased information on treatment pathways.</div><div>Using German national healthcare databases, we provide preliminary evidence of the likelihood of patients receiving optimal guideline recommended treatment, through treatment pathways, with, importantly, timely escalation for complex patients.</div></div><div><h3>Methods</h3><div>This population-based, retrospective, cross-sectional analysis of epilepsy treatment pathways utilized German statutory health insurance patient records from healthcare providers together with retail prescription data. Database identification of patients with epilepsy was based on ICD-10 codes and prescription data of 13 specific anti-seizure medications (ASM). Drug refractory (DR) patients with epilepsy were identified by treatment regime. Manually collected data from individual epilepsy centers validated the national results.</div></div><div><h3>Results</h3><div>This identification method determined national epilepsy prevalence was 0.67% of the German population with incidence of 0.09% and a female to male split of 49% to 51%. DR patients with epilepsy were determined at 36% of the epilepsy population.</div><div>The proportion of neurologists nationally available to treat patients outside of hospital was 30%, with state-by-state variation. The data analysis led to preliminary models of patient referral pathways for all patients with epilepsy. Of DR patients with epilepsy 59% were found not to have accessed appropriate outpatient center (OPC) treatment by referral, as recommended by the guidelines.</div></div><div><h3>Conclusion</h3><div>A persistence of under-referral of patients with epilepsy to epilepsy centers was identified. Patients with complex needs are too often inappropriately held in primary care. ASM prescribing highlights the need for structural and possibly policy-level reform in outpatient epilepsy care, to ensure patients with complex needs receive state of the art treatment at an appropriate OPC.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"138 ","pages":"Pages 157-166"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787292","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":"Variants in KLHL15, encoding a regulator of protein ubiquitination, linked to focal epilepsy with neurodevelopmental disorders.","authors":"Si-Qi Zhang, Zhi-Hong Lao, Wen-Hui Liu, Peng-Yu Wang, Zhong-Yan Zhu, Yi-Bo Qu, Qian-Ru Wen, Yan Ding, Heng Meng","doi":"10.1016/j.seizure.2026.04.029","DOIUrl":"https://doi.org/10.1016/j.seizure.2026.04.029","url":null,"abstract":"<p><strong>Purpose: </strong>KLHL15 encodes Kelch-like protein 15, an adapter for the Cullin3 (CUL3) E3 ubiquitin ligase complex. CUL3 variants are linked to developmental disorders and epilepsy. However, the association between KLHL15 variants and epilepsy is unclear. This study aimed to explore the association of KLHL15 with epilepsy.</p><p><strong>Methods: </strong>Exome sequencing was performed in patients with non-acquired focal epilepsy. Pathogenic variants' effects were assessed via protein modeling. Single-cell analysis of KLHL15 expression was performed to explore neurodevelopmental mechanisms. Its interacting proteins were analyzed via network diffusion analysis to explore functional links with epilepsy and neurodevelopmental disorders (NDDs).</p><p><strong>Results: </strong>KLHL15 missense variants were identified in four unrelated focal epilepsy cases with NDDs. These variants, absent in gnomAD, were predicted to alter protein stability. The observed genotype-phenotype associations suggest that variants within the domain may be implicated in epilepsy and neurodevelopmental disorders. Spatiotemporal analysis showed KLHL15 was highly expressed in the developing brain. Single-cell sequencing of organoids and adult brain demonstrated predominant expression in excitatory neurons across developmental stages. Functional enrichment revealed KLHL15 as a central component of the ubiquitin-proteasome pathway and Cullin-based E3 complexes. Network diffusion analysis confirmed functional links to epilepsy with NDDs genes.</p><p><strong>Conclusion: </strong>KLHL15 variants are correlated with focal epilepsy with NDDs. The observed domain variants contribute to elucidating genotype-phenotype relationships. The spatiotemporal expression profiles and functional network provide crucial insights into the pathogenic mechanisms of KLHL15 variants.</p>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"139 ","pages":"38-45"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845214","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":"Untreated epilepsy and pregnancy.","authors":"Frank J E Vajda, Terence J O'Brien, Janet E Graham, Alison E Hitchcock, Piero Perucca, Cecilie M Lander, Simon Rl Vajda, Mervyn J Eadie","doi":"10.1016/j.seizure.2026.04.025","DOIUrl":"https://doi.org/10.1016/j.seizure.2026.04.025","url":null,"abstract":"<p><strong>Purpose: </strong>Untreated pregnant women with epilepsy (WWE) are not readily available for study. We present data accumulated in the Australian Pregnancy Register (APR) between 1999 and March 2025, concerning the risk of foetal structural malformation (FM) and the maintenance of freedom from seizures in pregnant WWE, untreated.