Seizure-European Journal of Epilepsy最新文献

{"title":"Alterations in white matter integrity and correlations with clinical characteristics in children with non-lesional temporal lobe epilepsy","authors":"Siqi Luo ,&nbsp;Yaqin Xia ,&nbsp;Chaogang Lu ,&nbsp;Yi Wang ,&nbsp;Zhongwei Qiao","doi":"10.1016/j.seizure.2024.12.017","DOIUrl":"10.1016/j.seizure.2024.12.017","url":null,"abstract":"<div><h3>Purpose</h3><div>To complement the current research on altered white matter integrity in children with non-lesional temporal lobe epilepsy (NL-TLE), especially the correlation between diffusion metrics and clinical characteristics, so as to provide imaging evidence for clinical practice.</div></div><div><h3>Methods</h3><div>Children with temporal lobe epilepsy and no lesions on magnetic resonance imaging (MRI) were retrospectively collected from 2016.01.01 to 2022.12.31, and typically developing children (TDC) with normal MRI were collected as control group. Tract-based spatial statistics (TBSS) was used to compare the fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) between the two groups. Twenty fiber bundles were used as regions of interest (ROIs) to extract and compare the diffusion metrics. Partial correlation analysis was performed to assess the association between diffusion parameters within ROIs and clinical characteristics.</div></div><div><h3>Results</h3><div>TBSS and ROI analysis showed that FA values decreased and MD and RD values increased in the NL-TLE compared with the TDC, without significant differences in AD values. FA values in all ROIs increased with age, while the MD and RD values decreased in all ROIs, and the AD values decreased in most ROIs. Epilepsy duration was negatively correlated with FA values and positively correlated with MD and RD values in specific fibers. Frequency of seizures was negatively correlated with the FA values in a few trats. Full-scale intelligence quotient (FSIQ) was positively correlated with FA values and negatively with RD value in a few tracts.</div></div><div><h3>Conclusion</h3><div>Children with NL-TLE showed widespread alterations in white matter integrity, which were correlated with clinical characteristics.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 2-9"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899826","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":"Post-marketing safety of antiseizure medications: Focus on serious adverse effects including drug reaction with eosinophilia and systemic symptoms (DRESS)","authors":"Jingjing Qian ,&nbsp;Xiangzhong Xue ,&nbsp;Lotanna Ezeja ,&nbsp;Zachary Boxx ,&nbsp;Cherry W. Jackson","doi":"10.1016/j.seizure.2025.01.002","DOIUrl":"10.1016/j.seizure.2025.01.002","url":null,"abstract":"<div><h3>Purpose</h3><div>On November 28, 2023, the U.S. FDA issued a Drug Safety Communication, warning that antiseizure medications (ASMs) levetiracetam and clobazam can cause a rare but serious reaction, drug reaction with eosinophilia and systemic symptoms (DRESS). However, the risk of DRESS from other ASMs remains unclear. This observational study examined post-marketing safety of ASMs focusing on serious adverse events (AEs) reporting including DRESS.</div></div><div><h3>Methods</h3><div>This retrospective, cross-sectional study analyzed the U.S. FDA Adverse Event Reporting System (FAERS) data from January 1, 2004, to March 31, 2024. Ten older (valproic acid, carbamazepine, oxcarbazepine, phenytoin, and phenobarbital) and newer (zonisamide, topiramate, lamotrigine, lacosamide, and brivaracetam) frequently used ASMs and three benzodiazepines (lorazepam, chlordiazepoxide, and diazepam) in clinical practice as alternative treatments were examined together with levetiracetam and clobazam, respectively. Disproportionality analysis, reporting odds ratio (ROR), was used to detect reporting risk signals of DRESS along with serious AE, hospitalization, death, and Stevens-Johnson Syndrome (SJS) for levetiracetam/clobazam and alternative treatments. A statistically significant reporting risk signal was detected when the lower boundary of the 95 % confidence interval for the RORs exceeded 1.</div></div><div><h3>Results</h3><div>Levetiracetam had significant reporting risks of serious AE, hospitalization, DRESS, and SJS. Older ASMs including valproic acid, carbamazepine, oxcarbazepine, phenytoin, and phenobarbital all had significant reporting risks of DRESS and SJS. Newer ASMs including zonisamide and lamotrigine had significant reporting risks of DRESS and SJS, while topiramate, lacosamide, and brivaracetam did not exhibit reporting risk for DRESS. Clobazam had significant reporting risks of serious AE, DRESS, and SJS. Lorazepam, chlordiazepoxide, and diazepam did not exhibit reporting risks for DRESS or SJS.