Seizure-European Journal of Epilepsy最新文献

{"title":"Clinical reliability and concordance of drug-drug interaction tools as clinical decision support systems in patients with epilepsy","authors":"Maria Krayem ,&nbsp;Milena van der Goten ,&nbsp;Adam Strzelczyk ,&nbsp;Felix Rosenow ,&nbsp;Felix von Podewils ,&nbsp;Susanne Knake ,&nbsp;Stjepana Kovac ,&nbsp;Lisa Langenbruch ,&nbsp;Catrin Mann ,&nbsp;Johann Philipp Zöllner ,&nbsp;Laurent M. Willems","doi":"10.1016/j.seizure.2026.01.011","DOIUrl":"10.1016/j.seizure.2026.01.011","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the concordance and clinical correlation of drug-drug interaction tools (DDITs) as clinical decision support systems (CDSS) in patients with epilepsy.</div></div><div><h3>Methods</h3><div>All patients from the Epi2020 study cohort receiving ≥1 anti-seizure medication (ASM) and ≥1 concomitant drug (CD) were included. Individual treatment regimens were analyzed for drug-drug interactions (DDIs) using five DDITs (Drugbank, Drugs.com, mediQ, Medscape and WebMD). To address the clinical significance of possible DDIs, Spearman correlation between the number of detected DDIs and two established adverse event (AE) metrics (LAEP, QOLIE-31) was performed using post-hoc correction by Fisher’s z-transformation (FZT) for the total number of drugs taken. Multivariate ordinal regression analysis (MORA) was performed to identify ASM or CD classes associated with severe DDIs.</div></div><div><h3>Results</h3><div>Overall, 140 patients (57.9% female, median age 48 years) taking a median number of 4.0 drugs (2.0 ASMs and 2.0 CDs) were included. DDI were found in 51.4%–84.3% and severe interactions in 2.1%–17.8% of patients, depending on the DDIT. The concordance rate between DDITs was only 6.4% for all and only 63.6% for severe detected DDI, respectively. All concordant cases involved no detected interactions. The number of DDIs significantly correlated with AE metrics in 3/5 DDITs. Following the FZT, none of the DDI/AE correlations were superior to that between the number of DDIs and the number of drugs taken. MORA identified topiramate, valproate, zonisamide, hormones, and antipsychotics as independent predictors for the detection of severe DDIs.</div></div><div><h3>Conclusion</h3><div>When using DDITs as CDSS, it is important to consider that the results of different tools may vary greatly from one another and do not necessarily correlate with clinical AEs.</div></div><div><h3>Study registration</h3><div>The Epi2020 study was registered under the trial registration number: DRKS00022024, U1111-1252-5331.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 31-39"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167752","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":"Secondary hemophagocytic lymphohistiocytosis concurrent with febrile infection-related epilepsy syndrome in a child","authors":"Oi-Wa Chan ,&nbsp;Chun-Nun Chao ,&nbsp;Shao-Hsuan Hsia ,&nbsp;En-Pei Lee ,&nbsp;Kuang-Lin Lin ,&nbsp;Jainn-Jim Lin","doi":"10.1016/j.seizure.2026.01.015","DOIUrl":"10.1016/j.seizure.2026.01.015","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 1-3"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102612","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":"Pediatric new-onset super refractory status epilepticus: Potential of timely immunotherapy in a resource-limited PICU","authors":"Aakash Chandran Chidambaram ,&nbsp;Jerin C Sekhar ,&nbsp;Suresh Kumar Angurana ,&nbsp;Karthi Nallasamy ,&nbsp;Muralidharan Jayashree ,&nbsp;Naveen Sankhyan ,&nbsp;Jitendra Kumar Sahu ,&nbsp;Renu Suthar ,&nbsp;Arushi Gahlot Saini ,&nbsp;Arun Bansal","doi":"10.1016/j.seizure.2026.01.021","DOIUrl":"10.1016/j.seizure.2026.01.021","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To describe the clinical profile, management, and outcomes of children with new-onset super-refractory status epilepticus (NOSRSE), and to identify predictors of survival.