Seizure-European Journal of Epilepsy最新文献

{"title":"Evaluating the effect of an educational comic book on the knowledge, attitudes and practices regarding epilepsy among public schoolchildren in Mauritius","authors":"Sarah Altayyar ,&nbsp;Dana Chengan ,&nbsp;Youssouf Noormamode ,&nbsp;Vedas Moonsamy ,&nbsp;Neeshti Reetoo ,&nbsp;Pierre-Marie Preux ,&nbsp;Farid Boumediene","doi":"10.1016/j.seizure.2025.02.010","DOIUrl":"10.1016/j.seizure.2025.02.010","url":null,"abstract":"<div><h3>Purpose</h3><div>Epilepsy affects 70 million people globally, with over 80 % living in low- and middle-income countries. In Mauritius, treatment barriers include a lack of knowledge and stigma, particularly among children. We aim to assess the effect of reading an educational comic on the knowledge, attitudes and practices (KAP) regarding epilepsy among schoolchildren in Mauritius.</div></div><div><h3>Methods</h3><div>A quasi-experimental study was conducted in 16 public schools located in rural and urban areas. It targeted grade 5 pupils, aged 10 and 11. Data were collected using a structured KAP questionnaire before and immediately after reading the comic. Mean KAP scores were compared at baseline and after reading. A p-value&lt;0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>The study included 446 pupils, with 197 from rural and 249 from urban schools. A significant improvement in the global KAP score from 10.2 ± 2.9 to 16.4 ± 1.9 (<em>p</em> &lt; 0.0001) was noted. The knowledge sub-score and the attitudes and practices sub-scores showed significant improvement across all socio-demographic groups (<em>p</em> = 0.0002). Significant improvements in KAP scores resulted in very satisfactory scores in both rural (16.0 ± 2.0) and urban areas (16.7 ± 1.7). Obstacles to better learning were a higher initial score (OR=0.45, CI [0.39;0.53], <em>p</em> &lt; 0.0001) and monotonous reading (OR=0.34, CI [0.17;0.68], <em>p</em> = 0.002). All the pupils learnt a lot about epilepsy and greatly enjoyed the comic.</div></div><div><h3>Conclusion</h3><div>The comic is an effective tool to improve KAP regarding epilepsy in various environments regardless of sociodemographic or cultural characteristics. Raising awareness among children, in our opinion, is the best way to anticipate stigma linked to epilepsy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 106-113"},"PeriodicalIF":2.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and risk factors of sudden unexpected death in epilepsy in rural Northeast China","authors":"Rongxin Li ,&nbsp;Danyang Zhao ,&nbsp;Boqi Hu ,&nbsp;Nan Li ,&nbsp;Jing Li ,&nbsp;Weihong Lin","doi":"10.1016/j.seizure.2025.02.011","DOIUrl":"10.1016/j.seizure.2025.02.011","url":null,"abstract":"<div><h3>Purpose</h3><div>This prospective cohort study aims to provide detailed data on the incidence and risk factors of sudden unexpected death in epilepsy (SUDEP).</div></div><div><h3>Methods</h3><div>We recruited 6,513 patients with convulsive epilepsy from rural areas of Northeast China for regular follow-ups. Mortality cases, including probable and suspected SUDEP, were identified through death certificates, verbal autopsies, and expert panel discussions. We calculated overall, sex-adjusted, and age-specific SUDEP incidence rates, along with cumulative incidence under competing risks. We employed univariate Cox regression analysis and multivariable competing risks regression analysis to identify potential risk factors associated with SUDEP.</div></div><div><h3>Results</h3><div>The overall SUDEP incidence was 1.46 per 1,000 person-years, with rates of 1.50 for females and 1.42 for males. The cumulative incidence of SUDEP at 1, 3, and 5 years was 0, 1.09‰, and 1.95‰, respectively. SUDEP incidence peaked in individuals aged 30–49 years. Body mass index, age at onset, and recent high-frequency generalized tonic-clonic seizures significantly increased SUDEP risk, with high-frequency seizures being the strongest predictor. Epilepsy duration, consciousness status during seizures, and anti-seizure medication count were not linked to SUDEP. Improved medication adherence, though not directly reducing SUDEP risk, could lower seizure frequency, thus indirectly decreasing SUDEP risk.