Seizure-European Journal of Epilepsy最新文献

{"title":"Long-term seizure outcomes and the likelihood of antiseizure medication withdrawal in patients with juvenile absence epilepsy: A 10-year follow-up study","authors":"Xiaoli Wang ,&nbsp;Xinbo Zhang ,&nbsp;Jingya Wei ,&nbsp;Chenwei Li ,&nbsp;Yuanhang Pan,&nbsp;Gengyao Hu,&nbsp;Min Li,&nbsp;Wenjuan Zhang,&nbsp;Yong-Hong Liu","doi":"10.1016/j.seizure.2025.09.005","DOIUrl":"10.1016/j.seizure.2025.09.005","url":null,"abstract":"<div><h3>Background and Objective</h3><div>Juvenile absence epilepsy is a common idiopathic generalized epilepsy syndrome that often requires long-term antiseizure medications (ASMs). However, it remains unclear whether and when such long-term medication is necessary. In this study, we aimed to explore the long-term seizure outcomes and the feasibility of ASMs withdrawal in patients with JAE. Additionally, we aimed to investigate the evolution of EEG patterns over time.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study on patients diagnosed with JAE according to the 2022 ILAE at Xijing Hospital between March 2014 and Dec 2024. We performed a retrospective review of their 24-h video-EEG recordings for seizure semiology and EEG pattern. Patient demographics, baseline clinical characteristics, and treatment details were extracted from clinical charts and electronic health records. All further follow-up visits were either through telemedicine or in-person visits.</div></div><div><h3>Results</h3><div>This retrospective study included 58 patients diagnosed with JAE, with a mean age at epilepsy onset of 11.86 ± 3.87 years. The median follow-up duration was 9.57 years (range, 3–27 years). Among these patients, 38 (65.5 %) achieved seizure freedom for at least 2 years. Treatment with valproate was identified as an independent predictor of a favorable outcome in terms of seizure freedom. Conversely, the total number of generalized tonic-clonic seizures experienced, presence of absence seizures on follow-up EEG and the persistence of hyperventilation positivity on EEG were associated with an unfavorable outcome regarding seizure freedom. Among the 38 patients, 25 (65.8 %) did not experience seizure recurrence. ASMs withdrawal was attempted in 28 patients (48.3 %) and 18 of them did not experience seizure recurrence during the tapering process. Among these 18 patients, ASMs were discontinued in 9 patients at the last follow-up.</div><div>The age of onset (<em>p</em> = 0.040) and age at last follow up (<em>p</em> = 0.044) were associated with seizure recurrence. After a median EEG follow-up period of 6 years, abnormal EEG improved in 34 of the 58 patients (58.6 %). Additionally, 14 of the 58 patients (24.1 %) had normal EEG in subsequent recordings.</div></div><div><h3>Conclusion</h3><div>Seizures were effectively controlled with ASMs in most patients with JAE, and a significant proportion of patients were able to attempt ASMs withdrawal without experiencing seizure recurrence. Additionally, EEG patterns of GSWD improved on follow-up EEGs for the majority of patients.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"132 ","pages":"Pages 117-124"},"PeriodicalIF":2.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049576","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":"Characterizing CHD2-associated epilepsy: A multicenter study and pooled analysis of the literature","authors":"Anabel G. Puri ,&nbsp;Sean Woods ,&nbsp;John M. Schreiber ,&nbsp;Cynthia G. Keator ,&nbsp;Jason Coryell ,&nbsp;Sonal Bhatia ,&nbsp;Senyene E. Hunter ,&nbsp;Mahjabeen Khan ,&nbsp;Dylan C. Brock ,&nbsp;Christina Sanlnocencio ,&nbsp;Laura Marks ,&nbsp;Stephanie Prince ,&nbsp;Cemal Karakas","doi":"10.1016/j.seizure.2025.09.004","DOIUrl":"10.1016/j.seizure.2025.09.004","url":null,"abstract":"<div><h3>Background and objectives</h3><div><em>CHD2</em> variants have been implicated in a spectrum of neurodevelopmental disorders, including early-onset developmental and epileptic encephalopathy. Despite growing interest in <em>CHD2</em>-related disorders, the full phenotypic spectrum, including epilepsy features and genotype-phenotype relationships, is not fully understood. This study aims to systematically review the literature and analyze data from a multicenter registry to independently describe phenotypic and genotypic features of <em>CHD2</em>-associated epilepsy.</div></div><div><h3>Methods</h3><div>A systematic literature review was conducted from inception to 7/2024 using EMBASE, Web of Science, and PubMed with the keywords \"<em>CHD2”.</em> Additional data was collected from a search of the Pediatric Epilepsy Research Consortium (PERC) Epilepsy Genetics Database and the same parameters were used to gather relevant information about patients with both <em>CHD2</em> variants and epilepsy.