</div></div><div><h3>Conclusions</h3><div>Findings highlighted reporting risk signals of DRESS for levetiracetam/clobazam and alternative ASMs. Given the limitations from passive surveillance nature of FAERS, further surveillance and longitudinal studies are essential to evaluate and confirm our findings.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 37-43"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957820","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":"Etiological features of status epilepticus of the in-patient cohort in Tibet: A retrospective comparative study","authors":"Wei Peng ,&nbsp;Lu Lu ,&nbsp;Yu Hao ,&nbsp;Weixi Xiong ,&nbsp;Ammar T. Abdulaziz ,&nbsp;Yuqing Lian ,&nbsp;Lei Chen ,&nbsp;Xintong Wu ,&nbsp;Yuhua Zhao ,&nbsp;Dong Zhou","doi":"10.1016/j.seizure.2025.01.001","DOIUrl":"10.1016/j.seizure.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>The etiology of status epilepticus (SE) in Tibet has not yet been reported. We aimed to establish the etiological baseline of SE in the Tibet Autonomous Region in China and compare it with a SE cohort from a regional neuroscience centre in Sichuan, Southwestern China to reveal whether there was a unique etiology distribution in the Tibetan region.</div></div><div><h3>Methods</h3><div>We retrospectively captured clinical data of patients diagnosed with SE in the People's Hospital of Xizang Autonomous Region from January 2015 to December 2020. Control data were recorded during the same period from West China Hospital of Sichuan University, Sichuan Province. Clinical and etiology evaluations were conducted by 4 neurologists using a standard case report form.</div></div><div><h3>Results</h3><div>A total of 619 patients were enrolled, among whom 318 were from the Tibetan cohort. The median age of the Tibetan cohort was 37.5 years, with 109 (34.3%) being women. The main etiology in the Tibetan cohort was uncontrolled persistent epilepsy (70.1%, <em>N</em> = 223). Compared to the control cohort, the proportion of patients in Tibet whose SE could be controlled was higher (97.5% vs 81.1%, p&lt;.001) and the proportion of patients with refractory SE was lower (8.8% vs 35.2%, p&lt;.001). Among the 223 patients with epilepsy who developed SE, 111 had never been treated with anti-seizure medication, and 52 (23.3%) were judged only to have received inappropriate treatment of epilepsy. Forty patients (17.9%) were only receiving treatment with traditional Tibetan medicine for epilepsy prior to admission. Patients with epilepsy of infectious etiology were seen in 37 patients in Tibetan cohort. In twenty-eight patients neurocysticercosis was identified as the cause of epilepsy. And in two patients, the cause of epilepsy was brain hydatid.</div></div><div><h3>Conclusions</h3><div>The main etiology of SE in the Tibet Autonomous Region was unsatisfactory seizure control in patients with pre-existing epilepsy, while a greater proportion of epilepsy due to infectious causes was noted. Improved education for physicians and patients is needed to improve the management of epilepsy and SE in this population.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 179-185"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043074","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":"Negative impact of self-reported executive problems in patients with functional/dissociative seizures: Results from a prospective long-term observational study","authors":"Antonia Villagrán ,&nbsp;Erik Hessen ,&nbsp;Halvor Torgersen ,&nbsp;Kristin Å. Alfstad ,&nbsp;Roderick Duncan ,&nbsp;Lisa Evju Hauger ,&nbsp;Morten Ingvar Lossius","doi":"10.1016/j.seizure.2025.01.010","DOIUrl":"10.1016/j.seizure.2025.01.010","url":null,"abstract":"<div><h3>Objective</h3><div>Functional/dissociative seizures (FDS) are common and pose a considerable burden on both individual patients and healthcare systems. Cognitive complaints are frequent in patients with FDS. Previous studies on cognitive function in patients with FDS have yielded mixed results. We investigated executive function and its impact on long-term outcome in a prospective sample of patients with FDS.</div></div><div><h3>Methods</h3><div>Thirty-three inpatients (age range: 16-62 years) who had been admitted to the National Centre for Epilepsy in Norway with FDS underwent neuropsychological assessment for both tested and self-reported executive function, using the Behavior Rating Inventory of Executive Function, at baseline. Participants were evaluated for their medical status at a mean of 5.5 years (SD 2.4, range 1.9-10.9 years) after inclusion. To determine potential predictors of achieving cessation of FDS by time of follow-up a multivariate logistic regression analysis was conducted.