Seizure-European Journal of Epilepsy最新文献

{"title":"Predicting antiseizure medication response in newly diagnosed epilepsy using quantitative EEG and machine learning","authors":"Gha-Hyun Lee ,&nbsp;Sang Min Sung ,&nbsp;Kwang-Dong Choi ,&nbsp;Jiyoung Kim ,&nbsp;Jae Wook Cho ,&nbsp;Sang Ho Kim","doi":"10.1016/j.seizure.2025.05.007","DOIUrl":"10.1016/j.seizure.2025.05.007","url":null,"abstract":"<div><h3>Background</h3><div>Predicting long-term outcomes in newly diagnosed epilepsy remains limited by reliance on clinical features and visual EEG interpretation. Machine learning enhances this potential by identifying complex patterns in EEG data, as demonstrated in studies on predicting surgical outcomes and seizure initiation. However, its application to predicting ASM response in newly diagnosed epilepsy has been underexplored. This study aimed to develop a machine learning model to predict ASM response in newly diagnosed epilepsy patients, with the goal of improving personalized treatment strategies and early identification of drug resistance.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included adult patients with a new epilepsy diagnosis who underwent EEG prior to ASM initiation. Patients with structural brain lesions on MRI were excluded. Seizure control was assessed two years after starting ASM treatment, with responders defined as those achieving at least one year of seizure freedom during the second year. We applied three prediction approaches: one using only clinical variables, another using only EEG features, and a third integrating both clinical and EEG data. For each approach, Logistic Regression, Extreme Gradient Boosting (XGBoost) and Random Forest models were implemented to assess predictive performance and suitability for ASM response prediction. Model performance was evaluated at both epoch and patient levels, with patient-level predictions generated by averaging class probabilities across epochs.</div></div><div><h3>Results</h3><div>This study included 94 patients with newly diagnosed epilepsy who received EEG before starting ASM treatment, of whom 77 (81.9%) achieved seizure freedom. Machine learning models using clinical features showed moderate predictive performance, with the XGBoost model achieving the highest AUROC of 0.69. For EEG features, patient-level predictions improved model performance, with the Random Forest model achieving an AUROC of 0.68. The combined clinical-EEG model significantly enhanced accuracy, with Random Forest model achieving the best performance (AUROC: 0.81). Among EEG features, power spectral density (PSD) in the beta and gamma bands, along with sample entropy, were identified as the most predictive of treatment response.</div></div><div><h3>Conclusion</h3><div>Quantitative EEG analysis using machine learning shows significant potential in predicting the long-term prognosis of newly diagnosed epilepsy, even in patients without structural brain lesions or visually abnormal background EEGs. By integrating clinical variables with quantitative EEG features, these machine learning models demonstrate potential to support individualized treatment planning and the early identification of drug resistance. However, further validation in larger and diverse populations is needed before clinical implementation.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 59-67"},"PeriodicalIF":2.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072386","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":"Clinical and EEG-EMG characteristics of perioral myoclonia with absence seizures","authors":"Haipo Yang,&nbsp;Xiaoyan Liu,&nbsp;Jiaoyang Lu,&nbsp;Chenlu Jia,&nbsp;Qiujun Zhou,&nbsp;Lixuan Xu,&nbsp;Shuhui Fan,&nbsp;Shuang Wang","doi":"10.1016/j.seizure.2025.03.011","DOIUrl":"10.1016/j.seizure.2025.03.011","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to explore the clinical and electrophysiological characteristics and treatment prognosis of patients with perioral myoclonia with absence (POMA).</div></div><div><h3>Method</h3><div>Patients with POMA were selected from our EEG database. The collected data included detailed clinical information, VEEG characteristics, and brain MRI results. Previously reported patients with POMA were also screened for inclusion in the study.