</div></div><div><h3>Results</h3><div>Of the 644 screened articles, 74 articles containing individual participant data were included for full-text review and analysis, focusing on parameters such as CHD2 variants, clinical characteristics, neuroimaging findings, and electroencephalography (EEG) results. Data from 236 individuals with epilepsy and <em>CHD2</em> variants were included, including 12 previously unreported cases from the PERC Genetics database. Of the patients with available data, 53% (108/205) were male, and 95% (170/179) had confirmed <em>de novo</em> mutations. Seizure onset ranged from 1 day to 22 years, with 59% (80/136) of the cases exhibiting photosensitivity and 37% (33/90) fever sensitivity. Most common comorbidities included intellectual disability (86%, 121/141), developmental delay (88%, 156/177), and autism (45%, 68/150). EEG showed epileptiform abnormalities in 88% (122/138) of the cases. MRI findings were abnormal in 19% (22/116) of patients.</div></div><div><h3>Discussion</h3><div><em>CHD2</em>-associated epilepsy presents with considerable phenotypic variability, including variable age of seizure onset, photosensitivity, and neurodevelopmental comorbidities. This review highlights the importance of comprehensive phenotypic-genotypic characterization to better understand the clinical spectrum of <em>CHD2</em> variants, emphasizing the need for further investigation into the mechanisms driving phenotypic diversity.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"132 ","pages":"Pages 88-97"},"PeriodicalIF":2.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the letter by Mehta R and Sah R entitled “Developmental and/or epileptic encephalopathy with spike-and-wave activation in sleep: A single tertiary center experience”","authors":"Sibel Öz Yıldız ,&nbsp;Ceren Günbey ,&nbsp;Kader Karlı Oğuz ,&nbsp;Gökçen Konuşkan ,&nbsp;Göknur Haliloğlu ,&nbsp;Dilek Yalnızoğlu","doi":"10.1016/j.seizure.2025.09.003","DOIUrl":"10.1016/j.seizure.2025.09.003","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"132 ","pages":"Pages 145-146"},"PeriodicalIF":2.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087857","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":"Consanguinity and treatment strategy determine seizure outcome and mortality in infantile epileptic spasms syndrome in Azerbaijan","authors":"Ulviyya Guliyeva ,&nbsp;Nana Nino Tatishvili ,&nbsp;Kamran Salayev ,&nbsp;Rauan Kaiyrzhanov ,&nbsp;Semra Hiz ,&nbsp;Kerim Munir ,&nbsp;David A Williams ,&nbsp;Cavid Isayev ,&nbsp;Sughra Guliyeva ,&nbsp;Henry Houlden ,&nbsp;Olivier Dulac","doi":"10.1016/j.seizure.2025.09.001","DOIUrl":"10.1016/j.seizure.2025.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the etiology of Infantile Epileptic Spasms Syndrome (IESS) in Azerbaijan, and to evaluate treatment response and outcome.</div></div><div><h3>Methods</h3><div>For the seventy children referred for ongoing IESS over a 3-year period, we studied medical history, physical examination, EEG, neuroimaging and genetic testing.</div></div><div><h3>Results</h3><div>37.1% were born to consanguineous parents. The etiology was genetic in 50.0% of cases and brain injury in 17.1%. Epileptic spasms persisted for a median of 11.5 months. 72.9% of children experienced additional seizure types. Consanguinity, genetic etiology, and conventional treatment were significant predictors of mortality (<em>p</em> = 0.016, <em>p</em> = 0.034, and <em>p</em> = 0.002, respectively), with a 7.7-fold increased risk of death in children of consanguineous parents. In multivariate analysis, genetic etiology and treatment regimens that did not include first-line therapies such as vigabatrin and hormones remained significant risk factors. The mean duration of epileptic spasms was shortest with hormonal therapy (5.8 months), compared to vigabatrin (14.8 months), or other anti-seizure medications alone (30.6months). The risk of global developmental delay was 3.4 times higher in children with additional seizure types, and 37-times higher in those with neurological signs.</div></div><div><h3>Significance</h3><div>Genetic etiology, parental consanguinity, and treatment response that are correlated with increased mortality, are modifiable factors requiring education.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"132 ","pages":"Pages 125-132"},"PeriodicalIF":2.