</div></div><div><h3>METHOD</h3><div>This was a retrospective observational study conducted in the Pediatric Intensive Care Unit at PGIMER, Chandigarh, India, from January 2019 to August 2024. Thirty-six children diagnosed with NORSE who progressed to super-refractory status epilepticus were included. Clinical characteristics, neurodiagnostic findings, treatment details, and outcomes were analyzed. Univariate logistic regression was used to identify predictors of survival.</div></div><div><h3>RESULTS</h3><div>Median age was 8 years; 63.9 % were male. No etiology was identified in 28 (77.7 %) children, autoimmune encephalitis in 5 (13.9 %) and viral encephalitis in 3 (8.3 %) children. MRI abnormalities were seen in 72.7 %, and non-convulsive seizures on EEG in 55.6 %. Seizure control was achieved in 80.6 %, and 72.2 % survived to hospital discharge. Median PCPC score improved from 5 at discharge to 3 at 6-month follow-up. Early immunotherapy (OR 0.83; 95 % CI (0.69, 0.99); p 0.04) was associated with better survival.</div></div><div><h3>CONCLUSION</h3><div>Despite the severity of illness, favorable outcomes were achievable. Early immunotherapy was associated with improved survival. These findings underscore the need for time-sensitive, protocolized care in pediatric NOSRSE, especially in resource-limited settings.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 40-45"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183197","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":"Levetiracetam vs. valproate: Which antiseizure medication worsens insulin resistance and metabolic health?","authors":"Prateek Kumar Panda,&nbsp;Indar Kumar Sharawat","doi":"10.1016/j.seizure.2024.08.025","DOIUrl":"10.1016/j.seizure.2024.08.025","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 117-118"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147402150","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":"Characteristics associated with first anti-seizure medication prescribed in a cohort of adults with newly diagnosed epilepsy","authors":"Leah J. Blank ,&nbsp;Rachelle Morgenstern ,&nbsp;Kenneth Boockvar ,&nbsp;Nihal Mohamed ,&nbsp;Nathalie Jetté","doi":"10.1016/j.seizure.2026.02.007","DOIUrl":"10.1016/j.seizure.2026.02.007","url":null,"abstract":"<div><h3>Background</h3><div>Anti-seizure medication (ASM) is the primary treatment modality in epilepsy. There exist evidence-based recommendations published by the American Academy of Neurology and American Epilepsy Society for ASM selection in epilepsy, but these medication recommendations are inconsistently followed. We sought to examine predictors of recommended first ASM in newly diagnosed adults with epilepsy.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of adults (≥18 years) newly diagnosed with epilepsy in New York, identified using validated ICD-CM codes, for the period 2011 to 2019. The primary outcome of interest was use of an AES/AAN guideline-informed ASM, and exposures of interest included patient characteristics (e.g. age), provider characteristics (e.g. specialty) and structural characteristics (e.g., practice setting). Multivariable Poisson regression for risk ratios modeled the probability of being prescribed a neutral/recommended or non-recommended ASM, adjusting for covariates.</div></div><div><h3>Results</h3><div>2340 adults with newly diagnosed epilepsy were prescribed an ASM within 1-year. The most frequently prescribed ASM was levetiracetam (45.5%), which aligns with recommendations. However, 39% were prescribed a non-recommended medication. The prescription of a recommended ASM was associated with older age at diagnosis (relative risk (RR) 1.01; 95% confidence interval (CI) 1.00–1.01), Black race (RR 1.12; 95% CI 1.03–1.23), being in a relationship (vs. divorced/separated/single or widowed) (RR 1.13; 95% CI 1.06–1.22) and a history of stroke (RR 1.19; 95% CI 1.05–1.34). Prescriptions from physician trainees (vs. non-trainees) were more likely to align with recommended ASMs (RR 1.15; 95% CI 1.06–1.25), with no differences by physician specialty. Inpatient setting was associated with fewer recommended ASM prescriptions (vs. outpatient setting) (RR 0.82; 95% CI 0.75–0.89). There was no difference between emergency department and outpatient prescriptions.