Seizure-European Journal of Epilepsy最新文献

{"title":"Before status epilepticus in epilepsy patients is attributed to the SARS-CoV-2 vaccination, alternative causes must be ruled out","authors":"Josef Finsterer","doi":"10.1016/j.seizure.2024.10.014","DOIUrl":"10.1016/j.seizure.2024.10.014","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 119-120"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147402149","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":"Electroencephalography in the differential diagnosis of non-epileptic paroxysmal events in infants: clinical utility and other predictors","authors":"Hilal Karpuzcu ,&nbsp;Fatih Mehmet Kışlal ,&nbsp;Didem Ardıçlı ,&nbsp;Deniz Yılmaz (Clinical assessment)","doi":"10.1016/j.seizure.2026.02.006","DOIUrl":"10.1016/j.seizure.2026.02.006","url":null,"abstract":"<div><h3>Background</h3><div>Differentiating non-epileptic paroxysmal events (NEPE) from epileptic seizures in infants is challenging, especially in the 1–24 month age group where features overlap and data are limited. Meanwhile restricting studies to the first year may lead to overlook the events that persist into the second year. This study aimed to define the clinical spectrum of NEPE, assess diagnostic yield of electroencephalography (EEG), and identify predictors of specific subtypes.</div></div><div><h3>Methods</h3><div>This single-center, retrospective study included infants aged 1–24 months who underwent EEG for suspected NEPE between January 2015 and March 2021. Demographic, clinical, laboratory, neuroimaging, and EEG data were analyzed per Strengthening the reporting of observational studies in epidemiology (STROBE) guidelines.</div></div><div><h3>Results</h3><div>Of 5614 infants assessed, 1465 underwent EEG, and 216 (mean age 11.1 ± 6.5 months; 55.1% male) met inclusion criteria. Breath holding spells (BHS) were most frequent (55.1%), followed by jitteriness (10.6%) and shuddering attacks (9.3%). Crying was the predominant trigger for BHS (97.5%, <em>p</em> &lt; 0.001). EEG was abnormal in 8.8% of patients. Anemia was present in 23.4%. Independent predictors of BHS were crying (AOR 28.7), age 13–18 months (AOR 3.95), and anemia (AOR 2.65).</div></div><div><h3>Conclusions</h3><div>Most infants aged 1–24 months with suspected NEPE, had normal EEG, indicating limited diagnostic yield for epileptiform abnormalities. Age, specific triggers, and anemia can guide diagnosis and help to target EEG use to selected cases, thereby supporting more judicious resource utilization and avoiding unnecessary antiseizure medication.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 77-85"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214730","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":"Preoperative positron emission tomography for predicting postoperative epilepsy risk: A radiomics and clinical feature-based fusion model","authors":"Di Zhang,&nbsp;Zi-Hao Wang,&nbsp;Yan Feng,&nbsp;Yu-Tian Wang,&nbsp;Shun-Yao Zhang,&nbsp;Wen-Ling Li","doi":"10.1016/j.seizure.2026.01.018","DOIUrl":"10.1016/j.seizure.2026.01.018","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy is a common neurological disorder characterized by recurrent seizures, and predicting the risk of postoperative epilepsy is critical for patient management. The integration of radiomics and clinical factors offers a promising approach for accurate risk assessment.</div></div><div><h3>Methods</h3><div>In this study, preoperative positron emission tomography (PET) imaging and clinical data of 197 epilepsy patients were analyzed. The imaging features were extracted from three-dimensional regions of interest (ROIs). Key radiomics features were selected using the SelectKBest and the Least Absolute Shrinkage and Selection Operator (LASSO), while key clinical features were identified through univariate and multivariate analyses. Three models—radiomics, clinical, and fusion (fusing radiomics and clinical features)—were constructed using the Support Vector Machine (SVM) and Multilayer Perceptron (MLP) algorithms. The models were evaluated based on sensitivity, specificity, and area under the curve (AUC). A nomogram based on the best-performing model was developed and assessed for predictive accuracy using calibration and decision curve analysis (DCA) to estimate the risk of postoperative epilepsy following neurosurgery.