</div></div><div><h3>Result</h3><div>Nineteen patients were included in the study. The median seizure onset age was 5 years (range, 2–11 years), with 84.2 % (16/19) of the patients being male. POMA was VEEG monitored in 73.7 % of the patients during both wakefulness and sleep, and 63.2 % (12/19) could be induced by hyperventilation (HV). Synchronized perioral electromyography confirmed that the ictal 3-Hz discharge was time-locked with the myoclonic jerks. Twelve patients underwent VEEG follow-up, with 66.7 % achieving seizure-free with valproate (VPA) monotherapy. A review of previous reports on 15 patients with POMA revealed that 66.7 % of patients being male. Five patients experienced worsening of seizures with oxcarbazepine (OXC), carbamazepine (CBZ), or phenytoin.</div></div><div><h3>Conclusion</h3><div>POMA epilepsy, although rare, still presents distinctive characteristics. POMA tends to occur more frequently in males. 73.7 % of the patients had POMA during both wakefulness and sleep. The VEEG background is mostly normal, with rhythmic 3-Hz generalized spike and wave discharges during the ictal period that are time-locked with perioral myoclonia. Patients with POMA respond well to VPA. POMA may be misdiagnosed as focal seizures, but the use of OXC, CBZ, and phenytoin sodium for treatment should be avoided.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 51-55"},"PeriodicalIF":2.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934763","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":"Caregiver-reported non-seizure and seizure outcomes with cannabidiol and clobazam in patients aged ≥2 years with Lennox-Gastaut syndrome or Dravet syndrome: A subgroup analysis of the BECOME survey","authors":"M. Scott Perry ,&nbsp;Tracy Dixon-Salazar ,&nbsp;Mary Anne Meskis ,&nbsp;Sherry R. Danese ,&nbsp;Timothy B. Saurer ,&nbsp;Kishan Vyas ,&nbsp;Anne T. Berg","doi":"10.1016/j.seizure.2025.04.017","DOIUrl":"10.1016/j.seizure.2025.04.017","url":null,"abstract":"<div><h3>Purpose</h3><div>This subgroup analysis of the BECOME (<strong>BE</strong>havior, <strong>CO</strong>gnition, and <strong>M</strong>ore with <strong>E</strong>pidiolex®) survey analyzed caregiver-reported seizure and non-seizure outcomes, including changes in caregiver burden, following cannabidiol (CBD) treatment in patients with Lennox-Gastaut syndrome (LGS) or Dravet syndrome (DS) aged ≥2 years taking concomitant clobazam, aligned with the European Medicines Agency indication.</div></div><div><h3>Methods</h3><div>US-based caregivers of patients with LGS/DS receiving CBD (Epidiolex®, 100 mg/mL oral solution) for ≥3 months rated patient outcome changes, comparing the previous month with pre-CBD initiation. Multiple-choice and rank-order questions with symmetrical 3-, 5-, or 7-point scales ranging from worsening to improvement were used.</div></div><div><h3>Results</h3><div>Patients (<em>N</em> = 243; 76 % LGS, 24 % DS; 52 % male; mean [range] age 15 [2–53] years) took a median of 14 mg/kg/day CBD and a median of four other antiseizure medications, including clobazam. Caregivers reported improvements in seizure frequency (87 %), severity (81 %), and weekly seizure-free days (net improvement across seizure types 68 %). Caregivers noted improvements in ≥1 question for non-seizure domains (net data across questions within each domain): alertness, cognition, and executive function (84 %); language and communication in non-verbal (81 %) and verbal (76 %) patients; emotional and social functioning (79 %); daily activities (56 %); physical functioning (44 %); and sleep (56 %). Additionally, 4–26 % of caregivers (net) reported worsening in ≥1 question in any domain. Overall, 94 % of caregivers planned to continue CBD treatment.</div></div><div><h3>Conclusions</h3><div>Consistent with the overall BECOME survey, most caregivers of patients with LGS/DS aged ≥2 years taking concomitant clobazam reported improvements in seizure and non-seizure outcomes since initiating CBD treatment.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 32-40"},"PeriodicalIF":2.7,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934761","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":"Association of prenatal exposure to antiseizure medication with risk of autism: a systematic review and meta-analysis","authors":"Isabella Christina Amaral de Lara ,&nbsp;Pedro Henrique de Souza Wagner ,&nbsp;Gustavo Tadeu Freitas Uchôa Matheus ,&nbsp;Lara Eduardo Campos ,&nbsp;Celso de Almeida Souza Miranda ,&nbsp;Maria Eduarda Cavalcanti Souza ,&nbsp;Francisco Cezar Aquino de Moraes ,&nbsp;Francinny Alves Kelly ,&nbsp;Lilianne Rodrigues Fernandes","doi":"10.1016/j.seizure.2025.05.003","DOIUrl":"10.1016/j.seizure.