Seizure-European Journal of Epilepsy最新文献

{"title":"The effects of low glycemic index diet on epileptic seizure frequency, oxidative stress, mental health, and health-related quality of life in children with drug-resistant epilepsy","authors":"Gamze Yurtdaş Depboylu ,&nbsp;Olgay Bildik ,&nbsp;Gülşah Kaner ,&nbsp;Pınar Gençpınar ,&nbsp;Nihal Olgaç Dündar","doi":"10.1016/j.seizure.2025.03.010","DOIUrl":"10.1016/j.seizure.2025.03.010","url":null,"abstract":"<div><h3>Aim</h3><div>There is a gap in the existing literature regarding the evaluation of the effects of low glycemic index diet (LGID) on Turkish patients with drug-resistant epilepsy (DRE), as well as the impact of an LGID on oxidative stress markers in this population. This study aimed to evaluate the efficacy of an LGID on seizure frequency, oxidative stress markers [malondialdehyde (MDA), paraoxonase-1 (PON-1), total antioxidant status (TAS), and total oxidant status (TOS)], mental health, and health-related quality of life (HRQOL) in Turkish children with DRE.</div></div><div><h3>Methods</h3><div>The study used a pre-post design without a control group and involved 34 children with DRE. Seizure frequency, dietary intake, anthropometry, and biochemical parameters were assessed at baseline and after 3 months of LGID treatment. Behavioral and emotional difficulties were assessed with the “Strengths and Difficulties Questionnaire (SDQ)”. The depressive symptoms were evaluated using the “Children's Depression Inventory (CDI)” and HRQOL was assessed with the “Pediatric Inventory of Quality of Life (PedsQL)”.</div></div><div><h3>Results</h3><div>Thirty of the 34 included children completed the three-month LGID treatment. By the study's end, 38.2 % (13/34) achieved &gt;50 % seizure reduction and 41.2 % (14/34) were seizure-free. Glucose (<em>p</em> &lt; 0.001), insulin (<em>p</em> = 0.005), CRP (<em>p</em> = 0.046), and triglyceride levels (<em>p</em> = 0.015) significantly decreased. MDA levels decreased (<em>p</em> &lt; 0.001), whereas PON-1 levels increased significantly (<em>p</em> = 0.035). There was a significant improvement in all subscales of the HRQOL (<em>p</em> &lt; 0.001), as well as the total HRQOL and CDI scores (<em>p</em> &lt; 0.001). According to the SDQ, the conduct problems, hyperactivity/inattention, and emotional symptoms scores were significantly decreased. There was a negative correlation between MDA (<em>r</em> = -0.512, <em>p</em> = 0.005) and LGID efficacy after 3 months of LGID. Serum levels of MDA and glucose were positively correlated (<em>r</em> = 0.412, <em>p</em> = 0.033).</div></div><div><h3>Conclusion</h3><div>LGID shows promise in reducing seizures and improving oxidative stress, mental health, and quality of life for pediatric DRE in the short term. Further research is needed to address the limitations (small sample size, no control group, etc.) and investigate LGID's long-term effects.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 57-65"},"PeriodicalIF":2.7,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671536","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":"Novel epilepsy phenotype associated with a pathogenic GABRG2 variant","authors":"Raid Hommady ,&nbsp;Vivek Pai ,&nbsp;Fay Zhai ,&nbsp;Ashish R. Deshwar ,&nbsp;Robyn Whitney ,&nbsp;Suvasini Sharma ,&nbsp;Puneet Jain","doi":"10.1016/j.seizure.2025.03.007","DOIUrl":"10.1016/j.seizure.2025.03.007","url":null,"abstract":"<div><div>None.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 101-104"},"PeriodicalIF":2.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686840","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":"Sodium channel blockers for the treatment of focal epilepsy: A Chinese expert consensus","authors":"Raowei Yan ,&nbsp;Hesheng Zhang ,&nbsp;Zhen Hong ,&nbsp;Weiping Liao ,&nbsp;Xuefeng Wang ,&nbsp;Yuping Wang ,&nbsp;Bo Xiao ,&nbsp;Yanchun Deng ,&nbsp;Meiping Ding ,&nbsp;Xiong Han ,&nbsp;Shuli Liang ,&nbsp;Weihong Lin ,&nbsp;Xiaorong Liu ,&nbsp;Xuewu Liu ,&nbsp;Xin Wang ,&nbsp;Tiancheng Wang ,&nbsp;Xiangqing Wang ,&nbsp;Xiaoshan Wang ,&nbsp;Peimin Yu ,&nbsp;Kai Zhang ,&nbsp;Dong Zhou","doi":"10.1016/j.seizure.2025.02.016","DOIUrl":"10.1016/j.seizure.2025.02.016","url":null,"abstract":"<div><h3>Purpose</h3><div>To provide consensus-based recommendations for the use of sodium channel blockers (SCBs) in the management of focal epilepsy.