</div></div><div><h3>Conclusion</h3><div>High-frequency seizures, younger age at onset, and overweight status significantly increased the risk of SUDEP in patients with convulsive epilepsy. These findings contribute to the development of a SUDEP risk profile, facilitating the precise identification of high-risk individuals and informing prevention and management strategies.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 99-105"},"PeriodicalIF":2.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473989","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":"Yield in routine electroencephalography in adults with newly diagnosed epilepsy at a third-level epilepsy center in South Korea","authors":"Hak Loh Lee ,&nbsp;Yu Hyun Lee ,&nbsp;Kyung Wook Kang ,&nbsp;In-Seop Na ,&nbsp;Myeong-Kyu Kim","doi":"10.1016/j.seizure.2025.02.001","DOIUrl":"10.1016/j.seizure.2025.02.001","url":null,"abstract":"<div><h3>Purpose</h3><div>In people with epilepsy (PWE), the yield of interictal epileptiform discharges in electroencephalography (EEG) is an important determinant of good clinical practice. This study sought to investigate routine EEGs in adults with newly diagnosed epilepsy at a third-level epilepsy center in South Korea and assess the factors affecting yield.</div></div><div><h3>Methods</h3><div>Electronic medical records and 2,584 EEGs from 339 PWE were retrospectively reviewed from July to December 2023. Overall and cumulative yields, yield-increasing predictive factors, routine EEG natural sleep state, and yield changes before and after medical treatment were investigated.</div></div><div><h3>Results</h3><div>For the first EEG, the yield was 31.6 %, while the initial two and three consecutive EEGs had cumulative yields of 44.0 % and 49.6 %, respectively. Yield-increasing predictive factors included age ≤16 years at seizure onset, idiopathic generalized epilepsy, gender (female), and drug-resistant epilepsy. Of the PWE, approximately 90 % experienced natural sleep during routine EEG recordings, and the duration of sleep stage N2 was proven to be a yield-increasing predictive factor. Yield change before and after medical treatment was statistically significant.</div></div><div><h3>Conclusions</h3><div>At our center, among adults with newly diagnosed epilepsy, the yield from initial EEGs was comparable to that reported by some previous studies. Our results suggest that for epilepsy diagnosis, if necessary, repeated EEGs should be performed with sleep EEG before starting medical treatment for cost-effectiveness. After medical treatment, care should be taken not to underestimate the likelihood of false negatives in the EEG.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 79-85"},"PeriodicalIF":2.7,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394336","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":"Deep brain stimulation of the anterior nucleus of the thalamus reduces the risk for status epilepticus in focal drug-resistant epilepsy","authors":"Athina Firtinidou ,&nbsp;Lennart Stieglitz ,&nbsp;Lukas Imbach","doi":"10.1016/j.seizure.2025.02.004","DOIUrl":"10.1016/j.seizure.2025.02.004","url":null,"abstract":"<div><h3>Objective</h3><div>Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is a third-line treatment option for patients with refractory focal epilepsy. However, the effect on recurrent episodes of status epilepticus (SE) after ANT-DBS implantation has not been systematically investigated. Here, we set out to determine whether ANT-DBS has a preventive clinical effect on the risk of SE in difficult-to-treat epilepsies.</div></div><div><h3>Methods</h3><div>We performed a retrospective, monocentric analysis in a cohort of patients with refractory epilepsy who received bilateral DBS implantation in the ANT (<em>n</em> = 24). Medical records were reviewed to compare the total number of SE in each patient before and after surgery.</div></div><div><h3>Results</h3><div>Out of 24 patients, 11 (46 %) had 20 episodes of SE preoperatively, 17 of which were unprovoked. Postoperatively, only 2 patients developed SE, one of which was provoked. The relative annual risk of SE in this cohort was reduced from 28.8 % (per patient year) preoperatively to 1.9 % postoperatively, demonstrating a statistically significant reduction in SE incidence with ANT-DBS (<em>p</em> &lt; 0.005). Survival analysis confirmed significantly longer status-free survival postoperatively.