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087781","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":"Angiotensin receptor blockers (ARBs) reduce the risk of developing epilepsy in patients with ischemic stroke and hypertension","authors":"Giacomo Evangelista ,&nbsp;Fedele Dono ,&nbsp;Sara Melchiorre ,&nbsp;Clarissa Corniello ,&nbsp;Davide Liviello ,&nbsp;Paolo Quintieri ,&nbsp;Martina Di Pietro ,&nbsp;Mirella Russo ,&nbsp;Catello Vollono ,&nbsp;Stefano L. Sensi","doi":"10.1016/j.seizure.2025.09.002","DOIUrl":"10.1016/j.seizure.2025.09.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Stroke is the most common cause of seizures in patients older than 60 years. About 10–30 % of new epilepsy diagnoses in elderly patients are associated with a brain ischemic event. Hypertension is a major risk factor for epilepsy and stroke, and 2 % of patients with epilepsy have hypertension. According to the European Society of Cardiology guidelines, Angiotensin-Converting Enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs) are first-line hypertension treatment. ACEi and ARBs promote a protective effect against the development of seizures in the general population. However, no data are available about their possible preventive role in post-stroke epilepsy (PSE). In this study, we evaluated the relationship between different antihypertensive regimens and the risk of developing post-stroke epilepsy (PSE).</div></div><div><h3>Methods</h3><div>In this retrospective, observational study, we selected and evaluated data relative to patients with hypertension and a diagnosis of ischemic stroke (as confirmed by clinical and neuroimaging evaluations and who accessed our neurology ward between January 2016 and January 2022). All participants were followed up for a median period of 24 months. The PSE diagnosis was made according to the ILAE criteria. We excluded patients with acute symptomatic seizures. The details of the antihypertensive treatments, demographics, and clinical and neuroradiological data were analyzed.</div></div><div><h3>Results</h3><div>528 patients (mean age: 71.37 ± 13.64, 302 men, 57.19 %) were enrolled. Thirty-eight (7.2 %) patients developed PSE. Anterior Cerebral Artery involvement (<em>p</em> = 0.05) and cortico-subcortical lesions (<em>p</em> = 0.001) were associated with a higher risk of PSE. A lower risk of PSE was observed in patients treated with ARBs, both before (<em>p</em> = 0.009) and after (<em>p</em> = 0.02) the stroke event. PSE incidence was higher in patients receiving Calcium Channel blockers (CCBs) (<em>p</em> = 0.019) and Beta-blockers (BBs) (<em>p</em> = 0.008) before the stroke event as well as BBS after the stroke event (<em>p</em> = 0.003). No differences were observed for ACEi if administered previous (<em>p</em> = 0.42) or after (<em>p</em> = 0.48) the stroke event.</div></div><div><h3>Conclusions</h3><div>ARBs appear to offer a protective role against epilepsy development in patients with hypertension and stroke. These findings suggest that ARBs could be considered a promising target for future prospective studies evaluating PSE prevention in stroke patients.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"132 ","pages":"Pages 171-177"},"PeriodicalIF":2.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158776","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":"Economic instability, food insecurity, social isolation, and inadequate access to care in adults with epilepsy: A nationwide analysis.","authors":"Ryan Afreen, Omar Alani, Yehia Elkersh, Leah J Blank, Leah Habersham, Parul Agarwal","doi":"10.1016/j.seizure.2025.07.012","DOIUrl":"10.1016/j.seizure.2025.07.012","url":null,"abstract":"<p><strong>Background: </strong>Social needs of health, such as economic instability, food insecurity, social isolation, and inadequate access to care, significantly impact health outcomes and quality of life. People with epilepsy may face heightened challenges in these areas, but the extent of such disparities is not fully understood. This study investigates the association between epilepsy and economic instability, food insecurity, social isolation, and inadequate access to care to identify significant social and economic disparities impacting patient care.</p><p><strong>Methods: </strong>A cross-sectional analysis of adult participants from the 2021 National Health Interview Survey was conducted. The primary outcomes were economic instability, food insecurity, social isolation, and inadequate access to care. Participants were categorized as having active epilepsy (currently receiving treatment), inactive epilepsy (diagnosed but not receiving treatment), or no epilepsy. Univariable and multivariable logistic regressions were performed to assess associations between presence of epilepsy and social needs of health after controlling for age, sex, race, region, marriage/living status, education, insurance, and number of comorbidities. Factors contributing to disparities within the active epilepsy group were also analyzed.