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Antiseizure medications (ASMs) can affect neurodevelopment and cause congenital malformations. Autism spectrum disorder (ASD) is characterized by challenges in communication, behavior, and learning. This study evaluated the association between prenatal ASM exposure and ASD development.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis was conducted using PubMed, Scopus, Web of Science, and Cochrane databases to identify studies on fetal ASM exposure and ASD. Hazard ratio (HR) and risk ratio (RR) with 95 % confidence interval (CI) were pooled using a random-effects model. Heterogeneity was assessed using I² statistic. A p-value &lt; 0.05 was considered significant.</div></div><div><h3>Results</h3><div>10 studies were included in our meta-analysis, comprising 54,747 patients exposed to ASM. Prenatal ASM exposure significantly increased the risk of ASD (HR 1.8082; 95 % CI 1.2616 to 2.5916; <em>P</em> = 0.001; RR 2.0401; 95 % CI 1.7588 to 2.3664; <em>P</em> &lt; 0.0001). Subgroup analyses identified elevated risks with specific ASMs, including carbamazepine (HR 1.2213; 95 % CI 1.0047 to 1.4847; <em>P</em> = 0.045; I² = 0 %), valproate (HR 2.8306; 95 % CI 2.3881 to 3.3550; <em>P</em> &lt; 0.001; I² = 0 %), and oxcarbazepine (HR 1.6141; 95 % CI 1.1500 to 2.2655; <em>P</em> = 0.006; I² = 27 %). Among women with epilepsy, prenatal ASM exposure increased ASD risk (RR 1.4174; 95 % CI 1.2345 to 1.6273; <em>P</em> &lt; 0.0001; I² = 0 %).</div></div><div><h3>Conclusions</h3><div>This meta-analysis showed that prenatal exposure to antiseizures, particularly valproate, carbamazepine, and oxcarbazepine, significantly increases ASD risk. These findings emphasize the need for cautious ASM use during pregnancy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 41-47"},"PeriodicalIF":2.7,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934762","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 Cenobamate: a multicenter, retrospective evaluation of real-world clinical practice","authors":"Magdalena Bosak ,&nbsp;Hanna Podraza ,&nbsp;Dorota Włoch-Kopeć ,&nbsp;Andrzej Rysz ,&nbsp;Kamil Wężyk ,&nbsp;Katarzyna Grabska-Radzikowska ,&nbsp;Piotr Sobolewski ,&nbsp;Tomasz Siwek ,&nbsp;Iwona Kurkowska-Jastrzębska ,&nbsp;Monika Służewska-Niedźwiedź ,&nbsp;Katarzyna Sulima ,&nbsp;Lech Kipiński ,&nbsp;Lidia Kiryła ,&nbsp;Katarzyna Stopińska ,&nbsp;Elżbieta Płonka-Półtorak ,&nbsp;Justyna Tabaka-Pradela ,&nbsp;Magdalena Konopko ,&nbsp;Agnieszka Meller ,&nbsp;Monika Chorąży ,&nbsp;Maja Kopytek-Beuzen ,&nbsp;Katarzyna Zawiślak-Fornagiel","doi":"10.1016/j.seizure.2025.05.002","DOIUrl":"10.1016/j.seizure.2025.05.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Epilepsy is a common neurological disorder, with approximately one-third of patients experiencing drug-resistant epilepsy (DRE), which imposes significant clinical, social, and economic burdens. Cenobamate, a novel antiseizure medication (ASM), was included to the Polish therapeutic framework in March 2023.</div></div><div><h3>Materials and Methods</h3><div>This retrospective, multicenter study was conducted at 19 centers. Medical records of adult patients with DRE treated with cenobamate for at least six months were reviewed. Collected data included demographic characteristics, seizure frequency, treatment regimens, and adverse events (AEs). Descriptive statistical methods were employed to assess outcomes, with the primary efficacy endpoint of ≥50 % reduction in seizure frequency.</div></div><div><h3>Results</h3><div>The study cohort consisted of 475 patients with a median age of 37 years. Treatment with cenobamate (median maximal daily dose, 250 mg) resulted in <em>a</em> ≥ 50 % reduction in seizure frequency in 61.9 % of patients, with 16.5 % achieving seizure freedom during the final three months of observation, with better responses when the treatment was initiated earlier. The burden of polytherapy decreased, as 69.7 % of patients reduced or discontinued concomitant ASMs. Adverse events were reported in 48.8 % of patients, most commonly somnolence and dizziness, with no cases of severe dermatological reactions. Discontinuation of cenobamate occurred in 12 % of patients.