</div></div><div><h3>Methods</h3><div>A three-round modified Delphi procedure was conducted among a Delphi panel of 24 Chinese experts to build a consensus. A steering committee developed 9 statements related to SCBs for the treatment of focal epilepsy, and these statements were evaluated and voted upon by the expert panel.</div></div><div><h3>Results</h3><div>The expert panel achieved consensus on nine statements regarding the treatment recommendations for oxcarbazepine, lamotrigine, lacosamide, eslicarbazepine, topiramate, zonisamide and cenobamate in focal epilepsy patients and treatment adjustments for SCBs.</div></div><div><h3>Conclusion</h3><div>This is a Chinese expert consensus on the use of SCBs in focal epilepsy developed using the modified Delphi method. These recommendations can help clinicians in their practice and guide future research.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 105-114"},"PeriodicalIF":2.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686248","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":"Establishing essential clinical data elements for efficient epilepsy care in time-limited settings","authors":"Yong Seo Koo ,&nbsp;Tae Young Kim ,&nbsp;Seo-Young Lee ,&nbsp;Woo-Jin Lee ,&nbsp;Hunmin Kim ,&nbsp;Young-Min Shon ,&nbsp;The Research committee of Korean Epilepsy Society","doi":"10.1016/j.seizure.2025.03.008","DOIUrl":"10.1016/j.seizure.2025.03.008","url":null,"abstract":"<div><h3>Purpose</h3><div>We aimed to develop a core set of common data elements (CDEs) for routine epilepsy care to enhance consistency and efficiency within time-limited clinical environments.</div></div><div><h3>Methods</h3><div>We employed a modified Delphi method involving epileptologists from university-affiliated hospitals. Participants rated the feasibility and importance of proposed CDEs over three survey rounds. The primary objective was to create feasible CDEs for EHR integration that capture essential clinical information during 5–10-minute consultations. Participant feedback guided iterative refinements, culminating in two templates: follow-up notes and initial/periodic evaluations.</div></div><div><h3>Results</h3><div>Of the 68 invited epileptologists, 61 (89.7 %) participated. In Round 1, consensus (≥67 % agreement) was achieved on 5 of 6 CDEs for follow-up notes and 22 of 28 for initial/periodic evaluations. After three rounds, consensus was reached on 6 follow-up note CDEs and 20 initial/periodic evaluation CDEs, including seizure frequency, date of last seizure, and medication changes. Most participants endorsed the necessity (98 %) of clinical CDEs and intended to implement them (97 %).</div></div><div><h3>Conclusion</h3><div>These core CDEs provide a practical, consensus-based framework for standardizing epilepsy care in South Korea under short consultation constraints. They can improve consistency and quality of care across institutions. Future initiatives will expand the CDEs to other patient subgroups, integrate patient-reported outcomes, and embed the templates in EHR systems for clinical and research applications.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 50-56"},"PeriodicalIF":2.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671530","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":"Thalamic volumetric analysis in Developmental and/or Epileptic Encephalopathy with Spike Wave Activation in Sleep (D/EE-SWAS): A cross-sectional study","authors":"Gautam Kamila ,&nbsp;Prashant Jauhari ,&nbsp;Atin Kumar ,&nbsp;Sonali Singh ,&nbsp;Biswaroop Chakrabarty ,&nbsp;Sheffali Gulati ,&nbsp;RM Pandey","doi":"10.1016/j.seizure.2025.03.006","DOIUrl":"10.1016/j.seizure.2025.03.006","url":null,"abstract":"<div><h3>Objectives</h3><div>This cross-sectional study compared the thalamic volume (TV) of children with Developmental and/or Epileptic Encephalopathy with Spike-Wave Activation in Sleep (D/EE-SWAS) with age matched children with well-controlled epilepsy(WCE).</div></div><div><h3>Methods</h3><div>An unaided eye assessment of T1-weighted brain MRI sequences and quantitative volumetric analysis through “volBrain” online software was performed in children (5–12 years) with steroid-naïve D/EE-SWAS {spike-wave-index(SWI) in sleep≥50 %} and typically developing children with WCE (seizure-free period ≥1-year). The absolute and relative thalamic volume (ATV/RTV) (RTV: thalamic volume as percentage of the total intracranial volume), were compared between the two groups.