</p><p><strong>Results: </strong>Of 26,794 participants, 240 (0.90 %) reported active epilepsy, 212 (0.79 %) inactive epilepsy, and 26,342 (98.3 %) no epilepsy. Compared to individuals with no epilepsy, those with active epilepsy had significantly higher rates of economic instability (81 % vs. 46 %; p < 0.001), food insecurity (37 % vs. 20 %; p < 0.001), social isolation (37 % vs. 8 %; p < 0.001), and inadequate access to care (88 % vs. 56 %; p < 0.001). Multivariable analyses confirmed these associations, with disparities also observed among individuals with inactive epilepsy. Factors such as age, race, marital status, education, and comorbidities were significantly associated with social needs of health among those with active epilepsy.</p><p><strong>Significance: </strong>People with epilepsy experience substantial social and economic challenges, emphasizing the urgent need for targeted interventions to address these inequities and improve outcomes.</p>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"280-289"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805097","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":"Differences in the neuropsychological profiles of high-functioning TSC adults with and without epilepsy.","authors":"Anna B Marcinkowska, Sergiusz Jóźwiak, Aleksandra Bala, Agnieszka Tarasewicz, Agnieszka Sabisz, Izabella Kuźmiuk-Glembin, Paweł J Winklewski, Beata Rutkowska, Justyna Prokopiuk, Urszula Ławrynowicz, Kinga Drężek-Chyła, Monika Horbacz, Magdalena Koczkowska, Alicja Dębska-Ślizień, Edyta Szurowska","doi":"10.1016/j.seizure.2025.07.021","DOIUrl":"10.1016/j.seizure.2025.07.021","url":null,"abstract":"<p><strong>Background: </strong>Tuberous sclerosis complex (TSC) is a multisystem genetic disorder often accompanied by neuropsychiatric symptoms, including epilepsy and cognitive impairments. While the cognitive impact of epilepsy in TSC is well documented in children, there is a paucity of studies examining neuropsychological functioning in high-functioning adults, particularly in relation to epilepsy status.</p><p><strong>Objective: </strong>This study aimed to investigate cognitive functioning in adults with clinically or molecularly confirmed TSC, without intellectual disability or autism spectrum disorder (ASD), with a specific focus on the impact of epilepsy.</p><p><strong>Methods: </strong>Fifty-six adults were divided into three groups: individuals with TSC and epilepsy (EpiTSC; n = 18), individuals with TSC without epilepsy (NEpiTSC; n = 19), and healthy controls (n = 37). Participants underwent a comprehensive neuropsychological assessment targeting executive functions, attention, memory, and visuospatial abilities. Statistical analyses included ANOVA, Tukey's post-hoc tests, and Mann-Whitney U tests, with additional analyses limited to participants with confirmed TSC2 pathogenic variants.</p><p><strong>Results: </strong>Individuals with TSC and epilepsy exhibited significantly poorer performance on tasks assessing psychomotor speed, attention shifting, and executive control, including the Colour Trail Test and Trail Making Test. They also demonstrated lower scores in verbal memory and learning tasks, with a higher frequency of perseverative and intrusion errors on the California Verbal Learning Test (CVLT). Adults without epilepsy showed a distinct profile, characterized mainly by deficits in executive functioning and verbal fluency compared to controls. No significant group differences were observed in demographic variables.</p><p><strong>Conclusions: </strong>This study highlights the existence of two distinct cognitive phenotypes among high-functioning adults with TSC, based on epilepsy status. Epilepsy in this cohort is associated with global cognitive dysfunction, particularly affecting attention, executive control, and memory. These findings underscore the need for individualized cognitive assessment and targeted intervention strategies, especially in individuals with a history of epilepsy.</p>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"298-306"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812555","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":"Autism and prenatal exposure to antiseizure medications: Still a long-standing blind spot?","authors":"Alain Braillon","doi":"10.1016/j.seizure.2025.05.024","DOIUrl":"10.1016/j.seizure.2025.05.024","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 480-481"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048303","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":"Repetitive transcranial magnetic stimulation for the treatment of focal drug-resistant epilepsy: A crossover, randomized, single-blinded, sham-controlled clinical trial.","authors":"Jaroslav Melus, Iveta Waczulikova, Lenka Hapakova, Michaela Konecna, Peter Valkovic, Gabriela Timarova","doi":"10.1016/j.seizure.2025.07.015","DOIUrl":"10.1016/j.seizure.2025.07.015","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of low-frequency repetitive transcranial magnetic stimulation (LF rTMS) in patients with focal drug-resistant epilepsy (DRE) using a randomized, single-blinded, crossover design (NCT06681480 on ClinicalTrials.gov).