Seizure-European Journal of Epilepsy最新文献

{"title":"Phenotype and genotype of AKT3-related disorders","authors":"Shimin Zhang ,&nbsp;Qinrui Li ,&nbsp;Zhao Xu ,&nbsp;Jiong Qin ,&nbsp;Zhixian Yang ,&nbsp;Yue Niu","doi":"10.1016/j.seizure.2026.04.021","DOIUrl":"10.1016/j.seizure.2026.04.021","url":null,"abstract":"<div><h3>Objectives</h3><div>To systematically define and elucidate the relationship between clinical manifestations and genetic features of somatic and germline <em>AKT3</em> variants.</div></div><div><h3>Methods</h3><div>We collected clinical data, MRI and EEG data from five Chinese children with <em>AKT3</em> variants. Furthermore, we systematically reviewed published literature on <em>AKT3</em> variants.</div></div><div><h3>Results</h3><div>Five patients with germline <em>AKT3</em> variants were identified in the present study. Combined with 68 previously reported cases, a total of 74 patients have been documented to date, including 28 with somatic variants, 36 with germline single-nucleotide variants (SNVs), 4 with germline duplications, and 6 with germline pure <em>AKT3</em> deletions. Among patients with somatic variants, early-onset seizures were observed in 96.4%, with drug resistance epilepsy reported in 96.1%. Brain MRI abnormalities were detected in 96.4% of cases, most commonly focal cortical dysplasia and hemimegalencephaly. In patients with germline SNVs, developmental delay and megalencephaly were the most frequent manifestations, followed by seizures. Cranial MRI findings were heterogeneous, with megalencephaly accompanied by polymicrogyria representing the most common pattern, followed by isolated megalencephaly without cortical dysplasia and combined megalencephaly, polymicrogyria, and periventricular nodular heterotopia. Patients with germline <em>AKT3</em> duplications exhibited phenotypes broadly similar to those with germline SNVs. In contrast, individuals with germline pure <em>AKT3</em> deletions typically presented with microcephaly and developmental delay, without distinctive MRI abnormalities. Most germline variants were missense changes. The somatic variant E17K and the germline variant R465W exhibited as mutational hotspots.</div></div><div><h3>Interpretation</h3><div>Our study presented five cases with germline <em>AKT3</em> variants and expanded the understanding of genotype-phenotype correlations. Patients harboring somatic variants predominantly presented with early-onset seizures and demonstrated focal cortical dysplasia (FCD) or hemimegalencephaly (HME) on brain MRI. In contrast, individuals with SNVs or duplications most commonly exhibited neurodevelopmental delay, megalencephaly and seizures. Patients with germline <em>AKT3</em> deletions were characterized by microcephaly and developmental delay. Notably, phenotypic heterogeneity was observed even among patients carrying identical variants,</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"138 ","pages":"Pages 147-156"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787278","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":"Efficacy and safety of novel antiseizure medications as adjunctive treatment of focal epilepsy: An updated network meta-analysis","authors":"Zhijun Le,&nbsp;Zhujing Ou,&nbsp;Raowei Yan,&nbsp;Hesheng Zhang,&nbsp;Jiayu Mi,&nbsp;Yuzhen Baima,&nbsp;Dong Zhou,&nbsp;Xintong Wu","doi":"10.1016/j.seizure.2026.04.013","DOIUrl":"10.1016/j.seizure.2026.04.013","url":null,"abstract":"<div><h3>Objective</h3><div>Antiseizure medications (ASMs) are the cornerstone of epilepsy treatment. However, evidence on direct comparison of ASMs is lacking. This network meta-analysis evaluated the comparative efficacy and safety of approved and investigational add-on third-generation ASMs for focal epilepsy in adolescents and adults.</div></div><div><h3>Methods</h3><div>Data were retrieved through an extensive literature search of PubMed, Embase, Cochrane Library, and ClinicalTrial.gov databases from inception through August 2025. Findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline (CRD420251180027). Primary efficacy outcomes were ≥50 % and 100 % responder rates at 12-weeks maintenance duration. Secondary outcomes were corresponding responder rates at 8-weeks maintenance duration. Tolerability was assessed as retention rate. Treatment-emergent adverse events (TEAEs) and TEAEs leading to treatment discontinuation were the safety outcomes.</div></div><div><h3>Results</h3><div>The literature search retrieved 345 studies, of which 35 studies were included. All ASMs showed significantly higher responder rates compared with placebo. Significantly higher 100 % responder rate was observed with cenobamate (CNB; 400mg/d: Risk ratio [RR] 15; 95 % CI, 7.0-39; 200mg/d: RR 8.7; 95 % CI, 3.9-22) at a maintenance duration of 12 weeks and 8 weeks (400mg/d: RR 15; 95 % CI, 7.0-41; 200mg/d: RR 8.6; 95 % CI, 4.0-24). All ASMs showed a patient retention rate comparable with placebo. For overall TEAEs, brivaracetam (BRV; 50mg/d) and BRV ranked the lowest for individual and pooled doses, respectively; placebo ranked the highest in both cases. For TEAEs leading to treatment discontinuation, CNB ranked lower than the placebo.</div></div><div><h3>Significance</h3><div>All approved and investigational ASMs were effective add-on treatments for focal epilepsy, with CNB demonstrating the greatest likelihood of achieving seizure freedom.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"138 ","pages":"Pages 167-184"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787303","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":"Retrospective observational study of treatment and referral pathways of patients with epilepsy in Germany","authors":"Nils G. Margraf ,&nbsp;Adam Strzelczyk ,&nbsp;Karel Kostev ,&nbsp;Sergio R. Pérez Rosal ,&nbsp;Benedikt Greshake ,&nbsp;Felix von Podewils ,&nbsp;Thomas Mayer ,&nbsp;Andreas Schulze-Bonhage","doi":"10.1016/j.seizure.2026.04.001","DOIUrl":"10.1016/j.seizure.2026.04.