Seizure-European Journal of Epilepsy最新文献

{"title":"Evaluation of lateralization and localization value of hand postures in Pediatric Epilepsy","authors":"Deniz MENDERES ,&nbsp;Tuğba HIRFANOĞLU ,&nbsp;Esra SERDAROĞLU ,&nbsp;Ayşe SERDAROĞLU ,&nbsp;Ebru ARHAN","doi":"10.1016/j.seizure.2025.03.005","DOIUrl":"10.1016/j.seizure.2025.03.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Identifying epileptogenic zone is essential for selecting patients for epilepsy surgery and understanding seizure pathophysiology. This study aimed to evaluate the role of ictal hand postures in localization and lateralization value in children.</div></div><div><h3>Material and methods</h3><div>We conducted a retrospective evaluation of 628 individuals utilizing long-term video EEG recordings of Gazi University Video EEG Monitoring Unit (VEMU) between 2013 and 2022. Distinct hand postures were identified in fifty-six patients. The localization and lateralization value of the hand postures identified in these patients were assessed.</div></div><div><h3>Results</h3><div>A total of 91 seizures from 56 patients were analyzed, and hand postures were categorized as fist, thumb upside fist (TUF), fanning, holding, index-finger pointing (IFP), and pincer grasp. Fist posture was most frequently observed in frontal lobe seizures, while TUF was dominant in temporal lobe seizures. Fanning was primarily associated with generalized seizures. Lateralization analysis revealed that ipsilateral postures were more common in frontal lobe seizures, whereas contralateral postures were prevalent in temporal lobe seizures (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>In conclusion, ictal hand postures may serve as a straightforward and accessible tool for identifying seizure onset zones in children, especially in resource-limited settings. Semiological classification plays a crucial role in the interpretation of video EEG. Accurate identification of semiological manifestations can facilitate timely referral of patients with suspected drug-resistant focal epilepsy for presurgical evaluation.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 71-76"},"PeriodicalIF":2.7,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674833","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 outcomes of treatment with levetiracetam and valproate in idiopathic generalized epilepsy","authors":"Nasim Tabrizi ,&nbsp;Hamed Cheraghmakani ,&nbsp;Fahimeh Samadi ,&nbsp;Reza Alizadeh-Navaei","doi":"10.1016/j.seizure.2025.03.004","DOIUrl":"10.1016/j.seizure.2025.03.004","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to compare the efficacy and tolerability of valproate and levetiracetam monotherapy in patients with juvenile myoclonic epilepsy and epilepsy with generalized tonic-clonic seizure alone.</div></div><div><h3>Methods</h3><div>This retrospective-prospective cohort study was conducted on 170 adult patients who commenced monotherapy with valproate or levetiracetam between March 2019 and March 2023. The study outcomes were seizure-free rate, time to first seizure, retention rate, time to withdrawal and adverse events, which were registered following a one-to-five-year follow-up period.</div></div><div><h3>Results</h3><div>The seizure-free rates of levetiracetam and valproate were comparable in the one-year follow-up (65.9 % vs. 62.4 %, p:0.74) and in favor of levetiracetam in the five-year follow-up (90.9 % vs. 44.4 %, p:0.05). The retention rate of levetiracetam was higher than valproate (97.6 % vs. 82.4 % in the first year and 55.2 % vs. 21.6 % in the fifth year). The time to first seizure was found to be similar between the two groups (<em>p</em> = 0.43), but the time to withdrawal was significantly longer in patients on levetiracetam (<em>p</em> &lt; 0.001). The incidence of adverse events was comparable between the two groups. However, the withdrawal rate due to adverse events was significantly higher in the valproate group. Levetiracetam demonstrated a higher occurrence of psychiatric adverse events, which were addressed with dose adjustments and psychiatric intervention in 37.6 % of patients but resulted in drug discontinuation in 3.5 % of cases.</div></div><div><h3>Conclusion</h3><div>The findings of this study indicate that levetiracetam monotherapy may represent an efficacious alternative to valproate in patients with juvenile myoclonic epilepsy and epilepsy with generalized tonic-clonic seizure alone, particularly in women of reproductive age.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 66-70"},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674849","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":"Can Omega-3 fatty acid supplementation support the clinical management of drug-resistant epilepsy? A meta-analysis of randomized controlled trials","authors":"Xianghong Meng ,&nbsp;Wu-Chen Wu ,&nbsp;Kequan Zhou","doi":"10.1016/j.seizure.2025.03.003","DOIUrl":"10.1016/j.seizure.2025.03.003","url":null,"abstract":"<div><div>Approximately 30-40% of individuals with epilepsy develop drug-resistant epilepsy (DRE), a condition associated with substantial socioeconomic and psychological burdens for patients and their families. As standard anti-epileptic therapies often prove insufficient, alternative treatments have become a critical area of research. Dietary interventions, such as the ketogenic diet, have shown promise, and