</div></div><div><h3>Conclusion</h3><div>ANT-DBS may be beneficial as a preventive intervention in patients with refractory epilepsy at high risk for recurrent SE.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 71-75"},"PeriodicalIF":2.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apparent efficacy of NMDAR antagonist use as a targeted therapy for status epilepticus in an infant with ATP1A2-related developmental epileptic encephalopathy","authors":"Leman Tekin Orgun ,&nbsp;Adnan Deniz ,&nbsp;Ayfer Sakarya Güneş ,&nbsp;Deniz Akkoyunlu ,&nbsp;Gökçe Cırdı ,&nbsp;Anıl Gök ,&nbsp;Bülent Kara","doi":"10.1016/j.seizure.2025.02.002","DOIUrl":"10.1016/j.seizure.2025.02.002","url":null,"abstract":"<div><h3>Background</h3><div>N-methyl-D-aspartate receptor (NMDAR) blockers are important to control seizures in patients with refractory status epilepticus. ATP1A2 gene plays a role in protecting neurons from glutamate and NMDAR-related excitotoxicity. Although variations in the ATP1A2 gene are classically associated with hemiplegic migraine and alternating hemiplegia, in recent years, ATP1A2 variations have been reported with developmental and epileptic encephalopathy (DEE-98) and status epilepticus. <strong><em>Case report:</em></strong> An 11-month-old girl whose neuromotor development regressed following the onset of seizures at five months of age was admitted to the intensive care unit with a diagnosis of status epilepticus. Her seizure was partially responsive to ketamine, and she became seizure-free when memantine, another NMDA receptor blocker, was added to the treatment. Her WES analysis was completed during the second week of memantine treatment, revealing a heterozygous, de-nova, c.2432C&gt;G variant in the ATP1A2 gene.</div></div><div><h3>Conclusion</h3><div>ATP1A2-related DEE-98 is seen as very rare, and some of the patients with DEE-98 died due to refractory status epilepticus. The ATP1A2 gene is important for protecting neurons from glutamate and NMDAR-related excitotoxicity. We want to present the infant to emphasize the importance of targeted therapy with MNDARs in ATP1A2-related seizures, even during the status epilepticus period.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 95-98"},"PeriodicalIF":2.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436851","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":"Ictal-interictal continuum following coil embolization of cerebral aneurysms","authors":"Qi Huang ,&nbsp;Kai Qian ,&nbsp;Juan Ma ,&nbsp;Meigang Ma ,&nbsp;Lanfeng Sun ,&nbsp;Xing Wei ,&nbsp;Yuan Wu","doi":"10.1016/j.seizure.2025.02.007","DOIUrl":"10.1016/j.seizure.2025.02.007","url":null,"abstract":"<div><h3>Purpose</h3><div>The ictal-interictal continuum (IIC) has been reported in various clinical conditions, but its relationship with intravascular treatments remains poorly understood. This study reports three cases of IIC following coil embolization (CE) of cerebral aneurysms and evaluates associated outcomes.</div></div><div><h3>Methods</h3><div>A retrospective review of medical records from May 2018 to May 2024 was conducted, focusing on patients with reduced consciousness after CE. IIC was diagnosed based on EEG patterns following the guidelines of the American Clinical Neurophysiology Society. Factors related to outcomes, including IIC development, were analyzed using a multivariable linear regression model with robust standard errors.</div></div><div><h3>Results</h3><div>Of 30 patients who underwent continuous (3-hour) EEG monitoring post-coiling, three exhibited IIC patterns characterized by lateralized epileptic activity ipsilateral to the coiling site. One patient also displayed repeated electrographic seizures associated with subtle motor phenomena. EEG abnormalities resolved immediately after intravenous benzodiazepines, but coma persisted. Full recovery of consciousness occurred approximately one week after benzodiazepines withdrawal. Adjusting for other risk factors, patients with IIC had a mean Glasgow Coma Scale score 3.13 points higher at 14 days compared to those without IIC (95 % CI, 0.43∼5.84; <em>p</em> = 0.025). Durations of ICU stay (95 %CI, -6.30–8.27; <em>p</em> = 0.782) and total hospital stay (95 %CI, -43.15∼20.79; <em>p</em> = 0.477) were comparable between groups.</div></div><div><h3>Conclusions</h3><div>This study highlights IIC as a potential complication of CE. The development of postoperative IIC does not necessarily correlate with worse outcomes.