Seizure-European Journal of Epilepsy最新文献

{"title":"Ictal religious speech as a semiology of non-convulsive status epilepticus emerging from the right frontal lobe","authors":"Lorena Franco-Rubio, Adela Maruri-Pérez, Ana Aldaz-Burgoa, Nicolás Rodríguez-Albacete, Lucía López-Trashorras, Pablo Abizanda-Saro, Pablo Mayo-Rodríguez, Clara Lastras-Fernández-Escandón, Beatriz Parejo-Carbonell, Irene García-Morales","doi":"10.1016/j.seizure.2025.06.014","DOIUrl":"10.1016/j.seizure.2025.06.014","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 190-192"},"PeriodicalIF":2.7,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589129","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 multicenter study on cryptogenic NORSE/FIRES patients treated with anakinra","authors":"G Giussani ,&nbsp;E Bianchi ,&nbsp;CM Bonardi ,&nbsp;S Sartori ,&nbsp;S Buratti ,&nbsp;E Campostrini ,&nbsp;G Cantalupo ,&nbsp;AL Ghobert ,&nbsp;CA Cesaroni ,&nbsp;A Fetta ,&nbsp;E Freri ,&nbsp;L Giordano ,&nbsp;S Olivotto ,&nbsp;G Toscano ,&nbsp;A Papa ,&nbsp;F Brustia ,&nbsp;M Vissani ,&nbsp;S Micheli ,&nbsp;R Dilena","doi":"10.1016/j.seizure.2025.06.022","DOIUrl":"10.1016/j.seizure.2025.06.022","url":null,"abstract":"<div><h3>Purpose</h3><div>Refractory status epilepticus (RSE) is a neurological emergency characterized by persistent seizures despite two appropriate antiseizure medications. It is defined as new-onset RSE (NORSE) when occurring in previously healthy people. NORSE is defined as cryptogenic (cNORSE) when no cause is found. Febrile‐infection related epilepsy syndrome (FIRES) is now defined as the cNORSE variant preceded by fever. In 2016 anakinra was reported effective in an anecdotal case. After this experience, second-line immunotherapy has been increasingly used, being incorporated in cNORSE recommendations in 2022.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study in an Italian case series of 14 patients with cNORSE (including FIRES cases) treated with anakinra in Italy before implementation of the international recommendations, that could serve as historical reference for futures studies based on the shared recommendations.</div></div><div><h3>Results</h3><div>In our population higher duration of intensive care stay period was associated with later time of anakinra use, although no evidence of efficacy on the long-term neurological outcome was demonstrated.</div></div><div><h3>Conclusion</h3><div>There is an urgent need for well-designed head-to-head multicenter prospective clinical trials to clarify the benefits of available treatments and the role of biomarkers to guide choices.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 141-146"},"PeriodicalIF":2.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549386","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":"Monitoring cognition in people with epilepsy and intellectual disability","authors":"Judit Catalán-Aguilar ,&nbsp;Juri-Alexander Witt ,&nbsp;Christoph Helmstaedter","doi":"10.1016/j.seizure.2025.06.021","DOIUrl":"10.1016/j.seizure.2025.06.021","url":null,"abstract":"<div><div>Monitoring cognition is essential in patients with epilepsy and intellectual disability (ID) to assess the course of the disease and its treatment. Patients with developmental or non-developmental ID are particularly vulnerable, as they more frequently experience severe medical conditions (such as seizures) and cognitive or psychiatric comorbidities than individuals with average intelligence. Given the difficulties in assessing patients with ID, this study aims to contextualise the current field of cognitive screening for patients with epilepsy and moderate or severe ID. To this purpose, this narrative review offers a critique of current approaches and provides a practical framework for individualised patient care. Furthermore, it highlights the challenges in assessing cognitive and behavioural changes in this population and focuses on the need for assessments that adapt to individual patient capabilities. It addresses the specific cognitive domains that should be evaluated and provides an overview of the tools employed, analysing the advantages and limitations of subjective and objective measures. Finally, it examines different procedures for assessing cognitive changes and considers future directions, such as the potential for new technologies, to improve exploration accuracy. In conclusion, objective screening tools to monitor intrasubject short-term changes in this population are necessary. The current approach is eclectic, which combines various age-adjusted and domain-specific tests. Future efforts should incorporate measures based on the WHO International Classification of Functioning, daily living activity scales, and surrogate markers for cognition (e.g., eye-tracking, AI-driven motion analysis, and wearables) to fill diagnostic gaps and improve the precision of cognitive monitoring in these patients.