Seizure-European Journal of Epilepsy最新文献

{"title":"In vitro modelling of the neuropathophysiological features of mitochondrial epilepsy.","authors":"Laura A Smith, Ella B Keane, Kate Connor, Felix Chan, Mark O Cunningham","doi":"10.1016/j.seizure.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.seizure.2025.05.005","url":null,"abstract":"<p><p>Epilepsy is a common and severe neurological manifestation of primary mitochondrial disease, affecting approximately 60 % of paediatric patients and 20 % of adult patients. Many of the mitochondrial epilepsies, particularly those presenting in childhood, are refractory to anti-epileptic treatment. Moreover, these conditions are typically characterised by severe neurodegeneration and closely associated with neurological decline and premature death. Indeed, there persists an urgent need to delineate the mechanisms underpinning mitochondrial epilepsy in order to develop effective treatments. In this review, we provide an overview of currently available in vitro models of the mitochondrial epilepsies. Such models offer opportunities to characterise early disease pathophysiology and interrogate novel mitochondrial-targeting and anti-epileptic treatments, with an overall aim to modulate seizure associated pathology and activity for the mitochondrial epilepsies. We discuss the use of acute cortical and subcortical brain slice preparations, obtained from both neurosurgical patients and rodents, for modelling the common neuropathophysiological features of mitochondrial epilepsy. We also review the use of induced pluripotent stem cell derived neural and glial culture models, and the development of three-dimensional cerebral organoids, generated from fibroblasts obtained from patients with primary mitochondrial disease. Human-derived, disease-relevant in vitro model systems which recapitulate the complexity and pathological features observed in patient brain tissues are crucial to help bridge the gap between animal models and patients living with mitochondrial epilepsy.</p>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and EEG-EMG characteristics of perioral myoclonia with absence seizures","authors":"Haipo Yang,&nbsp;Xiaoyan Liu,&nbsp;Jiaoyang Lu,&nbsp;Chenlu Jia,&nbsp;Qiujun Zhou,&nbsp;Lixuan Xu,&nbsp;Shuhui Fan,&nbsp;Shuang Wang","doi":"10.1016/j.seizure.2025.03.011","DOIUrl":"10.1016/j.seizure.2025.03.011","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to explore the clinical and electrophysiological characteristics and treatment prognosis of patients with perioral myoclonia with absence (POMA).</div></div><div><h3>Method</h3><div>Patients with POMA were selected from our EEG database. The collected data included detailed clinical information, VEEG characteristics, and brain MRI results. Previously reported patients with POMA were also screened for inclusion in the study.</div></div><div><h3>Result</h3><div>Nineteen patients were included in the study. The median seizure onset age was 5 years (range, 2–11 years), with 84.2 % (16/19) of the patients being male. POMA was VEEG monitored in 73.7 % of the patients during both wakefulness and sleep, and 63.2 % (12/19) could be induced by hyperventilation (HV). Synchronized perioral electromyography confirmed that the ictal 3-Hz discharge was time-locked with the myoclonic jerks. Twelve patients underwent VEEG follow-up, with 66.7 % achieving seizure-free with valproate (VPA) monotherapy. A review of previous reports on 15 patients with POMA revealed that 66.7 % of patients being male. Five patients experienced worsening of seizures with oxcarbazepine (OXC), carbamazepine (CBZ), or phenytoin.</div></div><div><h3>Conclusion</h3><div>POMA epilepsy, although rare, still presents distinctive characteristics. POMA tends to occur more frequently in males. 73.7 % of the patients had POMA during both wakefulness and sleep. The VEEG background is mostly normal, with rhythmic 3-Hz generalized spike and wave discharges during the ictal period that are time-locked with perioral myoclonia. Patients with POMA respond well to VPA. POMA may be misdiagnosed as focal seizures, but the use of OXC, CBZ, and phenytoin sodium for treatment should be avoided.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 51-55"},"PeriodicalIF":2.