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 43-47"},"PeriodicalIF":2.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350123","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 factors related to epileptic seizures in cerebral venous sinus thrombosis in southern China: A retrospective, multicenter, self-controlled study","authors":"Lixia Li ,&nbsp;Yankun Yao ,&nbsp;Shiping Guan ,&nbsp;Jingjing Ji ,&nbsp;Yanting Lu ,&nbsp;Lang Shen ,&nbsp;Yongfeng Feng ,&nbsp;Lu Yu","doi":"10.1016/j.seizure.2025.02.005","DOIUrl":"10.1016/j.seizure.2025.02.005","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the risk factors for and prevention of seizures in cerebral venous sinus thrombosis patients.</div></div><div><h3>Methods</h3><div>This retrospective study included 216 patients with cerebral venous sinus thrombosis (CVST) from 3 hospitals in southern China from January 2010 to October 2020. Patients were divided into 2 groups comprising patients with and without early seizures (within 14 days of the diagnosis of CVST). The early seizure group was divided into 2 subgroups: those with late seizures (after 14 days of CVST diagnosis) and those without seizures. The non-early seizure group was also divided into 2 subgroups. The different groups were analyzed and compared in terms of demographics, laboratory indices, imaging data and the use of antiseizure medications (ASMs).</div></div><div><h3>Results</h3><div>A total of 216 patients with CVST were included in the study, including 33 patients in the early seizure group and 183 patients in the non-early seizure group. In this study, 9 (27.3 %) patients in the early seizure group and only 8 patients in the non-early seizure group experienced late seizures, and the difference in the incidence of late seizures between the two groups reached statistical significance (<em>p</em> &lt; 0.05, 9/33 vs. 8/183). Univariable analysis revealed statistically significant differences in d-dimer levels (<em>P</em> = 0.030), parenchymal lesions (<em>P</em> = 0.008), intracranial hemorrhage (<em>P</em> &lt; 0.001), superior sagittal sinus involvement (<em>P</em> = 0.003), and cortical venous involvement (<em>P</em> = 0.003) between the early seizure group and the non-early seizure group. Logistic regression analysis revealed that intracranial hemorrhage (<em>P</em> = 0.005<em>, OR</em>=6.303, 95 % <em>CI</em> 1.732–22.941) may be one of the risk factors for early seizures. There was no univariate difference between the late seizure subgroup in the early seizure group and the late seizure subgroup in the non-early seizure group, except for the involvement of three venous sinuses.</div></div><div><h3>Conclusions</h3><div>Patients with CVST who have early seizures are more likely to have late seizures than those who do not have early seizures. Intracranial hemorrhage may be one of the risk factors for early seizures. The risk factors for late seizures need to be identified in future clinical studies. There is insufficient evidence that the use of ASM prevents early seizures from progressing to late seizures.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 64-70"},"PeriodicalIF":2.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387850","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":"Amygdalar volume asymmetry informs laterality in temporal lobe epilepsy: MRI-SEEG study","authors":"Subeikshanan Venkatesan ,&nbsp;Abbas Babajani-Feremi ,&nbsp;Kajal Patel ,&nbsp;Steven N Roper ,&nbsp;Giridhar Kalamangalam","doi":"10.1016/j.seizure.2025.02.006","DOIUrl":"10.1016/j.seizure.2025.02.006","url":null,"abstract":"<div><h3>Objective</h3><div>Amygdalar volumes are right-left asymmetric in normal humans. Asymmetric amygdalar hyperplasia is described in temporal lobe epilepsy (TLE), but has unclear lateralizing significance. In this study of TLE patients undergoing stereo-electroencephalography (SEEG) we examined the lateralizing value of amygdalar volume (AV) asymmetry, and its relationship to amygdalar involvement in seizures.</div></div><div><h3>Methods</h3><div>Amygdalar volumes of 30 TLE patients without radiological hippocampal sclerosis undergoing SEEG were compared to those from a normative database. Devising a novel amygdalar (volume) asymmetry index (AAI), we correlated AAI to SEEG-ascertained TLE lateralization and amygdalar involvement in seizures.