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 150-162"},"PeriodicalIF":2.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489761","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":"Predicting seizure recurrence after status epilepticus: a multicenter exploratory machine learning approach","authors":"Francesco Pasini ,&nbsp;Manuel Quintana ,&nbsp;Marc Rodrigo-Gisbert ,&nbsp;Daniel Campos-Fernández ,&nbsp;Laura Abraira ,&nbsp;Elena Fonseca ,&nbsp;Samuel López-Maza ,&nbsp;Giada Giovannini ,&nbsp;Niccolò Orlandi ,&nbsp;Simona Lattanzi ,&nbsp;Simone Beretta ,&nbsp;Manuel Toledo ,&nbsp;Stefano Meletti ,&nbsp;Estevo Santamarina","doi":"10.1016/j.seizure.2025.06.019","DOIUrl":"10.1016/j.seizure.2025.06.019","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;Tools to predict seizure recurrence after status epilepticus (SE) are lacking. In this multicenter cohort study, we explored the ability of different machine learning (ML) models to predict seizure recurrence following a first episode of SE in patients without a prior history of seizures (&lt;em&gt;de novo&lt;/em&gt; SE, dnSE).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Consecutive SE patients aged ≥16 years without a previous history of seizures admitted to Vall d’Hebron University Hospital (Barcelona, Spain) from 2011 to 2021 and Modena Academic Hospital (Baggiovara, Italy) from 2013 to 2022 were reviewed. Different machine learning techniques (k-Nearest Neighbors, Naïve Bayes, Artificial Neural Network, Support Vector Machines, Decision Tree, Random Forest) as well as the classic logistic regression model were built using clinical and neurophysiological variables and applied to develop predictive models of seizure recurrence. Seventy percent of the total sample was randomly selected to train the models; the remaining 30 % was used for validation. The area under the receiver operating characteristic curves (AUROC) with a 95 % confidence interval (95 % CI) was calculated to assess their predictive capability.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 386 patients were included, of which 136 (35.2 %) had seizure recurrence within 2 years after the SE episode. Factors significantly associated with two-year seizure recurrence included progressive symptomatic SE etiology (&lt;em&gt;p&lt;/em&gt; &lt; 0.001), non-convulsive SE with coma (&lt;em&gt;p&lt;/em&gt; = 0.021), and out-of-hospital SE (&lt;em&gt;p&lt;/em&gt; = 0.033). Acute symptomatic SE etiology resulted a protective factor (&lt;em&gt;p&lt;/em&gt; &lt; 0.001). Among ML techniques, all were slightly superior to the logistic regression model in predicting two-year seizure recurrence, except for Artificial Neural Network. The Random Forest algorithm (AUROC 0.687, 95 %CI = 0.580 - 0.793) demonstrated the best predictive capability in the validation dataset, significantly outperforming the logistic regression model (AUROC 0.594, 95 %CI = 0.478 - 0.710).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;In our study, the Random Forest algorithm showed the best predictive capability for two-year seizure recurrence after a dnSE in adult patients. Further studies and additional data are needed to improve its predictive performance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;This multicenter international retrospective study found that over one-third (35.2 %) of patients who develop status epilepticus without a prior history of epilepsy will have a new seizure within two years after the event. By providing clinical and demographic variables, machine learning algorithms were built and their ability to predict seizure recurrence compared with that of classical statistical model. This is the first study to show that artificial intelligence - specifically, Random Forest algorithm - can outperform traditional statistical methods in predict","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 163-171"},"PeriodicalIF":2.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535509","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 refractory epilepsy related to tuberous sclerosis complex: A retrospective-cohort study of diagnosis and treatment","authors":"Rongbo Lin ,&nbsp;Zhao Liao ,&nbsp;Lingyu Kong ,&nbsp;Dian Jiang ,&nbsp;Cailei Zhao ,&nbsp;Xia Zhao ,&nbsp;Tian Yu ,&nbsp;Bixia Yuan ,&nbsp;Yuanzhen Ye ,&nbsp;Haifeng Wang ,&nbsp;Jianxiang Liao ,&nbsp;Jing Duan ,&nbsp;Zhanqi Hu","doi":"10.1016/j.seizure.2025.06.017","DOIUrl":"10.1016/j.seizure.2025.06.017","url":null,"abstract":"<div><h3>Background</h3><div>Tuberous sclerosis complex (TSC) patients often develop refractory epilepsy (RE). The present study evaluated numerous risk factors associated with TSC to determine risk factors of RE.