</div></div><div><h3>Results</h3><div>At follow-up, 14/33 (42 %) of the participants were FDS-free. Self-reported, but not tested, executive dysfunction was an independent risk factor for ongoing FDS at follow-up.</div></div><div><h3>Conclusion</h3><div>Our findings indicate an association between greater self-reported executive problems and poorer long term outcomes in patients with FDS. Screening for executive dysfunction with a self-report questionnaire may yield relevant information that could be used to guide psychological interventions.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 44-49"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972903","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":"Performance validity tests in people with epilepsy: A review of the literature","authors":"Lucy Roberts-West ,&nbsp;Sallie Baxendale","doi":"10.1016/j.seizure.2024.12.014","DOIUrl":"10.1016/j.seizure.2024.12.014","url":null,"abstract":"<div><h3>Objective</h3><div>Professional bodies recommend the use of performance validity tests (PVTs) to aid the interpretation of scores obtained in neuropsychological assessments, but base rates of failure differ according to neurological diagnosis and the associated impairments. This review summarises the PVT literature in people with epilepsy with the aim of establishing base rates of PVT failure and the factors associated with PVT performance in this population.</div></div><div><h3>Methods</h3><div>Ovid and PubMed databases were searched for studies reporting PVT test performance in people with epilepsy.</div></div><div><h3>Results</h3><div>The search strategy identified 29 studies reporting the performance of people with epilepsy on 23 PVTs. The most commonly reported PVTs were memory-based tasks including the Test of Memory Malingering (n=15) and the Word Memory Test (n=9). Highly variable failure rates were reported on these tasks using cut-offs established in other neurological groups. Factors associated with apparent failure on PVTs in people with epilepsy included older age, lower IQ, attention deficits, impaired verbal and working memory and epilepsy-related factors including a left sided seizure focus, the presence of interictal EEG abnormalities and recent seizure activity.</div></div><div><h3>Conclusions</h3><div>Epilepsy related factors are associated with apparent failures on some PVTs. Caution should be employed when interpreting scores on memory based PVTs in this population.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 23-30"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928248","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":"Corrigendum to “Predictive performances of STESS and EMSE in a Norwegian adult status epilepticus cohort” [Seizure 70 (2019) 6-11]","authors":"Line Bédos Ulvin ,&nbsp;Erik Taubøll ,&nbsp;Ketil Berg Olsen ,&nbsp;Kjell Heuser","doi":"10.1016/j.seizure.2024.12.009","DOIUrl":"10.1016/j.seizure.2024.12.009","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Page 1"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873314","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 clinical practice and experiences in buccal midazolam prescribing in community for status epilepticus termination in the United Kingdom: The Rescue Epilepsy Medication and Training (REMIT) study","authors":"Audrey McBride ,&nbsp;Lance Watkins ,&nbsp;Samuel Tromans ,&nbsp;Paraskevi Triantafyllopoulou ,&nbsp;Paul Basset ,&nbsp;Phil Tittensor ,&nbsp;Caryn Jory ,&nbsp;Rohit Shankar","doi":"10.1016/j.seizure.2024.12.022","DOIUrl":"10.1016/j.seizure.2024.12.022","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy is one of the commonest neurological conditions worldwide and confers a significant mortality risk, partly driven by status epilepticus (SE). Terminating SE is the goal of pharmaceutical rescue therapies. This survey evaluates UK-based healthcare professionals’ clinical practice and experience in community-based rescue therapy prescribing.</div></div><div><h3>Methods</h3><div>A cross-sectional, 21 item questionnaire composed of Likert-style and free-text based questions was administered online. It was distributed through a non-discriminative snow-balling methodology to members of the Epilepsy Specialist Nurses’ Association (ESNA) and the British International League Against Epilepsy (ILAE). Quantitative analysis used Chi-squared, Fishers’ exact and Mann-Whitney tests. Qualitative data were analysed through NVivo 14 software, following Braun and Clarke methodology.