</div></div><div><h3>Results</h3><div>Twenty-children each with D/EE-SWAS (14 boys; mean age: 8.05±1.76 years) and WCE (15 boys; mean age: 9.1 ± 1.74 years) were analysed. In the D/EE-SWAS group, (16/20) 80% of participants had a structural lesion while all the children in the WCE group had a presumed genetic etiology. Volumetric analysis detected low ATV (&lt;2 standard deviation) in 12/20 (60 %) children with D/EE-SWAS while unaided eye assessment could pick up thalamic involvement only in six (30 %). On comparison with WCE group (N = 20), mean ATV and RTV in structural D/EE-SWAS (<em>n</em> = 16) [(7.25 cm³ ± 1.66 versus 11.17 cm³ ± 1.22; <em>p</em> &lt; 0.0001)(0.73 % ± 0.17 versus 0.87 % ± 0.05; <em>p</em> &lt; 0.001)] and presumed genetic D/EE-SWAS (<em>n</em> = 4) [(9.25 cm³ ± 0.55, versus 11.17 cm³ ± 1.22, <em>p</em> &lt; 0.01)(0.74 % ± 0.04 versus 0.87 % ± 0.05; <em>p</em> &lt; 0.0001)] were significantly reduced. ATV did not correlate with SWI in sleep EEG (<em>r</em> =-0.25) in D/EE-SWAS.</div></div><div><h3>Conclusion</h3><div>Thalamic volume is reduced in majority of children with D/EE-SWAS in both structural and presumed genetic etiology.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 94-100"},"PeriodicalIF":2.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686249","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":"Evaluation of lateralization and localization value of hand postures in Pediatric Epilepsy","authors":"Deniz MENDERES ,&nbsp;Tuğba HIRFANOĞLU ,&nbsp;Esra SERDAROĞLU ,&nbsp;Ayşe SERDAROĞLU ,&nbsp;Ebru ARHAN","doi":"10.1016/j.seizure.2025.03.005","DOIUrl":"10.1016/j.seizure.2025.03.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Identifying epileptogenic zone is essential for selecting patients for epilepsy surgery and understanding seizure pathophysiology. This study aimed to evaluate the role of ictal hand postures in localization and lateralization value in children.</div></div><div><h3>Material and methods</h3><div>We conducted a retrospective evaluation of 628 individuals utilizing long-term video EEG recordings of Gazi University Video EEG Monitoring Unit (VEMU) between 2013 and 2022. Distinct hand postures were identified in fifty-six patients. The localization and lateralization value of the hand postures identified in these patients were assessed.</div></div><div><h3>Results</h3><div>A total of 91 seizures from 56 patients were analyzed, and hand postures were categorized as fist, thumb upside fist (TUF), fanning, holding, index-finger pointing (IFP), and pincer grasp. Fist posture was most frequently observed in frontal lobe seizures, while TUF was dominant in temporal lobe seizures. Fanning was primarily associated with generalized seizures. Lateralization analysis revealed that ipsilateral postures were more common in frontal lobe seizures, whereas contralateral postures were prevalent in temporal lobe seizures (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>In conclusion, ictal hand postures may serve as a straightforward and accessible tool for identifying seizure onset zones in children, especially in resource-limited settings. Semiological classification plays a crucial role in the interpretation of video EEG. Accurate identification of semiological manifestations can facilitate timely referral of patients with suspected drug-resistant focal epilepsy for presurgical evaluation.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 71-76"},"PeriodicalIF":2.7,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of treatment with levetiracetam and valproate in idiopathic generalized epilepsy","authors":"Nasim Tabrizi ,&nbsp;Hamed Cheraghmakani ,&nbsp;Fahimeh Samadi ,&nbsp;Reza Alizadeh-Navaei","doi":"10.1016/j.seizure.2025.03.004","DOIUrl":"10.1016/j.seizure.2025.03.004","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to compare the efficacy and tolerability of valproate and levetiracetam monotherapy in patients with juvenile myoclonic epilepsy and epilepsy with generalized tonic-clonic seizure alone.