</div></div><div><h3>Methods</h3><div>After enrollment, 315 pediatric patients with TSC-associated epilepsy were divided into control and RE groups. Multimodal data were used to characterize risk factors for RE, including clinical data, anti-seizure medication (ASM) or sirolimus use, family history, genotype, seizure types, neuroimaging and EEG findings, and developmental assessments.</div></div><div><h3>Results</h3><div>Infantile spasms, number of ASMs being taken, clustered seizures, family history, <em>TSC2</em> mutation, and presence of type II and Ⅲ lesions were positively correlated with RE. Age of onset, age of first hospital visit, and use of vigabatrin were negatively correlated with RE. MRI findings suggest lesion type is more important than lesion size and location in predicting RE. There were significant differences in spasms and delayed motor development or cognitive delay between the control and RE groups. Valproate was the most common ASM used, followed by vigabatrin and oxcarbazepine. Risk of RE was increased as much as 1.63-fold by the presence of type II lesions.</div></div><div><h3>Conclusions</h3><div>Age of onset, infantile spasms, type II lesions, <em>TSC2</em> mutation status, family history, and clustered seizures were identified as potential risk factors for the development of RE. ASM should be recommended for TSC patients even in cases with subclinical epileptiform EEG discharge. Using vigabatrin and sirolimus earlier in childhood may reduce the occurrence of RE.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 132-139"},"PeriodicalIF":2.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365351","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":"Outcomes and responses to anti-seizure medications in status epilepticus: The significance of peri-ictal EEG and MRI abnormalities","authors":"Sung Eun Kim ,&nbsp;Ju Young Kim","doi":"10.1016/j.seizure.2025.06.015","DOIUrl":"10.1016/j.seizure.2025.06.015","url":null,"abstract":"<div><h3>Background</h3><div>Peri-ictal MRI (PMA) and EEG abnormalities (PEA) may predict the outcomes and responses to anti-seizure medications (ASMs) in patients with status epilepticus (SE).</div></div><div><h3>Methods</h3><div>The inclusion criteria were as follows: (1) patients with SE aged &gt;18 years, (2) peri‑ictal MRI including DWI and FLAIR, (3) peri‑ictal EEG, (4) well-documented medical records, and (5) recruitment between January 2016 and December 2023. Patients with hypoxic-ischemic encephalopathy as the etiology were excluded. Outcomes were classified as good (modified Rankin Scale 0–3) or poor (modified Rankin Scale 4–6) at discharge. Response to ASMs was defined as a failure if SE was not controlled with second-line ASMs at standard doses. PEA was defined as electro-clinical seizures, ictal-interictal continuum, or lateralized periodic discharges. PMA was defined as increased signal intensities in the cortex, thalamus, or hippocampus. A model was developed to predict poor outcomes using multivariate logistic regression with PMA, PEA, and response to second-line ASMs as dependent variables.</div></div><div><h3>Results</h3><div>A total of 114 patients were included. Poor outcomes were observed in 43.9 % (50/114), and 31 % (35/114) were refractory to second-line ASMs. A multivariate logistic regression predicting poor outcomes identified four variables that were independently associated with poor outcomes (<em>p</em> &lt; 0.0001, R²=0.46): PEA (OR 4.4, 95 % CI 1.68–11.31), PMA (OR 3.8, 95 % CI 1.22–12.1), failure of second-line ASMs (OR 3.7, 95 % CI 1.29–10.84) and status epilepticus severity score (OR 1.6, 95 % CI 1.16–2.13).</div></div><div><h3>Conclusions</h3><div>PMA, PEA and failure of second-line ASMs were robust predictors of poor outcomes in patients with SE.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 135-140"},"PeriodicalIF":2.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144534808","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":"Systematic review of paediatric SUDEP and epilepsy-related deaths to inform a safety counselling checklist for clinical practice","authors":"Rohini Ranganath Rattihalli ,&nbsp;Sammy Ashby ,&nbsp;Lisa Burrows ,&nbsp;Rachel Howells ,&nbsp;Kezie Chukwudebelu ,&nbsp;Rohit Shankar","doi":"10.1016/j.seizure.2025.06.013","DOIUrl":"10.1016/j.seizure.2025.06.013","url":null,"abstract":"<div><h3>Background</h3><div>One in 200 children - in the UK have epilepsy. Approximately, 1 in 1,000 children with epilepsy die yearly from Sudden unexpected death in epilepsy (SUDEP), a leading cause of death in epilepsy. Various risk factors contributing to epilepsy mortality particularly SUDEP, some modifiable, have been identified. Structured discussion of risks results in behavioural change that reduces individual risk factors.