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934763","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":"Caregiver-reported non-seizure and seizure outcomes with cannabidiol and clobazam in patients aged ≥2 years with Lennox-Gastaut syndrome or Dravet syndrome: A subgroup analysis of the BECOME survey","authors":"M. Scott Perry ,&nbsp;Tracy Dixon-Salazar ,&nbsp;Mary Anne Meskis ,&nbsp;Sherry R. Danese ,&nbsp;Timothy B. Saurer ,&nbsp;Kishan Vyas ,&nbsp;Anne T. Berg","doi":"10.1016/j.seizure.2025.04.017","DOIUrl":"10.1016/j.seizure.2025.04.017","url":null,"abstract":"<div><h3>Purpose</h3><div>This subgroup analysis of the BECOME (<strong>BE</strong>havior, <strong>CO</strong>gnition, and <strong>M</strong>ore with <strong>E</strong>pidiolex®) survey analyzed caregiver-reported seizure and non-seizure outcomes, including changes in caregiver burden, following cannabidiol (CBD) treatment in patients with Lennox-Gastaut syndrome (LGS) or Dravet syndrome (DS) aged ≥2 years taking concomitant clobazam, aligned with the European Medicines Agency indication.</div></div><div><h3>Methods</h3><div>US-based caregivers of patients with LGS/DS receiving CBD (Epidiolex®, 100 mg/mL oral solution) for ≥3 months rated patient outcome changes, comparing the previous month with pre-CBD initiation. Multiple-choice and rank-order questions with symmetrical 3-, 5-, or 7-point scales ranging from worsening to improvement were used.</div></div><div><h3>Results</h3><div>Patients (<em>N</em> = 243; 76 % LGS, 24 % DS; 52 % male; mean [range] age 15 [2–53] years) took a median of 14 mg/kg/day CBD and a median of four other antiseizure medications, including clobazam. Caregivers reported improvements in seizure frequency (87 %), severity (81 %), and weekly seizure-free days (net improvement across seizure types 68 %). Caregivers noted improvements in ≥1 question for non-seizure domains (net data across questions within each domain): alertness, cognition, and executive function (84 %); language and communication in non-verbal (81 %) and verbal (76 %) patients; emotional and social functioning (79 %); daily activities (56 %); physical functioning (44 %); and sleep (56 %). Additionally, 4–26 % of caregivers (net) reported worsening in ≥1 question in any domain. Overall, 94 % of caregivers planned to continue CBD treatment.</div></div><div><h3>Conclusions</h3><div>Consistent with the overall BECOME survey, most caregivers of patients with LGS/DS aged ≥2 years taking concomitant clobazam reported improvements in seizure and non-seizure outcomes since initiating CBD treatment.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 32-40"},"PeriodicalIF":2.7,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934761","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":"Association of prenatal exposure to antiseizure medication with risk of autism: a systematic review and meta-analysis","authors":"Isabella Christina Amaral de Lara ,&nbsp;Pedro Henrique de Souza Wagner ,&nbsp;Gustavo Tadeu Freitas Uchôa Matheus ,&nbsp;Lara Eduardo Campos ,&nbsp;Celso de Almeida Souza Miranda ,&nbsp;Maria Eduarda Cavalcanti Souza ,&nbsp;Francisco Cezar Aquino de Moraes ,&nbsp;Francinny Alves Kelly ,&nbsp;Lilianne Rodrigues Fernandes","doi":"10.1016/j.seizure.2025.05.003","DOIUrl":"10.1016/j.seizure.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Antiseizure medications (ASMs) can affect neurodevelopment and cause congenital malformations. Autism spectrum disorder (ASD) is characterized by challenges in communication, behavior, and learning. This study evaluated the association between prenatal ASM exposure and ASD development.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis was conducted using PubMed, Scopus, Web of Science, and Cochrane databases to identify studies on fetal ASM exposure and ASD. Hazard ratio (HR) and risk ratio (RR) with 95 % confidence interval (CI) were pooled using a random-effects model. Heterogeneity was assessed using I² statistic. A p-value &lt; 0.05 was considered significant.</div></div><div><h3>Results</h3><div>10 studies were included in our meta-analysis, comprising 54,747 patients exposed to ASM. Prenatal ASM exposure significantly increased the risk of ASD (HR 1.8082; 95 % CI 1.2616 to 2.5916; <em>P</em> = 0.001; RR 2.0401; 95 % CI 1.7588 to 2.3664; <em>P</em> &lt; 0.0001). Subgroup analyses identified elevated risks with specific ASMs, including carbamazepine (HR 1.2213; 95 % CI 1.0047 to 1.4847; <em>P</em> = 0.045; I² = 0 %), valproate (HR 2.8306; 95 % CI 2.3881 to 3.3550; <em>P</em> &lt; 0.001; I² = 0 %), and oxcarbazepine (HR 1.6141; 95 % CI 1.1500 to 2.2655; <em>P</em> = 0.006; I² = 27 %). Among women with epilepsy, prenatal ASM exposure increased ASD risk (RR 1.4174; 95 % CI 1.2345 to 1.6273; <em>P</em> &lt; 0.0001; I² = 0 %).