</div></div><div><h3>Conclusions</h3><div>Understanding where/why less favorable ASM prescription may occur is important to target potential prescribing interventions. In this study, recommended ASM prescriptions were associated with patient, prescriber and setting characteristics. Notably, trainees prescribed recommended/neutral ASM more often, which underscores the importance of prescriber education in improving prescribing practices.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 60-65"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190814","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":"Applications and impact of telemedicine for persons with epilepsy: a scoping review","authors":"Jitendra Kumar Sahu ,&nbsp;Ana Carolina Coan ,&nbsp;Josephine Chan ,&nbsp;Bosanka Jocic-Jakubi ,&nbsp;Pooja Dhir ,&nbsp;Mamidi Niveditha ,&nbsp;Nagita Devi ,&nbsp;Mamta Bhushan Singh ,&nbsp;Patricia Osborne Shafer ,&nbsp;Yu Hsiang-Yu ,&nbsp;Amza Ali ,&nbsp;Ji Yeoun Yoo ,&nbsp;Johan Zelano ,&nbsp;Fred Stephen Sarfo ,&nbsp;Fortini Pablo Sebastián ,&nbsp;Samson Awili Gwer ,&nbsp;Yanin Rivera ,&nbsp;Najib Kissani ,&nbsp;Roberto Horacio Caraballo ,&nbsp;Dipika Bansal ,&nbsp;Pauline Samia","doi":"10.1016/j.seizure.2026.01.016","DOIUrl":"10.1016/j.seizure.2026.01.016","url":null,"abstract":"<div><div>Telemedicine is emerging as a promising strategy to overcome geographical and specialist access constraints in epilepsy care. This scoping review, conducted by the International League Against Epilepsy (ILAE) Telemedicine Task Force, aimed to map the existing evidence on the applications, effectiveness, and challenges of telemedicine in epilepsy management. A systematic search of PubMed, Embase, and Web of Science, conducted up to May 2025 without language restrictions, identified original studies evaluating telemedicine for epilepsy diagnosis, management, or follow-up. Data were extracted and synthesized narratively. Of the 201 included studies, approximately 70% originated from high-income settings. Evidence demonstrated diagnostic accuracy ranging from 75% to 97%, cost savings of about US$30 per consultation, and high satisfaction levels among patients (87–95%) and physicians (74–94%). Telemedicine also reduced no-shows by 45%, ensuring continuity of care during healthcare disruptions such as the COVID-19 pandemic. Overall, telemedicine is a feasible adjunct to conventional epilepsy care, enhancing access, accuracy, and cost-effectiveness. To substantiate its role in diverse settings, well-designed randomized controlled trials are needed to evaluate long-term outcomes, equity, and sustainability.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 107-116"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349584","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":"Prognostic performance of STESS and qSOFA scores in pre-hospital status epilepticus: A prospective cohort study","authors":"Hela Manai,&nbsp;Teycir Kharraz,&nbsp;Houyem Zouari,&nbsp;Saida Zelfani","doi":"10.1016/j.seizure.2026.01.017","DOIUrl":"10.1016/j.seizure.2026.01.017","url":null,"abstract":"<div><h3>Background</h3><div>Status epilepticus (SE) is a life-threatening, multisystem disorder. Prognostic factors are variable, and several scores have been developed for SE, some requiring electroencephalogram results that may not be available pre-hospital. We aimed to evaluate the prognostic performance of two rapid, easily applicable pre-hospital scores: the STESS and qSOFA scores.</div></div><div><h3>Methods</h3><div>We conducted a prospective, observational study of SE patients managed in pre-hospital emergency care in Tunis over 35 months. We assessed the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and optimal cutoffs for both STESS and qSOFA in predicting 48-hour mortality, in-hospital mortality, and the need for mechanical ventilation.