</div></div><div><h3>Results</h3><div>A total of 11 key radiomics features were identified, with prior brain damage (PBD) as the key clinical feature. The MLP fusion model demonstrated the highest predictive performance, with an AUC of 0.85 in the validation set. The nomogram showed good predictive accuracy and superior clinical utility.</div></div><div><h3>Conclusion</h3><div>The integration of radiomics and clinical features provides a more accurate and clinically useful tool for predicting postoperative epilepsy risk. The fusion model demonstrates significant potential in guiding clinical decision-making and personalized treatment for epilepsy patients.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 93-101"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229547","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":"Evolution of disparities in pediatric epilepsy surgery use over two decades","authors":"Alex S. Aguirre ,&nbsp;Ellen C. Broekhuizen ,&nbsp;Daan A. Pijs ,&nbsp;Iván Sánchez Fernández","doi":"10.1016/j.seizure.2026.01.020","DOIUrl":"10.1016/j.seizure.2026.01.020","url":null,"abstract":"<div><h3>Objective</h3><div>To describe how disparities in the use of epilepsy surgery have evolved between 2004 and 2024 among children with drug-resistant epilepsy.</div></div><div><h3>Methods</h3><div>Retrospective descriptive study using the Pediatric Health Information System database. Outcomes were use of epilepsy surgery and time from first diagnosis of drug-resistant epilepsy to epilepsy surgery, main predictors were type of insurance, race, and ethnicity.</div></div><div><h3>Results</h3><div>We studied 50,953 patients with drug-resistant epilepsy (median (p₂₅-p₇₅) age: 8.0 (3.5–13.4) years, 54% males), of whom 7220 (14.2%) patients had at least one epilepsy surgery. The number of epilepsy surgeries per 100 person-years increased from 4.0 in 2004–2006 to 15.8 in 2022–2024. On multivariable analysis, the odds ratio (OR) of receiving epilepsy surgery for patients with private versus public insurance increased from OR: 1.50 (1.25–1.80) in 2004–2006 to OR: 1.75 (1.50–2.04) in 2022–2024; increased for White patients versus Black patients from OR: 1.35 (1.03–1.76) in 2004–2006 to OR: 2.39 (1.86–3.08) in 2022–2024; and increased for Not Hispanic/Latino patients versus Hispanic/Latino patients from OR: 1.08 (0.85–1.38) in 2007–2009 (first years with the “Not Hispanic/Latino” category) to OR: 1.23 (1.01–1.51) in 2022–2024. On multivariable Cox regression analysis, the hazard ratio (HR) of receiving epilepsy surgery for patients with private insurance versus public insurance increased from HR: 1.55 (1.32–1.82) in 2004–2006 to HR: 1.92 (1.65–2.24) in 2022–2024; increased for White patients versus Black patients from HR: 1.46 (1.14–1.86) in 2004–2006 to HR: 2.67 (2.05–3.48) in 2022–2024; and increased for Not Hispanic/Latino patients versus Hispanic/Latino patients from HR: 1.20 (0.96–1.51) in 2007–2009 to HR: 1.30 (1.06–1.60) in 2022–2024.</div></div><div><h3>Conclusion</h3><div>Despite increasing use of epilepsy surgery in pediatric patients with drug-resistant epilepsy between 2004 and 2024, disparities by type of insurance, race, and ethnicity are widening.