</div></div><div><h3>Results</h3><div>86 participants comprising of nurses (<em>n</em> = 64) and doctors (<em>n</em> = 21) responded. Participants’ responses reflected guideline-concordant use of emergency management plans and buccal midazolam (BM) as a first-choice therapy for terminating tonic-clonic seizures in SE. However, significant variation (<em>P &lt;</em> 0.05) was found between doctors and nurses in prescribing practices of BM including maximum dose prescribed/day, withdrawal plans and the use in multimorbid patients. Eight themes were identified with some suggestive of concerns of overuse, misuse and abuse of BM by patients/carers.</div></div><div><h3>Conclusion</h3><div>This is the first study to give insights to community management of SE using rescue therapies particularly BM. Further evidence-based guidelines are needed for BM use in multimorbid patients and for its deprescribing. Robust safeguarding protocols and vigilance is needed to regulate BM's misuse and abuse potential. Oncoming community-based technology could provide objective assurance for evidencing utility of rescue medications.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 62-72"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985246","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":"Association between anti-seizure medications and cardiac arrhythmias in patients undergoing ambulatory electroencephalographic and electrocardiographic monitoring","authors":"Francis J. Ha ,&nbsp;Ewan S. Nurse ,&nbsp;Vanessa Di Tano ,&nbsp;Duron Prinsloo ,&nbsp;Hariharan Sugumar ,&nbsp;Elizabeth D. Paratz ,&nbsp;Mark J. Cook","doi":"10.1016/j.seizure.2025.01.009","DOIUrl":"10.1016/j.seizure.2025.01.009","url":null,"abstract":"<div><div><em>Background</em> Anti-seizure medications (ASMs) are commonly prescribed in epilepsy. However some have been associated with adverse cardiac outcomes including cardiac arrhythmias.</div><div><em>Methods</em> We conducted an observational study evaluating patients aged ≥16 years undergoing ambulatory video – electroencephalographic (EEG) – electrocardiographic (ECG) monitoring (AVEEM) between 2020 and 2023 in Australia. Data collected included baseline demographics, type, number and dose of ASMs and cardiac arrhythmias during monitoring. ASMs were not withdrawn while monitored. Average QT interval was calculated and corrected for heart rate (QTc). Logistic regression was used to evaluate association between demographic variables, ASMs and cardiac arrhythmias.</div><div><em>Results</em> 3695 patients underwent AVEEM (median age 40 years [interquartile range 26–57], female 64 %). Median AVEEM duration was 6.8 days. 51 % of patients were taking ≥1 ASMs. About 28 % (1029/3695) patients had a cardiac arrhythmia; the most frequent was non-sustained SVT (19 %; 695/3695). On multivariable analysis, carbamazepine (OR 0.72, 95 %CI 0.53–0.98, <em>p</em> = 0.03), lamotrigine (OR 0.57, 95 %CI 0.44–0.73, <em>p</em>&lt;0.001) and lacosamide (OR 0.63, 95 %CI 0.43–0.92, <em>p</em> = 0.02) were associated with fewer cardiac arrhythmias. Their association with cardiac arrhythmias was not dose-dependent. No commonly-prescribed ASMs were associated with increased risk of cardiac arrhythmias. There was no significant association between use of ASMs and dynamic QTc interval change.</div><div><em>Conclusions</em> Certain ASMs, namely carbamazepine, lamotrigine and lacosamide, were associated with fewer cardiac arrhythmias and this association was not dose-dependent. No other ASM was associated with cardiac arrhythmias. Further large clinical prospective studies are needed to confirm these findings and to clarify the mechanism for any potential antiarrhythmic properties of ASMs.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 113-117"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014970","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 value of saliva therapeutic drug monitoring of newer antiseizure medications","authors":"Eva Choong ,&nbsp;Paola Vassallo ,&nbsp;Irene Aícua-Rapún ,&nbsp;Camille Stampfli ,&nbsp;Pascal André ,&nbsp;Andrea O. Rossetti ,&nbsp;Thierry Buclin ,&nbsp;Jan Novy ,&nbsp;Laurent A. Decosterd","doi":"10.1016/j.seizure.2025.01.013","DOIUrl":"10.1016/j.seizure.2025.01.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Saliva is a promising option for therapeutic drug monitoring, with studies since the 1970s indicating a good correlation between plasma and saliva levels for early anti-seizure medications, although limited data exist for newer generation drugs.</div></div><div><h3>Objectives</h3><div>To evaluate the reliability and predictive power of saliva as a minimally invasive surrogate marker of plasma concentration for the routine therapeutic drug monitoring (TDM) of newer anti-seizure medications (ASM).