</div></div><div><h3>Conclusions</h3><div>This meta-analysis showed that prenatal exposure to antiseizures, particularly valproate, carbamazepine, and oxcarbazepine, significantly increases ASD risk. These findings emphasize the need for cautious ASM use during pregnancy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 41-47"},"PeriodicalIF":2.7,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934762","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: a multicenter, retrospective evaluation of real-world clinical practice","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.2025.05.002","DOIUrl":"10.1016/j.seizure.2025.05.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Epilepsy is a common neurological disorder, with approximately one-third of patients experiencing drug-resistant epilepsy (DRE), which imposes significant clinical, social, and economic burdens. Cenobamate, a novel antiseizure medication (ASM), was included to the Polish therapeutic framework in March 2023.</div></div><div><h3>Materials and Methods</h3><div>This retrospective, multicenter study was conducted at 19 centers. Medical records of adult patients with DRE treated with cenobamate for at least six months were reviewed. Collected data included demographic characteristics, seizure frequency, treatment regimens, and adverse events (AEs). Descriptive statistical methods were employed to assess outcomes, with the primary efficacy endpoint of ≥50 % reduction in seizure frequency.</div></div><div><h3>Results</h3><div>The study cohort consisted of 475 patients with a median age of 37 years. Treatment with cenobamate (median maximal daily dose, 250 mg) resulted in <em>a</em> ≥ 50 % reduction in seizure frequency in 61.9 % of patients, with 16.5 % achieving seizure freedom during the final three months of observation, with better responses when the treatment was initiated earlier. The burden of polytherapy decreased, as 69.7 % of patients reduced or discontinued concomitant ASMs. Adverse events were reported in 48.8 % of patients, most commonly somnolence and dizziness, with no cases of severe dermatological reactions. Discontinuation of cenobamate occurred in 12 % of patients.</div></div><div><h3>Discussion</h3><div>Cenobamate demonstrated notable efficacy in patients with treatment-resistant epilepsy, and its early initiation may improve outcomes. Treatment has a large potential for significant simplification of treatment regimens. Adverse events were manageable.</div></div><div><h3>Conclusions</h3><div>Cenobamate is a highly effective and well-tolerated ASM for patients with DRE, offering significant clinical benefits, including improved seizure control and reduced polytherapy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 25-31"},"PeriodicalIF":2.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143929432","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":"Brain tumor-associated epilepsies in adulthood: Current state of diagnostic and individual treatment options","authors":"Hermann Stefan ,&nbsp;Frank Bösebeck ,&nbsp;Karl Rössler","doi":"10.1016/j.seizure.2024.06.004","DOIUrl":"10.1016/j.seizure.2024.06.004","url":null,"abstract":"<div><div>Brain tumors are one of the most frequent causes of structural epilepsy and set a major burden on treatment costs and the social integrity of patients. Although promising oncological treatment strategies are already available, epileptological treatment is often intractable and requires lifelong epileptological care. Therefore, treatment strategies must be adapted to age-related needs, and specific aspects of late-onset epilepsy (LOE) must be considered. The practical implementation of individual decisions from tumor boards and the current state of the art in scientific knowledge about pathological mechanisms, modern diagnostic procedures and biomarkers, and patient-individualized treatment options into practical epileptological disease management is a prerequisite.</div><div>This narrative review focuses on the current work progress regarding pathogenesis, diagnosis, and therapy. Exemplarily, interdisciplinary approaches for optimized individualized therapy will be discussed, emphasizing the combination of neurological-epileptological and oncological perspectives.