</div></div><div><h3>Aim</h3><div>To investigate and collate risk factors for SUDEP and epilepsy mortality in children to propose a structured communication tool (“Checklist”) for person centred communication.</div></div><div><h3>Methods</h3><div>A Systematic review for children’s epilepsy mortality risk factors was conducted. The search strategy was developed by clinical and topic experts in conjunction with a clinical evidence specialist and an epilepsy charity. Database searches (MEDLINE, Embase, CINAHL, PsycINFO) were performed in 06/2022 and updated 02/2024, with results assessed independently by two reviewers. Terms covered paediatrics, epilepsy, epilepsy mortality and SUDEP. Results were synthesised into risk factor domain.</div></div><div><h3>Results</h3><div>Six papers encompassing three review articles (covering 33 original research articles), and three other original research articles were included. A further four articles specifically looking at different genetic epilepsies and SUDEP were also added. There was heterogeneity among papers. No RCTs, including papers in the review, were identified. Quality analysis of papers was not undertaken. Eleven key risk factors covering domains of seizure presentation, management, co-morbidity and genetics were identified.</div></div><div><h3>Conclusions</h3><div>A safety Checklist is proposed with identified risk factors for routine clinical–patient interaction to facilitate easier, structured, individualised and evidence-based communication.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 172-179"},"PeriodicalIF":2.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549056","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 stereoelectroencephalography in pediatric patients: Clinical practice and considerations","authors":"Nunthasiri Wittayanakorn ,&nbsp;Nathan T. Cohen ,&nbsp;Ersida Buraniqi ,&nbsp;Veronica D. Linan-Martinez ,&nbsp;Saige A. Teti ,&nbsp;Ban H. Shoukeir ,&nbsp;William D. Gaillard ,&nbsp;Chima O. Oluigbo","doi":"10.1016/j.seizure.2025.06.012","DOIUrl":"10.1016/j.seizure.2025.06.012","url":null,"abstract":"<div><h3>Objective</h3><div>Neuromodulation of cortical and subcortical structures is integral to pediatric epilepsy surgery. Subcortical and thalamic targets for neuromodulation continue to evolve. This paper reports the practical considerations and outcomes of pediatric thalamic stereoelectroencephalography (sEEG) at a single institution.</div></div><div><h3>Methods</h3><div>A retrospective study involved 16 patients with drug-resistant epilepsy who underwent sEEG with thalamic nuclei sampling at Children’s National Hospital (CNH) from July 2023 to Aug 2024. Electrodes targeted thalamic nuclei, including the anterior nucleus of thalamus (ANT), centromedian (CM), and/or pulvinar (PUL). Two pediatric epileptologists reviewed sEEG recordings at enhanced sensitivity to identify thalamic spread patterns. The definitive procedure after sEEG and the outcomes were reported for those who proceeded to surgery with at least six months of follow-up.</div></div><div><h3>Results</h3><div>Sixteen subjects underwent sEEG with thalamic nuclei sampling. Thirty-five thalamic electrodes were implanted, and four patients had multisite thalamic nuclei sampling. Most seizures reviewed (84 %) had early thalamic involvement (&lt;500 ms from seizure onset). A variety of early thalamic spread patterns were detected: spike wave, 30 % (<em>n</em> = 15/50); rhythmic slowing, 20 % (<em>n</em> = 10/50); and low voltage fast activity (LVFA), 16 % (<em>n</em> = 8/50). Among the fifteen patients exhibiting thalamic involvement, nine (60 %) demonstrated congruent ictal patterns originating from the neocortex, whereas 40 % exhibited discordant patterns. Furthermore, 60 % of patients (<em>n</em> = 9) exhibited consistent thalamic spread patterns, whereas 40 % demonstrated variable patterns across different nuclei within the same seizure or within the same nucleus across seizures. Eleven patients underwent surgery after the sEEG, and seizure outcomes of seven patients with a mean follow-up period of 7.9 months were reported. Only one patient experienced transient hemiparesis from an anterior insular hemorrhage.</div></div><div><h3>Conclusion</h3><div>Thalamic sEEG may serve as a valuable tool for selected patients with complex or extensive epileptic networks and may aid in the identification of neuromodulation targets when resection or ablation is not feasible.