emerging evidence highlights the potential role of omega-3 fatty acids, particularly docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), due to their neuroprotective and anticonvulsant properties. However, the clinical application of omega-3 fatty acids for DRE remains uncertain due to limited high-quality randomized controlled trials (RCTs). To address this gap, we conducted a meta-analysis incorporating newly published RCTs to evaluate the clinical efficacy of omega-3 fatty acid supplementation as an adjunct to standard anti-epileptic medications in both children and adults with DRE. Our meta-analysis, incorporating high-quality RCTs, provides moderate-certainty evidence that omega-3 fatty acid supplementation, particularly at doses between 0.3 and 1.7 g/day, is associated with a reduction in seizure frequency in individuals with DRE. Notably, larger RCTs (sample size &gt;30) demonstrated more consistent favorable outcomes. However, the evidence primarily reflects short-term effects, as the majority of included studies were of limited duration. These findings underscore the potential role of omega-3 fatty acids as an adjunctive therapy for DRE while highlighting the need for larger, long-term trials to better understand their clinical utility.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 77-87"},"PeriodicalIF":2.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674829","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":"Validation of ICD codes for the identification of patients with functional seizures","authors":"Jonah Fox,&nbsp;Hannah E. Branstetter,&nbsp;Robert Havranek,&nbsp;Murli Mishra,&nbsp;Nicholas S. Mallett","doi":"10.1016/j.seizure.2025.03.002","DOIUrl":"10.1016/j.seizure.2025.03.002","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the validity of ICD-9-CM and ICD-10 codes for the identification of patients with functional seizures (FS).</div></div><div><h3>Methods</h3><div>We evaluated the charts of 800 patients including 400 in an institution wide sample and 400 in an epilepsy monitoring unit (EMU) sample. Half of the patients from each sample came from 2012–2013 and 2022–2023 since ICD-9-CM codes and ICD-10 codes were exclusively used in these respective periods. The charts of each patient were manually reviewed and evaluated for the presence of epilepsy and FS. Based on the 2013 International League Against Epilepsy (ILAE) Nonepileptic Seizures Task Force guidelines we determined whether a patient had either presumptive (clinically established or documented) or probable/possible FS. We evaluated ICD-9-CM codes 300.11 (conversion disorder) and 780.39 (other convulsions) as well as ICD-10 codes F44.5 (conversion disorder or functional neurological disorder with seizures or convulsions) and R56.9 (unspecified convulsions). The positive predictive value (PPV) of each ICD code was calculated in the institution wide sample and the sensitivity, specificity, PPV and negative predictive values (NPV) were calculated in the EMU sample.</div></div><div><h3>Results</h3><div>In the institution wide sample, F44.5 had a PPV of 74.0 % (64.6–81.6) for presumptive FS and 80.0 % (71.1–86.7) when probable/possible FS patients were included. The code 300.11 had a PPV of 52.0 % (42.3–61.5) for presumptive FS and 59.0 % (49.2–68.1) when probable/possible FS patients were included. Codes R56.9 and 780.39 had PPVs that were equal to or less than 20 %. In the EMU sample, the code F44.5 had a sensitivity, specificity, PPV and NPV of 67.1 % (56.3–76.3), 95.8 % (90.5–98.2), 91.7 % (81.9–96.4), and 80.7 % (73.4–86.4), respectively for presumptive FS. The code 300.11 had a sensitivity, specificity, PPV and NPV of 30.1 % (20.8–41.4), 95.3 % (90.1–97.8), 78.6 % (60.5–89.8), and 70.4 % (63.1–76.7), respectively for presumptive FS. The codes R56.9 and 780.39 performed poorly.</div></div><div><h3>Significance</h3><div>ICD codes had a mixed performance when used to identify patients with FS. ICD-10 code F44.5 appeared to perform the best overall.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 44-49"},"PeriodicalIF":2.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619393","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":"Characterization of a unique patient cohort with spike-wave activation in sleep without cognitive decline or increased seizure burden: Considerations for a more conservative treatment approach","authors":"Rene Andrade Machado ,&nbsp;Jennifer Meylor ,&nbsp;Shruti L. Narayan ,&nbsp;Natalie B. Norton","doi":"10.1016/j.seizure.2025.03.001","DOIUrl":"10.1016/j.seizure.2025.03.001","url":null,"abstract":"<div><h3>Objective</h3><div>The goal of this study is to better characterize a unique subset of patients who present with so-called “isolated SWAS” (Spike Wave Activation in Sleep) by analyzing electrographic and neuropsychological data.</div></div><div><h3>Methods</h3><div>We evaluated our institution's population of patients with SWAS, defined as &gt;/= 50 % spike-wave index potentiated during slow-wave sleep. Of this group, 26 patients were identified with no worsening cognitive performance or seizure burden at the time of diagnosis, deemed “isolated SWAS”, in comparison to patients with Developmental and/or Epileptic Encephalopathy (D/EE)-SWAS. Paraclinical studies of this cohort were analyzed, including high-frequency oscillations, specifically on scalp electroencephalogram as well as comprehensive behavioral and neuropsychologic data at one-year follow-up.