</div></div><div><h3>Discussion</h3><div>Cenobamate demonstrated notable efficacy in patients with treatment-resistant epilepsy, and its early initiation may improve outcomes. Treatment has a large potential for significant simplification of treatment regimens. Adverse events were manageable.</div></div><div><h3>Conclusions</h3><div>Cenobamate is a highly effective and well-tolerated ASM for patients with DRE, offering significant clinical benefits, including improved seizure control and reduced polytherapy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 25-31"},"PeriodicalIF":2.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143929432","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":"The impact and adherence of ketogenic dietary therapies for Dravet syndrome: A systematic review and meta-analysis","authors":"Yan Li,&nbsp;Sisi Dai,&nbsp;Qingqing Deng,&nbsp;Zhanli Liu","doi":"10.1016/j.seizure.2025.05.001","DOIUrl":"10.1016/j.seizure.2025.05.001","url":null,"abstract":"<div><div>This systematic review and meta-analysis evaluated the efficacy, safety, and adherence of ketogenic dietary therapies (KDTs) in patients with Dravet syndrome (DS). This study found that KDTs were effective in reducing seizure frequency, especially in the short term, with pooled efficacy rates of 73.4% at 3 months, 59.0% at 6 months, 44.4% at 12 months, and 51.0% for interventions that lasted longer than 1 year. However, long-term adherence to KDTs still remains challenging, as evidenced by the sharp decline in adherence rates from 90.6% at 3 months to 43.8% at 12 months. With the majority of side effects being minor and temporary, KDTs have a typically good safety profile. The study highlights the need for comprehensive support strategies to optimize treatment outcomes and suggests that future research should focus on well-designed randomized controlled trials and innovative approaches to enhance the efficacy and acceptability of KDTs in DS patients.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 16-24"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906415","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":"Appropriately designed studies are required to assess sleep quality in epilepsy patients","authors":"Josef Finsterer","doi":"10.1016/j.seizure.2025.04.018","DOIUrl":"10.1016/j.seizure.2025.04.018","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 49-50"},"PeriodicalIF":2.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934765","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":"Successful use of fenfluramine in drug resistant epileptic encephalopathy with spike-wave activation in sleep (EE-SWAS)– an automated EEG study","authors":"J. Koch ,&nbsp;K. Steinbrücker ,&nbsp;G. Kluger ,&nbsp;S. Knasmüller ,&nbsp;E. Trinka","doi":"10.1016/j.seizure.2025.04.016","DOIUrl":"10.1016/j.seizure.2025.04.016","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 56-58"},"PeriodicalIF":2.7,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069509","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":"Epilepsy treatment gap and its associated factors in individuals aged 65 years and older with active convulsive epilepsy in rural Northwestern China","authors":"Bofei Tan ,&nbsp;Qiang Liu ,&nbsp;Jianming Wu ,&nbsp;Xianrui Xu ,&nbsp;Xu Wang ,&nbsp;Pingping Lei ,&nbsp;Mengyun Li ,&nbsp;Fei Huang ,&nbsp;Qing Zhang","doi":"10.1016/j.seizure.2025.04.015","DOIUrl":"10.1016/j.seizure.2025.04.015","url":null,"abstract":"<div><h3>Purpose</h3><div>We investigated the epilepsy treatment gap (ETG) and its associated factors in individuals aged≥65 years with active convulsive epilepsy(ACE) in rural Northwestern China.</div></div><div><h3>Method</h3><div>Between 2008 and 2021, We recruited individuals with ACE in rural Northwestern China as part of an epilepsy management project launched by the Chinese government. A team of primary care doctors from 423 township hospitals participated in the project. Each local primary health organization screens patients from the local community through well-trained local physicians within a study period. Questionnaire-based interviews were conducted to identify patients with ACE, with information collected during the survey. ETG in individuals aged≥65 years with ACE were calculated in the study from 2012 to 2021, and logistic regression analysis was employed to analyze associated factors of ETG in individuals aged≥65 years with ACE in rural northwestern China.