</div></div><div><h3>Results</h3><div>One hundred SE patients with motor-predominant seizures were included. For 48-hour mortality, AUC was 0.855 for STESS and 0.787 for qSOFA; for mechanical ventilation, AUC was 0.693 and 0.705, respectively. STESS ≥3 predicted 48-hour mortality with specificity 87.0% and sensitivity 66.7%, while qSOFA ≥3 had specificity 95.8% and sensitivity 64.3%. Exploratory analysis for in-hospital mortality (37%) showed STESS ≥3 with specificity 86% and sensitivity 68%, and qSOFA ≥3 with specificity 95% and sensitivity 64%.</div></div><div><h3>Conclusions</h3><div>STESS and qSOFA are simple, rapid scores suitable for pre-hospital SE management. Both exhibit good specificity but moderate sensitivity. STESS may be more informative for in-hospital outcomes, while qSOFA reflects early systemic severity. Scores should be interpreted alongside a comprehensive clinical assessment to guide triage and early management.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 46-50"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183156","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":"Tele-neuropsychological assessment in children with self-limited epilepsy with centrotemporal spikes: a pilot study","authors":"Viola Margheri ,&nbsp;Simona Pellacani ,&nbsp;Edoardo Fino ,&nbsp;Martina Calì ,&nbsp;Sara Senese ,&nbsp;Costanza Ruffini ,&nbsp;Carmen Barba ,&nbsp;Renzo Guerrini ,&nbsp;Chiara Pecini","doi":"10.1016/j.seizure.2026.02.004","DOIUrl":"10.1016/j.seizure.2026.02.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Telemedicine has gained increasing prominence in healthcare services, with neuropsychological tele-assessment emerging as a promising tool for evaluating and monitoring cognitive functions remotely, even in clinical conditions with mild vulnerabilities. Despite its growing application in adults, its use in pediatric clinical contexts remains understudied. Among pediatric disorders, Self-limited epilepsy with centrotemporal spikes (SeLECTs) may feature subtle neuropsychological deficits, particularly in higher order cognitive processes such as Executive Functions (EF), and in learning skills. Early tele-neuropsychological assessment can help delineate the neuropsychological profile in this population.</div></div><div><h3>Method</h3><div>The feasibility of a fully remote neuropsychological assessment protocol in children with SeLECTs was examined. Forty-seven children (aged 6–13) were recruited, of whom 43 underwent the assessment. Two online sessions via Google Meet and web-based platforms (TeleFE battery), to assess children’s cognitive and executive functioning were conducted. Clinicians evaluated the children's engagement and parents completed remote questionnaires addressing academic performances, EF-related behaviors, and feasibility of the procedure.</div></div><div><h3>Results</h3><div>The protocol demonstrated high feasibility and acceptability, with participants’ strong compliance and no major technical issues. Descriptive analyses highlighted the presence of vulnerabilities in executive functioning and school achievement in children with SeLECTs.</div></div><div><h3>Discussion</h3><div>These findings support the clinical relevance of remote neuropsychological assessment in pediatric epilepsy, offering a scalable and accessible tool to enhance care.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 69-75"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203474","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":"Neonatal-onset epileptic encephalopathy with lissencephaly associated with a SCN3A variant: The first case in Korea and literature review","authors":"Hyun A Lee ,&nbsp;Seong Wan Kim ,&nbsp;Seoheui Choi ,&nbsp;Jang Hoon Lee ,&nbsp;Moon Sung Park ,&nbsp;Rita Yu ,&nbsp;Yoong-A Suh","doi":"10.1016/j.seizure.2026.01.008","DOIUrl":"10.1016/j.seizure.2026.01.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Pathogenic variants in<em>SCN3A,</em> encoding the voltage-gated sodium channel Naᵥ1.3, have been implicated in early infantile epileptic encephalopathy (EIEE) and cortical malformations. We report the first Korean case of <em>SCN3A</em>-related EIEE and discuss its contribution to the expanding phenotypic spectrum.