</p><p><strong>Methods: </strong>APR contained records of 2826 pregnancies in Australian WWE since 1999. Of these, 69 ASM-treated ones had ended in spontaneous abortions. Of the remaining 2757 pregnancies, 2538 had been treated with antiseizure medication (ASM) therapy continuously throughout pregnancy, 219 had commenced pregnancy untreated. Of these 219, ASM treatment had recommenced in 91 during pregnancy while 128 (58.5%) remained untreated with ASMs throughout pregnancy.</p><p><strong>Results: </strong>The occurrence rate for a malformed foetus (FM) in the ASM-untreated pregnancies tended to be lower than in the ASM-treated pregnancies (R.R. = 0.48, 95% C.I. 0.23, 1.00). Seizure freedom occurrence rates throughout pregnancy were not statistically significantly different (R.R. = 0.90, 95% C.I. 0.82, 1.08).</p><p><strong>Conclusions: </strong>The outcomes of the presence or absence of ASM therapy during pregnancy were not statistically significantly different in relation to the occurrences of seizure freedom and FM but the lower occurrence of FM in the untreated pregnancies was at the P < 0.05 significance threshold. The number of FM encountered was small so that statistically significant findings were unlikely. Seizures occurring during pregnancy were an appreciable factor in restarting ASM therapy. Trends found in the study, interpreted cautiously, may be helpful in future treatment management decisions.</p>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"139 ","pages":"33-37"},"PeriodicalIF":2.8,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845154","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":"Response of the ILAE FDS task force to: A call for reflection on unintended consequences: Should 'Functional/Dissociative Seizures' replace 'Psychogenic Nonepileptic Seizures'?","authors":"Coraline Hingray, Stoyan Popkirov, Kasia Kozlowska, Chrisma Pretorius, Mercedes Sarudiansky, Wissam El-Hage, Dong Zhou, Deniz Ertan, W Curt LaFrance, Markus Reuber","doi":"10.1016/j.seizure.2026.04.015","DOIUrl":"https://doi.org/10.1016/j.seizure.2026.04.015","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822898","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":"Sequential radiological manifestations in Dyke-Davidoff-Masson Syndrome—Comparison with recent systematic review","authors":"Suat Yee Lee ,&nbsp;Fatt Yang Chew","doi":"10.1016/j.seizure.2025.09.022","DOIUrl":"10.1016/j.seizure.2025.09.022","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 121-122"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145394819","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":"Are enlarged perivascular spaces a predictor of early post-traumatic seizures after traumatic brain injury?- A pilot study","authors":"G. Hlauschek ,&nbsp;B. Sinclair ,&nbsp;H․Flatmark Sødal ,&nbsp;E. Taubøll ,&nbsp;E. Helseth ,&nbsp;C․Buaas Tverdal ,&nbsp;P. Sowa ,&nbsp;P. Kwan ,&nbsp;T.J. O'Brien ,&nbsp;L. Vivash ,&nbsp;M. Law ,&nbsp;M.I. Lossius","doi":"10.1016/j.seizure.2026.02.010","DOIUrl":"10.1016/j.seizure.2026.02.010","url":null,"abstract":"<div><h3>Objective</h3><div>Post-traumatic epilepsy (PTE) is a significant long-term complication following traumatic brain injury (TBI), while early post-traumatic seizures (EPTS), occurring within the first week after TBI, are a critical risk factor that can elevate the likelihood of developing PTE later on. Here we investigate the potential of MRI-based enlarged perivascular space (ePVS) analysis as an imaging biomarker for acute in-hospital EPTS.</div></div><div><h3>Methods</h3><div>Forty patients who experienced a moderate-severe TBI with early post-traumatic seizures (EPTS+) (32.5% female, median age 52 years) and 88 patients without (EPTS-) (35.2% female, median age 53 years) were recruited from the Oslo University Hospital's head injury registry. PVS were measured on brain MRIs taken within one month post- TBI using an automated ePVS segmentation algorithm. The analysis included PVS count, volume, and asymmetry index (AI) across both hemispheres and vascular territories. Brain volume analysis was conducted using the FreeSurfer software suite, and PVS characteristics were compared between EPTS+ and EPTS- patients using non-parametric tests and generalized linear models.</div></div><div><h3>Results</h3><div>The study found no statistically significant differences in the number, volume, or asymmetry of ePVS between EPTS+ and EPTS- patients. Specifically, the median counts of ePVS and the volume fractions did not vary between the groups, indicating that ePVS did not correlate with the occurrence of EPTS in the studied cohort.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that ePVS may not be reliable biomarkers for predicting EPTS (after TBI). However, future longitudinal studies that track ePVS changes over time could better illuminate their relationship with PTE development. This approach may reveal critical mechanisms influencing seizure risk and identify potential intervention points for at-risk patients, ultimately enhancing strategies for managing TBI-related epilepsy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 86-92"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221763","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}