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Epilepsy is one of the most common chronic neurological disorders. Epilepsy treatment is supported and managed through clinical practice guidelines which aim to improve patient care by educating and supporting prescribers. This is achieved through presenting unbiased information on treatment pathways.</div><div>Using German national healthcare databases, we provide preliminary evidence of the likelihood of patients receiving optimal guideline recommended treatment, through treatment pathways, with, importantly, timely escalation for complex patients.</div></div><div><h3>Methods</h3><div>This population-based, retrospective, cross-sectional analysis of epilepsy treatment pathways utilized German statutory health insurance patient records from healthcare providers together with retail prescription data. Database identification of patients with epilepsy was based on ICD-10 codes and prescription data of 13 specific anti-seizure medications (ASM). Drug refractory (DR) patients with epilepsy were identified by treatment regime. Manually collected data from individual epilepsy centers validated the national results.</div></div><div><h3>Results</h3><div>This identification method determined national epilepsy prevalence was 0.67% of the German population with incidence of 0.09% and a female to male split of 49% to 51%. DR patients with epilepsy were determined at 36% of the epilepsy population.</div><div>The proportion of neurologists nationally available to treat patients outside of hospital was 30%, with state-by-state variation. The data analysis led to preliminary models of patient referral pathways for all patients with epilepsy. Of DR patients with epilepsy 59% were found not to have accessed appropriate outpatient center (OPC) treatment by referral, as recommended by the guidelines.</div></div><div><h3>Conclusion</h3><div>A persistence of under-referral of patients with epilepsy to epilepsy centers was identified. Patients with complex needs are too often inappropriately held in primary care. ASM prescribing highlights the need for structural and possibly policy-level reform in outpatient epilepsy care, to ensure patients with complex needs receive state of the art treatment at an appropriate OPC.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"138 ","pages":"Pages 157-166"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787292","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":"Sequential radiological manifestations in Dyke-Davidoff-Masson Syndrome—Comparison with recent systematic review","authors":"Suat Yee Lee ,&nbsp;Fatt Yang Chew","doi":"10.1016/j.seizure.2025.09.022","DOIUrl":"10.1016/j.seizure.2025.09.022","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 121-122"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145394819","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":"Are enlarged perivascular spaces a predictor of early post-traumatic seizures after traumatic brain injury?- A pilot study","authors":"G. Hlauschek ,&nbsp;B. Sinclair ,&nbsp;H․Flatmark Sødal ,&nbsp;E. Taubøll ,&nbsp;E. Helseth ,&nbsp;C․Buaas Tverdal ,&nbsp;P. Sowa ,&nbsp;P. Kwan ,&nbsp;T.J. O'Brien ,&nbsp;L. Vivash ,&nbsp;M. Law ,&nbsp;M.I. Lossius","doi":"10.1016/j.seizure.2026.02.010","DOIUrl":"10.1016/j.seizure.2026.02.010","url":null,"abstract":"<div><h3>Objective</h3><div>Post-traumatic epilepsy (PTE) is a significant long-term complication following traumatic brain injury (TBI), while early post-traumatic seizures (EPTS), occurring within the first week after TBI, are a critical risk factor that can elevate the likelihood of developing PTE later on. Here we investigate the potential of MRI-based enlarged perivascular space (ePVS) analysis as an imaging biomarker for acute in-hospital EPTS.</div></div><div><h3>Methods</h3><div>Forty patients who experienced a moderate-severe TBI with early post-traumatic seizures (EPTS+) (32.5% female, median age 52 years) and 88 patients without (EPTS-) (35.2% female, median age 53 years) were recruited from the Oslo University Hospital's head injury registry. PVS were measured on brain MRIs taken within one month post- TBI using an automated ePVS segmentation algorithm. The analysis included PVS count, volume, and asymmetry index (AI) across both hemispheres and vascular territories. Brain volume analysis was conducted using the FreeSurfer software suite, and PVS characteristics were compared between EPTS+ and EPTS- patients using non-parametric tests and generalized linear models.</div></div><div><h3>Results</h3><div>The study found no statistically significant differences in the number, volume, or asymmetry of ePVS between EPTS+ and EPTS- patients. Specifically, the median counts of ePVS and the volume fractions did not vary between the groups, indicating that ePVS did not correlate with the occurrence of EPTS in the studied cohort.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that ePVS may not be reliable biomarkers for predicting EPTS (after TBI). However, future longitudinal studies that track ePVS changes over time could better illuminate their relationship with PTE development. This approach may reveal critical mechanisms influencing seizure risk and identify potential intervention points for at-risk patients, ultimately enhancing strategies for managing TBI-related epilepsy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 86-92"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221763","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 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":"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}