</div></div><div><h3>Results</h3><div>At the group level, right AVs in right TLE (RTLE) and left AVs in left TLE (LTLE) were significantly higher than in controls (right difference: mean 226 mm³; left difference: mean 206 mm³). AAI was significantly higher than in RTLE and bitemporal epilepsy than in controls (16/17 patients; mean AAI difference 8.4 %) and significantly lower than in LTLE than in controls (8/9 patients; mean AAI difference -8.3 %). Amygdalar involvement in seizures correlated positively with absolute AAI (Spearman's ρ = 0.45, <em>p</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Significant deviation from physiological right-left AV asymmetry is almost universal in TLE and has robust lateralizing value. Relatively positive AAI is associated with RTLE or bitemporal epilepsy; relatively negative AAI is associated with LTLE. Larger AAI deviations are associated with a higher proportion of seizures with amygdalar involvement, suggesting a causal influence of seizures on amygdalar expansion in TLE.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 58-63"},"PeriodicalIF":2.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377552","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":"Hemorrhagic complication due to vascular side branch injury from a distant site in stereoelectroencephalography: A case report and proposed rules for safer electrode implantation","authors":"Takahiro Suzuki ,&nbsp;Tomotaka Ishizaki ,&nbsp;Satoshi Maesawa ,&nbsp;Miki Hashida ,&nbsp;Yoshiki Ito ,&nbsp;Takafumi Tanei ,&nbsp;Ryuta Saito","doi":"10.1016/j.seizure.2024.12.019","DOIUrl":"10.1016/j.seizure.2024.12.019","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 50-53"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972905","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":"First clinical post-approval, observational study to assess clinical safety and effectiveness of brivaracetam sustained-release formulation in real-life settings of India: BEAM study","authors":"Lakshmi Narasimhan Ranganathan ,&nbsp;Girish Kulkarni ,&nbsp;Ashutosh Kakkad ,&nbsp;Krishnaprasad Korukonda ,&nbsp;Narendra Chouksey","doi":"10.1016/j.seizure.2025.01.011","DOIUrl":"10.1016/j.seizure.2025.01.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Brivaracetam (BRV) sustained-release (SR) tablets have recently been approved to treat focal seizures in India. SR formulations enhance patient adherence and quality of life (QoL). We assessed safety and effectiveness of BRV-SR for epilepsy management in Indian real-life settings.</div></div><div><h3>Methods</h3><div>A post-approval observational study involving 1989 patients receiving BRV-SR from 181 centres were analysed. Primary endpoints are efficacy variables derived from seizure-related changes, and secondary endpoints include responder rate (≥50% reduction in focal-onset seizures [FoS]/focal-to-bilateral tonic-clonic seizures [FBTCS] frequency), usage pattern data, clinician's global impression on efficacy index (CGI-EI) and safety variables.</div></div><div><h3>Results</h3><div>Patients’ mean age was 42.33±12.33 years, and 1441 (72.44%) were men. Psychiatric comorbidities included depression (21.97%), sleep disturbance (15.54%), and anxiety (9.60%). The predominant seizure types were FoS (71.44%) and FBTCS (28.56%). BRV-SR 100 mg once-daily was most prescribed dose (57.37%) at baseline and follow-up visits (51.94%). Median seizure frequency decreased from 2 at baseline to 1 at follow-up visit. At follow-up, 72.1% patients were responders, and 63.75% were seizure-free. BRV-SR showed “marked” to “moderate” improvement in 92.99% of patients according to CGI-EI. Subgroup-analysis revealed a positive correlation between BRV-SR use in patients with drug-resistant epilepsy, psychiatric co-morbidities, and behavioural adverse events (AEs) with past anti-seizure medications. AEs were rare, with none reported in 97.39% patients during study period.</div></div><div><h3>Conclusion</h3><div>The BEAM study findings provide first real-world evidence on effectiveness and safety of BRV-SR in Indian real-life settings. Furthermore, BRV-SR is a feasible option for focal epilepsy management with good retention rates and improved QoL.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 132-139"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}