</div></div><div><h3>Methods</h3><div>Clinical features, electroencephalography (EEG), brain magnetic resonance imaging (MRI), treatment response, and outcomes were analyzed. A literature review of previously reported <em>SCN3A</em> cases was performed for phenotypic comparison.</div></div><div><h3>Results</h3><div>A female neonate developed tonic seizures 7 h after birth. EEG showed multifocal epileptiform discharges with burst-suppression patterns. Brain MRI demonstrated diffuse cortical thickening consistent with the lissencephaly–pachygyria spectrum and corpus callosum dysgenesis. Despite multiple antiseizure medications, seizures remained intractable. Profound bulbar dysfunction required gastrostomy, tracheostomy, and home ventilation. Next-generation sequencing identified a heterozygous <em>SCN3A</em> c.2624T&gt;C (p.Ile875Thr) variant, previously reported as pathogenic and associated with gain-of-function effects. The patient died at 6 months of age.</div></div><div><h3>Conclusion</h3><div>This first Korean case of <em>SCN3A</em>-related EIEE caused by the recurrent p.Ile875Thr variant highlights a severe neonatal phenotype characterized by early-onset refractory seizures, profound cortical malformations, and early mortality. The case broadens both the phenotypic and geographic spectrum of <em>SCN3A</em>-associated neurodevelopmental disorders and underscores the importance of early genetic testing in neonates with refractory seizures and cortical malformations.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 13-17"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127093","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":"Quality and safety of youtube videos on epilepsy-specific exercises: A systematic analysis using a novel evaluation tool","authors":"Yakup Gonulal ,&nbsp;Tuba Denizci ,&nbsp;Mehmetcan Yesilkaya ,&nbsp;Eda Agascioglu ,&nbsp;Serdar Aykac ,&nbsp;Rabia Hurrem Ozdurak Singin","doi":"10.1016/j.seizure.2026.02.002","DOIUrl":"10.1016/j.seizure.2026.02.002","url":null,"abstract":"<div><h3>Objective</h3><div>Exercise benefits people with epilepsy (PWE) by reducing seizure frequency, improving quality of life, and fostering social participation. YouTube, a popular platform for health information, hosts numerous exercise videos for PWE, yet their quality, reliability, and safety remain unevaluated. This study aimed to evaluate the quality, reliability, and engagement of YouTube videos on epilepsy-specific exercises using the novel Epilepsy Content Evaluation (ECE) tool, alongside DISCERN, JAMA, and Global Quality Score (GQS).</div></div><div><h3>Method</h3><div>A systematic search conducted on July 22, 2025, identified 45 English-language YouTube videos, which were independently evaluated by two neurologists using the ECE, DISCERN, JAMA, and GQS tools. Video characteristics, publisher sources, and engagement metrics were analyzed.</div></div><div><h3>Results</h3><div>Most videos (53.3%) were rated low quality (ECE score 0–7), with only one (2.2%) achieving high quality (ECE score 12–15). The Safety and Risk Management subdomain scored lowest (median: 2, IQR: 1.25), reflecting inadequate attention to seizure triggers and supervision. Athlete-targeted videos outperformed general-population videos in quality (<em>p</em> &lt; 0.05). View counts negatively correlated with ECE scores (<em>r</em> = –0.375 to –0.712, <em>p</em> &lt; 0.05). ECE demonstrated strong convergent validity with DISCERN (Phi = 0.606, <em>p</em> = 0.035).</div></div><div><h3>Conclusion</h3><div>In conclusion, most YouTube videos on epilepsy-specific exercises lack clinical reliability and safety guidance, posing potential risks for PWE. The ECE tool effectively identifies these deficiencies, enabling clinicians to recommend ILAE-aligned videos to enhance patient safety. Curated, evidence-based digital resources could empower millions of PWE to engage in safe physical activity, reducing stigma and improving health outcomes.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 51-59"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183133","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}