</div></div><div><h3>Methods</h3><div>We collected blood samples at steady state in patients at least 6 h post-dose, paired with unstimulated saliva samples. We evaluated the correlation between plasma and saliva drug levels and the positive and negative predictive value for plasma values extrapolation from saliva levels. A very low saliva level was defined as below half the plasma lower reference limit.</div></div><div><h3>Results</h3><div>294 adult patients (53 % male) with a mean age of 40 (SD: 16) were enrolled and 589 paired saliva-plasma samples were quantified. The highest significant correlations between saliva and plasma were observed for zonisamide (R²: 0.92) perampanel (0.91), brivaracetam (0.87), followed by topiramate, lamotrigine, lacosamide (0.76–0.68), and rufinamide, levetiracetam, pregabalin (0.63–0.55). No significant correlation was found for the active mono-hydroxy derivative of oxcarbazepine. Despite a good correlation coefficient, the correlations between saliva and plasma levels were generally loose, resulting in a broad predicted range of plasma levels for a given saliva level. Nonetheless, very low saliva levels exhibited strong specificity in predicting low plasma levels, with 87 % to 100 % accuracy, and when saliva levels fell below the limit of quantification, all corresponding plasma levels were below reference ranges.</div></div><div><h3>Conclusions</h3><div>This large newer ASM paired plasma-saliva collection allows to precise the potential use of saliva in the management of epilepsy, especially for commonly used ASM such as lamotrigine and levetiracetam. Although they correlate well, extrapolating plasma levels from saliva samples is still an imprecise approximation, making it inadequate for fine dosage adjustments. Yet, a very low saliva level has an appreciable discriminative ability for low plasma level. Unstimulated saliva represents a convenient non-invasive alternative to plasma, to readily identify compliance issues or major drug-drug interactions.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 106-112"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015008","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":"Investigating the frequency of neural autoantibodies in refractory focal epilepsy","authors":"Lisa Gillinder ,&nbsp;Donald Craig ,&nbsp;Tamara Powell ,&nbsp;Stephen Walsh ,&nbsp;John Phamnguyen ,&nbsp;Ian Wilson ,&nbsp;Xiaohua Chen ,&nbsp;David Gillis ,&nbsp;Pamela McCombe","doi":"10.1016/j.seizure.2025.01.007","DOIUrl":"10.1016/j.seizure.2025.01.007","url":null,"abstract":"<div><h3>Objectives</h3><div>There have been conflicting reports about the frequency of neural autoantibodies in epilepsy cohorts, which is confounded by the lack of clear distinction of epilepsy from acute symptomatic seizures due to encephalitis. The aim of this study was to determine the frequency of neural autoantibodies in a well characterised population of refractory focal epilepsy of known and unknown cause.</div></div><div><h3>Methods</h3><div>Cases were recruited from epilepsy outpatient clinics at the Princess Alexandra, Mater, Royal Brisbane and Women's and Cairns Base Hospitals from 2021 – 2023. Included cases were refractory to medical therapy, met the ILAE definition of focal epilepsy and were characterised using anatomo-electro-clinical correlation. Cases with prior encephalitis, inflammatory neurological disease or prior parenchymal brain insults were excluded.</div></div><div><h3>Results</h3><div>A total of 100 patients were recruited. No cases with clinically significant neural autoantibodies were discovered. One was positive for serum anti-NMDAR antibodies, however autoantibodies were absent from CSF. Cases were also screened using a predictive score (McGinty et al.). From this, 2 cases were identified as seronegative autoimmune associated epilepsy and demonstrated significant reduction in seizure frequency with administration of immunotherapy. These cases had common features including temporo-perisylvian semiology especially ictal piloerection and high seizure frequency.</div></div><div><h3>Conclusion</h3><div>Clinically relevant neural autoantibodies are uncommon in well characterised chronic focal epilepsy populations. Despite this there are isolated cases that still demonstrate improved seizure control with the use of immunotherapy. Such cases highlight the need for further studies to understand the role of immunity in novel pathophysiological mechanisms in epilepsy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 73-78"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015096","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}