</div></div><div><h3>Methods</h3><div>This retrospective-prospective cohort study was conducted on 170 adult patients who commenced monotherapy with valproate or levetiracetam between March 2019 and March 2023. The study outcomes were seizure-free rate, time to first seizure, retention rate, time to withdrawal and adverse events, which were registered following a one-to-five-year follow-up period.</div></div><div><h3>Results</h3><div>The seizure-free rates of levetiracetam and valproate were comparable in the one-year follow-up (65.9 % vs. 62.4 %, p:0.74) and in favor of levetiracetam in the five-year follow-up (90.9 % vs. 44.4 %, p:0.05). The retention rate of levetiracetam was higher than valproate (97.6 % vs. 82.4 % in the first year and 55.2 % vs. 21.6 % in the fifth year). The time to first seizure was found to be similar between the two groups (<em>p</em> = 0.43), but the time to withdrawal was significantly longer in patients on levetiracetam (<em>p</em> &lt; 0.001). The incidence of adverse events was comparable between the two groups. However, the withdrawal rate due to adverse events was significantly higher in the valproate group. Levetiracetam demonstrated a higher occurrence of psychiatric adverse events, which were addressed with dose adjustments and psychiatric intervention in 37.6 % of patients but resulted in drug discontinuation in 3.5 % of cases.</div></div><div><h3>Conclusion</h3><div>The findings of this study indicate that levetiracetam monotherapy may represent an efficacious alternative to valproate in patients with juvenile myoclonic epilepsy and epilepsy with generalized tonic-clonic seizure alone, particularly in women of reproductive age.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 66-70"},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Omega-3 fatty acid supplementation support the clinical management of drug-resistant epilepsy? A meta-analysis of randomized controlled trials","authors":"Xianghong Meng ,&nbsp;Wu-Chen Wu ,&nbsp;Kequan Zhou","doi":"10.1016/j.seizure.2025.03.003","DOIUrl":"10.1016/j.seizure.2025.03.003","url":null,"abstract":"<div><div>Approximately 30-40% of individuals with epilepsy develop drug-resistant epilepsy (DRE), a condition associated with substantial socioeconomic and psychological burdens for patients and their families. As standard anti-epileptic therapies often prove insufficient, alternative treatments have become a critical area of research. Dietary interventions, such as the ketogenic diet, have shown promise, and emerging evidence highlights the potential role of omega-3 fatty acids, particularly docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), due to their neuroprotective and anticonvulsant properties. However, the clinical application of omega-3 fatty acids for DRE remains uncertain due to limited high-quality randomized controlled trials (RCTs). To address this gap, we conducted a meta-analysis incorporating newly published RCTs to evaluate the clinical efficacy of omega-3 fatty acid supplementation as an adjunct to standard anti-epileptic medications in both children and adults with DRE. Our meta-analysis, incorporating high-quality RCTs, provides moderate-certainty evidence that omega-3 fatty acid supplementation, particularly at doses between 0.3 and 1.7 g/day, is associated with a reduction in seizure frequency in individuals with DRE. Notably, larger RCTs (sample size &gt;30) demonstrated more consistent favorable outcomes. However, the evidence primarily reflects short-term effects, as the majority of included studies were of limited duration. These findings underscore the potential role of omega-3 fatty acids as an adjunctive therapy for DRE while highlighting the need for larger, long-term trials to better understand their clinical utility.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 77-87"},"PeriodicalIF":2.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of ICD codes for the identification of patients with functional seizures","authors":"Jonah Fox,&nbsp;Hannah E. Branstetter,&nbsp;Robert Havranek,&nbsp;Murli Mishra,&nbsp;Nicholas S. Mallett","doi":"10.1016/j.seizure.2025.03.002","DOIUrl":"10.1016/j.seizure.2025.03.002","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the validity of ICD-9-CM and ICD-10 codes for the identification of patients with functional seizures (FS).