</div></div><div><h3>Results</h3><div>A total of 480 individuals aged≥65 years with ACE (male, 62.7 %) were included. Of these, 176 did not receive appropriate treatment, resulting in an ETG of 36.7 %; Among individuals with an onset age of &lt;65 years, a significantly larger proportion did not receive appropriate treatment compared to those who did receive appropriate treatment(69.9 % vs. 60.9 %, <em>p</em> = 0.047); Univariate analysis indicated that an onset age of &lt;65 years, epilepsy duration of≥20 years, and higher seizure frequency of 12∼23 times within 1 year before inclusion may be associated with ETG in individuals aged≥65 years with ACE (<em>p</em> &lt; 0.05); In multivariate analysis, higher seizure frequency of 12∼23 times within 1 year before inclusion (OR = 1.733,95 % CI 1.031–2.940, <em>p</em> = 0.042) were significantly associated with ETG in individuals aged≥65 years with ACE.</div></div><div><h3>Conclusion</h3><div>Northwestern China rural areas has relatively smaller ETG in the elderly with ACE,at about 36.7 %. However, efforts to prevent and treat ACE in the elderly with a younger onset age (&lt;65 years) and higher seizure frequency (12–23 times within 1 year before inclusion) should be intensified to further narrow the ETG.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"129 ","pages":"Pages 123-128"},"PeriodicalIF":2.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874792","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":"The current state of cognitive rehabilitation for individuals with epilepsy and pathways for improvement: a multinational cross-sectional survey of epilepsy specialists","authors":"Rūta Mameniškienė ,&nbsp;Kristijonas Puteikis","doi":"10.1016/j.seizure.2025.04.008","DOIUrl":"10.1016/j.seizure.2025.04.008","url":null,"abstract":"<div><h3>Objective</h3><div>Despite the relevance of psychosocial and cognitive issues for people with epilepsy (PWE), there remains scarce data on cognitive rehabilitation programs as a central care pathway alongside pharmacological and surgical treatment in epilepsy. We aimed to map the use, availability and characteristics of rehabilitation programs for epilepsy across different countries worldwide.</div></div><div><h3>Methods</h3><div>We conducted a web-based survey of epilepsy specialists practicing in different countries around the world. Participants were asked to provide information on the availability, accessibility, use and methodology of cognitive rehabilitation in their country of practice.</div></div><div><h3>Results</h3><div>One hundred and ten responses were received across 66 different countries: 45 respondents were from Europe, 35 – from Latin America, 14 – from the Eastern Mediterranean region, 7 – from Asia and Oceania, 8 – from Africa and 1 – from North America. Most participants were neurologists and/or epileptologists (96, 87 %) practicing in university hospitals (69, 63 %) and caring for adult patients (85, 77 %). Any rehabilitation measures for PWE were reported as generally available by 75 (68 %) respondents. For cognitive rehabilitation, this was reported by 40 (36 %) specialists with an average service accessibility of 5.4 ± 2.5 out of 10. When available, cognitive rehabilitation is primarily used in patients with cognitive complaints (38, 81 %), mood complaints or comorbid psychiatric disorders (27, 57 %). While individual sessions predominate (29, 62 %), cognitive rehabilitation programs are heterogeneous in form – compensatory (10, 21 %), restitution (12, 26 %) techniques, internal (12, 26 %) and external (12, 26 %) strategies are used alongside psychoeducation (15, 32 %) and psychological counselling (16, 34 %) without clear predominance of either approach. In 13 (32.5 %) cases, cognitive rehabilitation was supported by national standards of practice or state legislature.</div></div><div><h3>Conclusions</h3><div>Cognitive rehabilitation programs for PWE are generally less available than other forms of rehabilitation across the world. New evidence-based procedure development and harmonization is required to promote establishment and effective use of these services.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 4-10"},"PeriodicalIF":2.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898456","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}