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 4-11"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102611","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":"Corrigendum to “Optimal cutoff score for diagnosing generalized anxiety disorder with the Generalized Anxiety Disorder 7-item scale in people living with epilepsy: A systematic review with diagnostic test accuracy meta-analysis” [Seizure: European Journal of Epilepsy 134 (2026) 229237]","authors":"Minjung Kim ,&nbsp;Rock Bum Kim ,&nbsp;Tae-Won Yang ,&nbsp;Young-Soo Kim ,&nbsp;Do-Hyung Kim ,&nbsp;Oh-Young Kwon","doi":"10.1016/j.seizure.2026.01.007","DOIUrl":"10.1016/j.seizure.2026.01.007","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Page 12"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102613","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":"Syncope due to loss of ventricular capture during sleep misdiagnosed as epilepsy: A case report","authors":"Pavithra Murugesan ,&nbsp;Matthias Dullaert ,&nbsp;Frederic Van Heuverswyn ,&nbsp;Alfred Meurs ,&nbsp;Stephanie Hödl","doi":"10.1016/j.seizure.2026.02.003","DOIUrl":"10.1016/j.seizure.2026.02.003","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 66-68"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190815","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":"Corrigendum to “Does 7 T MRI offer an added value in drug resistant temporal lobe epilepsy?” [Seizure: European Journal of Epilepsy 134 (2026) 27–36]","authors":"Ariadne Zampeli ,&nbsp;Miroslav Malac ,&nbsp;Isabella M. Björkman-Burtscher ,&nbsp;Boel Hansson ,&nbsp;Linda Wennberg ,&nbsp;Karin Markenroth Bloch ,&nbsp;Kristina Källén ,&nbsp;Maria Compagno Strandberg","doi":"10.1016/j.seizure.2026.02.008","DOIUrl":"10.1016/j.seizure.2026.02.008","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Page 76"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203471","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":"Lamotrigine as an antiseizure medication in pregnancy","authors":"Frank J.E. Vajda ,&nbsp;Terence J. O’Brien ,&nbsp;Janet E. Graham ,&nbsp;Alison E. Hitchcock ,&nbsp;Piero Perucca ,&nbsp;Cecilie M. Lander ,&nbsp;Mervyn J. Eadie","doi":"10.1016/j.seizure.2026.02.001","DOIUrl":"10.1016/j.seizure.2026.02.001","url":null,"abstract":"<div><h3>Aim</h3><div>To try to ascertain in APR data why lamotrigine was the preferred ASM in treating women with epilepsy,</div></div><div><h3>Method</h3><div>Statistical analysis of foetal malformation and seizure free pregnancy occurrence rates associated with lamotrigine use in monotherapy and polytherapy</div></div><div><h3>Results</h3><div>Among commonly used ASMs, lamotrigine (4.6%) and levetiracetam (4.5%) in monotherapy had the lowest associated foetal malformation rates, compared with a 3.2% rate in ASM-untreated pregnancy in women with epilepsy. The lamotrigine monotherapy seizure freedom rate during pregnancy (56.6%) was lower than that associated with all other ASM monotherapy combined (68.7%; R.R. 1.21, 95% C.I. 1.12, 1.32).</div></div><div><h3>Conclusion</h3><div>Those prescribing ASM therapy for women capable of pregnancy seem to have given priority to avoiding foetal malformation over achieving seizure freedom in pregnancy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 18-22"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138047","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 cenobamate-based combination therapy in drug-resistant epilepsy: Secondary analysis by mechanisms of action of concomitant antiseizure medications","authors":"Magdalena Bosak ,&nbsp;Hanna Podraza ,&nbsp;Dorota Włoch-Kopeć ,&nbsp;Andrzej Rysz ,&nbsp;Kamil Wężyk ,&nbsp;Katarzyna Grabska-Radzikowska ,&nbsp;Piotr Sobolewski ,&nbsp;Tomasz Siwek ,&nbsp;Iwona Kurkowska-Jastrzębska ,&nbsp;Monika Służewska-Niedźwiedź ,&nbsp;Katarzyna Sulima ,&nbsp;Lech Kipiński ,&nbsp;Lidia Kiryła ,&nbsp;Katarzyna Stopińska ,&nbsp;Elżbieta Płonka-Półtorak ,&nbsp;Justyna Tabaka-Pradela ,&nbsp;Magdalena Konopko ,&nbsp;Agnieszka Meller ,&nbsp;Monika Chorąży ,&nbsp;Maja Kopytek-Beuzen ,&nbsp;Katarzyna Zawiślak-Fornagiel","doi":"10.1016/j.seizure.2026.02.013","DOIUrl":"10.1016/j.seizure.2026.02.013","url":null,"abstract":"<div><h3>Introduction</h3><div>In a secondary analysis of a cohort of 475 adults with drug-resistant epilepsy treated with adjunctive cenobamate, we assessed whether treatment outcomes were influenced by concomitant antiseizure medication class and cenobamate dose.