</div></div><div><h3>Results</h3><div>We found that 80 % (n=21) of the cohort was started on a unique treatment for SWAS at the time of diagnosis, with the most common treatment being clobazam (n=12; 57 %) followed by valproic acid (n=9; 43 %). The cognitive performance of patients who received treatment and those who did not receive treatment was not statistically significant, and after one year of follow-up the patients who did not receive treatment for SWAS had no cognitive decline. Furthermore, the treatment group reported more medication side effects (n=14/21; 67 %). Seven patients (27 %) of the cohort continued to have SWAS at follow-up, and 11 patients (42 %) had ongoing seizures. The presence of ripples did not correlate with cognitive outcomes.</div></div><div><h3>Significance</h3><div>This study suggests that if patients have “isolated-SWAS” at the time of diagnosis a more conservation approach may be considered.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 115-126"},"PeriodicalIF":2.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686260","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":"Aging and Late-Onset Epilepsy: An urgent call for action!","authors":"Christoph Helmstaedter, Hermann Stefan, Friedhelm Schmitt, Markus Reuber","doi":"10.1016/j.seizure.2025.02.017","DOIUrl":"https://doi.org/10.1016/j.seizure.2025.02.017","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587871","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":"Authors’ response to letter by Amanda Medeiros Fernandes et al.","authors":"Yu Zhang ,&nbsp;Haijiao Wang ,&nbsp;Ling liu","doi":"10.1016/j.seizure.2024.12.018","DOIUrl":"10.1016/j.seizure.2024.12.018","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Page 116"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025426","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":"Heading: When change creates chaos - A dilemma with brand versus generic antiseizure medications,,","authors":"Khushboo Verma,&nbsp;Sisira Yadala","doi":"10.1016/j.seizure.2024.12.005","DOIUrl":"10.1016/j.seizure.2024.12.005","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 117-118"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684179","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":"Incidence and independently associated variables of acute postoperative seizures after epilepsy surgery","authors":"Wei Ma ,&nbsp;Yufu Zhang ,&nbsp;Long Chen","doi":"10.1016/j.seizure.2025.02.015","DOIUrl":"10.1016/j.seizure.2025.02.015","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the incidence and independently associated variables of acute postoperative seizures (APOS) occurring in the first postoperative week after resective epilepsy surgery.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed clinical data from consecutive patients who underwent resective epilepsy surgery in a tertiary hospital. The clinical characteristics of patients with and without APOS were compared, and binary logistic regression was used to identify the independently associated variables of APOS.</div></div><div><h3>Results</h3><div>Of the 1269 epilepsy surgeries (1261 patients) included in this analysis, 10.6 % (134/1269) resulted in APOS. Univariate analysis showed that sex, age at surgery, epilepsy duration, seizure frequency, number of anti-seizure medications (ASMs) at the time of surgery, drug resistant epilepsy (DRE); previous surgery, interictal EEG, intracranial monitoring, surgical extent, and complications were associated with APOS. When surgery was limited to a single brain lobe, frontal and parietal lobe surgery were more likely to result in APOS than temporal lobe surgery (11.7 %, 17.2 % vs<em>.</em> 7.5 %, <em>p</em> = 0.033, 0.008, respectively). Multivariate analysis demonstrated that an epilepsy duration of ≥3.75 years (OR 1.789 95 % CI 1.128–2.837 <em>p</em> = 0.013), using ≥3 types of ASMs at the time of surgery (OR 1.649 95 % CI 1.025–2.652 <em>p</em> = 0.039), and complications (OR 1.761 95 % CI 1.179–2.628 <em>p</em> = 0.006) were the independently associated variables of APOS. Postoperative seizure outcome at last follow-up was significantly worse in patients with APOS than in those without (Engel class Ⅰ: 41.1 % vs<em>.</em> 70.4 % <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The overall incidence of APOS in our cohort was moderate. Surgery for temporal lobe epilepsy was less likely to result in APOS. Early surgery, use of fewer ASMs, and control of complications were independently associated with a lower incidence of APOS.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"129 ","pages":"Pages 9-13"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714418","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":"What are the risk factors for suicide-related events in patients with epilepsy? A critical review of methodology and evidence","authors":"Amanda Medeiros Fernandes ,&nbsp;Ana Zélia Abreu Pires de Sousa ,&nbsp;Fabio Gomes de Matos e Souza ,&nbsp;Luísa Weber Bisol","doi":"10.1016/j.seizure.2024.12.016","DOIUrl":"10.1016/j.seizure.2024.12.016","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 114-115"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684178","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}