</div></div><div><h3>Methods</h3><div>We evaluated the charts of 800 patients including 400 in an institution wide sample and 400 in an epilepsy monitoring unit (EMU) sample. Half of the patients from each sample came from 2012–2013 and 2022–2023 since ICD-9-CM codes and ICD-10 codes were exclusively used in these respective periods. The charts of each patient were manually reviewed and evaluated for the presence of epilepsy and FS. Based on the 2013 International League Against Epilepsy (ILAE) Nonepileptic Seizures Task Force guidelines we determined whether a patient had either presumptive (clinically established or documented) or probable/possible FS. We evaluated ICD-9-CM codes 300.11 (conversion disorder) and 780.39 (other convulsions) as well as ICD-10 codes F44.5 (conversion disorder or functional neurological disorder with seizures or convulsions) and R56.9 (unspecified convulsions). The positive predictive value (PPV) of each ICD code was calculated in the institution wide sample and the sensitivity, specificity, PPV and negative predictive values (NPV) were calculated in the EMU sample.</div></div><div><h3>Results</h3><div>In the institution wide sample, F44.5 had a PPV of 74.0 % (64.6–81.6) for presumptive FS and 80.0 % (71.1–86.7) when probable/possible FS patients were included. The code 300.11 had a PPV of 52.0 % (42.3–61.5) for presumptive FS and 59.0 % (49.2–68.1) when probable/possible FS patients were included. Codes R56.9 and 780.39 had PPVs that were equal to or less than 20 %. In the EMU sample, the code F44.5 had a sensitivity, specificity, PPV and NPV of 67.1 % (56.3–76.3), 95.8 % (90.5–98.2), 91.7 % (81.9–96.4), and 80.7 % (73.4–86.4), respectively for presumptive FS. The code 300.11 had a sensitivity, specificity, PPV and NPV of 30.1 % (20.8–41.4), 95.3 % (90.1–97.8), 78.6 % (60.5–89.8), and 70.4 % (63.1–76.7), respectively for presumptive FS. The codes R56.9 and 780.39 performed poorly.</div></div><div><h3>Significance</h3><div>ICD codes had a mixed performance when used to identify patients with FS. ICD-10 code F44.5 appeared to perform the best overall.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 44-49"},"PeriodicalIF":2.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of a unique patient cohort with spike-wave activation in sleep without cognitive decline or increased seizure burden: Considerations for a more conservative treatment approach","authors":"Rene Andrade Machado ,&nbsp;Jennifer Meylor ,&nbsp;Shruti L. Narayan ,&nbsp;Natalie B. Norton","doi":"10.1016/j.seizure.2025.03.001","DOIUrl":"10.1016/j.seizure.2025.03.001","url":null,"abstract":"<div><h3>Objective</h3><div>The goal of this study is to better characterize a unique subset of patients who present with so-called “isolated SWAS” (Spike Wave Activation in Sleep) by analyzing electrographic and neuropsychological data.</div></div><div><h3>Methods</h3><div>We evaluated our institution's population of patients with SWAS, defined as &gt;/= 50 % spike-wave index potentiated during slow-wave sleep. Of this group, 26 patients were identified with no worsening cognitive performance or seizure burden at the time of diagnosis, deemed “isolated SWAS”, in comparison to patients with Developmental and/or Epileptic Encephalopathy (D/EE)-SWAS. Paraclinical studies of this cohort were analyzed, including high-frequency oscillations, specifically on scalp electroencephalogram as well as comprehensive behavioral and neuropsychologic data at one-year follow-up.</div></div><div><h3>Results</h3><div>We found that 80 % (n=21) of the cohort was started on a unique treatment for SWAS at the time of diagnosis, with the most common treatment being clobazam (n=12; 57 %) followed by valproic acid (n=9; 43 %). The cognitive performance of patients who received treatment and those who did not receive treatment was not statistically significant, and after one year of follow-up the patients who did not receive treatment for SWAS had no cognitive decline. Furthermore, the treatment group reported more medication side effects (n=14/21; 67 %). Seven patients (27 %) of the cohort continued to have SWAS at follow-up, and 11 patients (42 %) had ongoing seizures. The presence of ripples did not correlate with cognitive outcomes.</div></div><div><h3>Significance</h3><div>This study suggests that if patients have “isolated-SWAS” at the time of diagnosis a more conservation approach may be considered.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 115-126"},"PeriodicalIF":2.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}