</div></div><div><h3>Materials and methods</h3><div>Concomitant antiseizure medications (ASMs) were grouped as sodium channel blockers (SCBs), SV2A ligands, valproate, carbonic anhydrase inhibitors, or GABA analogs. Efficacy and safety outcomes were analyzed using multivariate logistic regression, adjusting for confounders.</div></div><div><h3>Results</h3><div>Baseline use of valproate was associated with higher odds of achieving ≥50 % seizure reduction and seizure freedom, whereas SCB co-therapy was associated with lower odds of seizure freedom. At the final follow-up, these efficacy differences largely disappeared, except that SCB use modestly favored ≥50 % response. SCB co-medication was associated with a decreased risk of somnolence, while the presence of an SV2A ligands, valproate, or carbonic anhydrase inhibitors was correlated with lower treatment discontinuation rates. Cenobamate dose showed no significant association with achieving ≥50 % response, seizure freedom, or overall AE occurrence, reflecting the pragmatic character of the studied cohort.</div></div><div><h3>Conclusion</h3><div>Cenobamate demonstrated optimal efficacy when combined with valproate and broad-spectrum agents, and suboptimal efficacy when coadministered with SCB. Substantial seizure improvements were often achieved at moderate doses of cenobamate, underscoring the value of individualized titration and comedication management.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 102-106"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776848","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":"Automatic recognition of epileptic spasm via large-scale visual AI model","authors":"Jialu Xu ,&nbsp;Chenyu Yan ,&nbsp;Xiaoyan Shen ,&nbsp;Tiejia Jiang ,&nbsp;Wencong Ruan ,&nbsp;Haifeng Li ,&nbsp;Ning Ma","doi":"10.1016/j.seizure.2026.01.009","DOIUrl":"10.1016/j.seizure.2026.01.009","url":null,"abstract":"<div><h3>Purpose</h3><div>To develop effective visual AI recognition models for epileptic spasm (ES), and to promote the professionalism and convenience of ES detection.</div></div><div><h3>Method</h3><div>We collected about 330 hours of infant motion videos with epileptic spasm in Children's Hospital, Zhejiang University School of Medicine from November 2022 to October 2024. A video-centered AI model was constructed, with a pre-trained Vision Transformer (ViT) via Contrastive Language-Image Pre-training (CLIP), serving as the core to extract spatial features. Additionally, a temporal convolution module was integrated to extract temporal information and a multi-layer perceptron was used to perform a normal-abnormal binary classification task. Focal loss was applied to mitigate class imbalance, prioritizing the learning of hard-to-classify samples. The model was trained for 100 epochs with 5-times random dataset splitting, in which the dataset was partitioned by individual infants to ensure disjoint training and test sets. Model performance was validated using metrics (including Precision, Recall, F-score, Accuracy, AUROC) based on test set results.</div></div><div><h3>Results</h3><div>The median age of ES onset was 0.4 (0.3, 0.7) years. All patients exhibited isolated or clustered epileptic spasms. By employing a CLIP-based classifier, the system reached a recall rate of 1.00 ± 0.00, a precision of 0.78 ± 0.01, an F-score of 0.87 ± 0.01, an accuracy of 0.98 ± 0.01, and an AUROC of 0.99 ± 0.01 in detecting epileptic spasm — outperforming previously reported methods. Case studies involving four infants’ motion videos showed a high degree of consistency between the model’s predictions and expert annotations. The model effectively distinguished ES episodes from normal patterns, even in videos with multiple intermittent ES segments.</div></div><div><h3>Conclusion</h3><div>We developed an automatic motion recognition model that holds significant potential in early automated detection of ES.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"136 ","pages":"Pages 23-30"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144495","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}