Seizure-European Journal of Epilepsy最新文献

{"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}

{"title":"Aging and Late-Onset Epilepsy: An urgent call for action!","authors":"Christoph Helmstaedter, Hermann Stefan, Friedhelm Schmitt, Markus Reuber","doi":"10.1016/j.seizure.2025.02.017","DOIUrl":"https://doi.org/10.1016/j.seizure.2025.02.017","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587871","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":"Authors’ response to letter by Amanda Medeiros Fernandes et al.","authors":"Yu Zhang ,&nbsp;Haijiao Wang ,&nbsp;Ling liu","doi":"10.1016/j.seizure.2024.12.018","DOIUrl":"10.1016/j.seizure.2024.12.018","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Page 116"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025426","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":"Heading: When change creates chaos - A dilemma with brand versus generic antiseizure medications,,","authors":"Khushboo Verma,&nbsp;Sisira Yadala","doi":"10.1016/j.seizure.2024.12.005","DOIUrl":"10.1016/j.seizure.2024.12.005","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 117-118"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684179","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":"Incidence and independently associated variables of acute postoperative seizures after epilepsy surgery","authors":"Wei Ma ,&nbsp;Yufu Zhang ,&nbsp;Long Chen","doi":"10.1016/j.seizure.2025.02.015","DOIUrl":"10.1016/j.seizure.2025.02.015","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the incidence and independently associated variables of acute postoperative seizures (APOS) occurring in the first postoperative week after resective epilepsy surgery.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed clinical data from consecutive patients who underwent resective epilepsy surgery in a tertiary hospital. The clinical characteristics of patients with and without APOS were compared, and binary logistic regression was used to identify the independently associated variables of APOS.</div></div><div><h3>Results</h3><div>Of the 1269 epilepsy surgeries (1261 patients) included in this analysis, 10.6 % (134/1269) resulted in APOS. Univariate analysis showed that sex, age at surgery, epilepsy duration, seizure frequency, number of anti-seizure medications (ASMs) at the time of surgery, drug resistant epilepsy (DRE); previous surgery, interictal EEG, intracranial monitoring, surgical extent, and complications were associated with APOS. When surgery was limited to a single brain lobe, frontal and parietal lobe surgery were more likely to result in APOS than temporal lobe surgery (11.7 %, 17.2 % vs<em>.</em> 7.5 %, <em>p</em> = 0.033, 0.008, respectively). Multivariate analysis demonstrated that an epilepsy duration of ≥3.75 years (OR 1.789 95 % CI 1.128–2.837 <em>p</em> = 0.013), using ≥3 types of ASMs at the time of surgery (OR 1.649 95 % CI 1.025–2.652 <em>p</em> = 0.039), and complications (OR 1.761 95 % CI 1.179–2.628 <em>p</em> = 0.006) were the independently associated variables of APOS. Postoperative seizure outcome at last follow-up was significantly worse in patients with APOS than in those without (Engel class Ⅰ: 41.1 % vs<em>.</em> 70.4 % <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The overall incidence of APOS in our cohort was moderate. Surgery for temporal lobe epilepsy was less likely to result in APOS. Early surgery, use of fewer ASMs, and control of complications were independently associated with a lower incidence of APOS.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"129 ","pages":"Pages 9-13"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714418","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":"What are the risk factors for suicide-related events in patients with epilepsy? A critical review of methodology and evidence","authors":"Amanda Medeiros Fernandes ,&nbsp;Ana Zélia Abreu Pires de Sousa ,&nbsp;Fabio Gomes de Matos e Souza ,&nbsp;Luísa Weber Bisol","doi":"10.1016/j.seizure.2024.12.016","DOIUrl":"10.1016/j.seizure.2024.12.016","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 114-115"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684178","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":"Author's reply to comment “When changes creates chaos”","authors":"Magdalena Bosak","doi":"10.1016/j.seizure.2024.12.015","DOIUrl":"10.1016/j.seizure.2024.12.015","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Page 119"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041368","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":"Impact of vagus nerve stimulation on refractory epilepsy with myoclonic atonic seizures: Case series insights","authors":"Fatima Jaafar ,&nbsp;Christian Kaufman ,&nbsp;Leena Abdelmoity ,&nbsp;Ahmed Madkoor ,&nbsp;Kailash Pawar ,&nbsp;Julie Kostreva ,&nbsp;Lalit Bansal","doi":"10.1016/j.seizure.2025.02.014","DOIUrl":"10.1016/j.seizure.2025.02.014","url":null,"abstract":"<div><h3>Purpose</h3><div>Epilepsy with myoclonic atonic seizures (EMAtS) is a rare childhood-onset developmental and epileptic encephalopathy, often resistant to pharmacologic treatments and is associated with significant cognitive impairments. Early seizure control is crucial for optimal neurodevelopmental outcomes. This study describes seizure frequency and neurodevelopmental outcome following vagus nerve stimulation (VNS) implantation in children with EMAtS.</div></div><div><h3>Methods</h3><div>We conducted a retrospective review of pediatric patients with EMAtS who underwent VNS implantation to treat their refractory seizures from 2011 to May 2024.</div></div><div><h3>Results</h3><div>Six pediatric patients with EMAtS underwent VNS implantation and were followed for an average of 4.6 years post implantation. Six months post-VNS activation, significant improvement in seizure frequency or intensity was observed in five patients, with four achieving a mean seizure reduction of 76 %. At the last follow-up (mean of 8.1 years), three patients were seizure-free. Positive neuropsychological outcomes were present in four patients.</div></div><div><h3>Conclusion</h3><div>These findings suggest that VNS can be an effective therapeutic option for pediatric patients with refractory EMAtS, leading to improvements in seizure control and neurodevelopmental outcomes.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 25-28"},"PeriodicalIF":2.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143526758","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}