</p><p><strong>Methods: </strong>Eighteen patients with focal DRE completed two 5-day treatment phases with either active or sham LF rTMS (0.5 Hz, 90 % rMT, 3000 pulses/session), separated by a 3-month washout period. The epileptogenic focus was targeted using MRI-guided neuronavigation. Primary outcomes included monthly seizure frequency, responder and seizure-free rates, and duration of seizure freedom. Secondary outcomes included weekly seizure frequency, interictal epileptiform discharges (IEDs), seizure severity, and quality of life. Crossover-specific analyses were performed with baseline correction.</p><p><strong>Results: </strong>Active rTMS resulted in a significant reduction in monthly seizure frequency compared to sham (p = 0.0399), with 50 % of patients classified as responders and 16.7 % achieving seizure freedom. The seizure reduction was most prominent during the first two weeks after stimulation. Active rTMS also significantly reduced seizure severity (p < 0.0001) and improved quality of life (p = 0.0212). Although a trend toward reduction in IEDs was observed, this did not reach statistical significance. No serious adverse events occurred, and treatment was well tolerated.</p><p><strong>Significance: </strong>LF rTMS targeting the epileptogenic focus appears to be a safe and potentially effective non-invasive adjunctive therapy for focal DRE. Its short-term efficacy and favorable safety profile support further investigation, including studies incorporating maintenance stimulation protocols and biomarker-guided treatment strategies.</p>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"290-297"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812556","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":"Modified Atkins Diet versus low glycemic index treatment in children with drug-resistant epilepsy: A systematic review and meta-analysis","authors":"Indar Kumar Sharawat ,&nbsp;Pragnya Panda ,&nbsp;Lesa Dawman ,&nbsp;Diksha Gupta ,&nbsp;Prateek Kumar Panda","doi":"10.1016/j.seizure.2024.12.001","DOIUrl":"10.1016/j.seizure.2024.12.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Both the Modified Atkins Diet (MAD) and Low Glycemic Index Treatment(LGIT) are considered less restrictive than the ketogenic diet and effective in children with drug-resistant epilepsy(DRE). Several randomized controlled trials (RCTs) have compared these two diets.</div></div><div><h3>Methods</h3><div>All RCTs directly comparing MAD and LGIT for DRE were included in the review. We pooled estimates for percentage seizure frequency reduction, the number of participants with seizure freedom, ≥90 % and ≥50 % reduction in seizure frequency, as well as changes in cognition, behavior, and adverse effects in both groups.</div></div><div><h3>Results</h3><div><span>Three RCTs with 265 participants were included. The pooled estimates for the number of children achieving seizure freedom, ≥50 %, and ≥90 % reduction in seizure frequency post-intervention, as well as weekly percentage seizure frequency reduction, were comparable between the MAD and LGIT groups(RR: 1.24 [95 % CI: 0.71–2.16]; I²=0 %, </span><em>p</em> = 0.45, RR: 0.86 [95 % CI: 0.57–1.29]; I²=62 %, <em>p</em> = 0.45, RR: 1.35 [95 % CI: 0.82–2.21]; I²=5 %, <em>p</em> = 0.24, and MD:6.5 [95 % CI:13.8 to 0.6]; I²=45 %, <em>p</em> = 0.07). The number of children showing improvement in cognition and changes in behavioral comorbidities were also comparable between the groups(<em>p</em> = 0.60 and 0.21). However, the MAD group had a higher incidence of adverse effects(RR: 1.37 [95 % CI: 1.12–1.68]; I²=42 %, <em>p</em> = 0.002), though the number of participants experiencing serious adverse effects was similar in both groups(RR: 1.68 [95 % CI: 0.71–3.99]; I²=0 %, <em>p</em> = 0.24). Adherence rates to the allocated intervention were numerically higher in the LGIT group(<em>p</em> = 0.73).</div></div><div><h3>Conclusion</h3><div>Both MAD and LGIT are comparable in efficacy, but LGIT is associated with fewer adverse effects.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 471-479"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873313","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}