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 121-131"},"PeriodicalIF":2.7,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312741","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":"Developmental and/or epileptic encephalopathy with spike-and-wave activation in sleep: A single tertiary center experience","authors":"Sibel Öz Yıldız ,&nbsp;Ceren Günbey ,&nbsp;Kader Karlı Oğuz ,&nbsp;Gökçen Konuşkan ,&nbsp;Göknur Haliloğlu ,&nbsp;Dilek Yalnızoğlu","doi":"10.1016/j.seizure.2025.06.010","DOIUrl":"10.1016/j.seizure.2025.06.010","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to analyze the clinical characteristics, etiology, neuroimaging, treatment, neurocognitive and EEG outcomes of patients with developmental and/or epileptic encephalopathy with spike-and-wave activation in sleep (D/EE-SWAS).</div></div><div><h3>Methods</h3><div>Patients diagnosed with D/EE-SWAS, between 2014 and 2021, with a spike-wave index (SWI) ≥50 % in NREM sleep EEG, were analyzed retrospectively. Outcome measures included neurocognitive assessment, SWI, and seizure frequency.</div></div><div><h3>Results</h3><div>A total of 80 patients were included. Median age at initial admission was 43.5 (0.03–148) months, with seizures as the main symptom in 66 (82.5 %) patients. Median age at D/EE-SWAS onset and follow-up was 92.5 (21.3–193.6), and 86.9 (12–204) months, respectively. At diagnosis, 56 patients had seizures (focal: 13, generalized: 43). Unknown group (36; 45 %) constituted the most common etiology. There was a shift towards benzodiazepines, mostly as a combination therapy, in 58 (72.5 %). At the final visit, 38 (47.5 %) of the patients had favorable cognitive outcome which was correlated with older epilepsy onset (≥3 years), normal neurological examination, unknown etiology, seizure freedom during D/EE-SWAS, normal EEG background, fewer ASMs, shorter D/EE-SWAS duration, SWI response, decreased seizure frequency, and SWAS resolution. EEG recovery occurred in 48 (60 %) (median duration: 24 months), with 12(15 %) achieving complete resolution. Of the patients, 38 (47.5 %) were seizure-free at the end of the study period.</div></div><div><h3>Conclusions</h3><div>Baseline neurologic examination, age at onset of epilepsy/D/EE-SWAS, etiology, and number of ASMs at diagnosis had an impact on outcomes. Etiology and number of ASMs may serve as parameters to predict treatment response, and underscore the need for tailored approaches for D/EE-SWAS.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 203-211"},"PeriodicalIF":2.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653949","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":"Seizure reporting in older patients with developmental and epileptic encephalopathies: A retrospective review of ambulatory video-EEG reports","authors":"Ewan S. Nurse ,&nbsp;Mark J. Cook ,&nbsp;Linda J. Dalic","doi":"10.1016/j.seizure.2025.06.003","DOIUrl":"10.1016/j.seizure.2025.06.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Accurate seizure reporting is crucial for assessing treatment efficacy and guiding acute management in developmental and epileptic encephalopathies (DEEs). This study evaluates the sensitivity and positive predictive value (PPV) of seizure diaries compared to ambulatory video-EEG reports.</div></div><div><h3>Methods</h3><div>This retrospective cohort study (2018–2024) analyzed video-EEG reports from 19 Australian clinics. vEEG data were not re-reviewed. Patients with confirmed DEEs underwent 1–7 days of ambulatory video-EEG and completed seizure diaries. Sensitivity (proportion of true seizures correctly recorded) and PPV (proportion of diary events confirmed as seizures) were compared to neurologist-reported vEEG events. Demographic and clinical data were also collected.</div></div><div><h3>Results</h3><div>The study included 108 recordings from 65 patients with Lennox-Gastaut Syndrome (LGS), 10 with Dravet Syndrome, and 33 with other/unspecified DEEs. The cohort was 51 % female, with a median age of 15 years (range 5–63). In LGS and other DEEs, higher reporting of non-epileptic events correlated with fewer true seizure recordings. While many participants achieved a sensitivity or PPV of 1, few achieved both. No significant group-level differences in sensitivity or PPV were found across diagnostic categories.</div></div><div><h3>Conclusion</h3><div>Seizure diaries show variability in accurately capturing seizure activity in DEEs, with over-reporting of non-epileptic events and under-recognition of true seizures. These findings highlight the need for objective tools like video-EEG to improve seizure reporting accuracy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 50-56"},"PeriodicalIF":2.7,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253387","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}