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"128 ","pages":"Pages 29-37"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141394423","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":"Late onset epilepsy and stroke: Diagnosis, pathogenesis and prevention","authors":"Hermann Stefan ,&nbsp;Georg Michelson","doi":"10.1016/j.seizure.2024.06.011","DOIUrl":"10.1016/j.seizure.2024.06.011","url":null,"abstract":"<div><div>The association of stroke and late-onset epilepsy (LOE) is discussed with special regard to its diagnosis, pathogenesis, and prevention. In addition to epidemiological data, including those from different age groups, the mechanisms for the development of acute symptomatic and remote symptomatic seizures<span><span> are reviewed. The risk factors associated with seizures<span> and post-stroke epilepsy (PSE) are considered, along with the methodological limitations of the study. For future research, the distinction between acute and remote symptomatic seizure before or after seven days from stroke onset should be reviewed because different acute symptomatic seizures (ASSs) themselves can entail a variable PSE risk. The definition of LOE by age is hitherto inconsistent. Comparing adult lifespan epochs, it is evident that stroke and seizures exhibit similar prevalence profiles. Young adulthood, old adulthood, and elderly epochs may be relevant for the differentiation of </span></span>LOE subtype by age, vascular comorbidity, and other characteristics. A step-scheme strategy as a possible contribution to cerebrovascular prevention approaches is proposed.</span></div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"128 ","pages":"Pages 38-47"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141409909","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":"Focused review: Clinico-neuropathological aspects of late onset epilepsies","authors":"Attila Rácz ,&nbsp;Daniel S. Galvis-Montes ,&nbsp;Valeri Borger ,&nbsp;Albert J. Becker ,&nbsp;Julika Pitsch","doi":"10.1016/j.seizure.2024.06.015","DOIUrl":"10.1016/j.seizure.2024.06.015","url":null,"abstract":"<div><div>The aim of the present study was to review the current knowledge on the neuropathological spectrum of late onset epilepsies. Several terms including ‘neuropathology*’ AND ‘late onset epilepsy’ (LOE) combined with distinct neuropathological diagnostic terms were used to search PubMed until November 15, 2023. We report on the relevance of definitional aspects of LOE with implications for the diagnostic spectrum of epilepsies. The neuropathological spectrum in patients with LOE is described and includes vascular lesions, low-grade neuroepithelial neoplasms and focal cortical dysplasias (FCD). Among the latter, the frequency of the FCD subtypes appears to differ between LOE patients and those with seizure onset at a younger age. Neurodegenerative neuropathological changes in the seizure foci of LOE patients require careful interdisciplinary interpretation with respect to the differential diagnosis of primary neurodegenerative changes or epilepsy-related changes. Innate and adaptive neuroinflammation represents an important cause of LOE with intriguing therapeutic options.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"128 ","pages":"Pages 48-53"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141451955","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":"Patient-centered outcomes and quality of life in elderly people with epilepsy: A focused review","authors":"Kristina Malmgren","doi":"10.1016/j.seizure.2024.06.025","DOIUrl":"10.1016/j.seizure.2024.06.025","url":null,"abstract":"<div><div>The highly heterogeneous population of elderly with epilepsy continues to increase as the incidence of epilepsy rises with increasing life expectancy. There are many aspects to consider in the treatment of elderly with epilepsy, e g comorbidities and the complexity of polypharmacy. The literature on quality-of-life (QoL) and patient-centered outcomes in elderly in general as well as in elderly with epilepsy is limited, most of the existing studies report results from quality-of-life surveys. No such QoL questionnaires have, however, in the validation process explored issues specific to the elderly. Seizure frequency, co-morbidities and depression predicted QoL in elderly with epilepsy and the energy/fatigue domain scored worst when QOLIE-31 was used. In the handful of qualitative interview studies identified in this review, a number of topics specific for elderly with epilepsy were explored. Some of these were difficulties with information gathering, the importance of maintaining normalcy, incongruence with provider goals and wanting to be more involved in the treatment. There is a need for further exploration of the specific concerns of elderly with epilepsy. This review provides a comprehensive overview of the studies and emphasizes the importance of involving elderly people with epilepsy in their own care.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"128 ","pages":"Pages 64-67"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applications of teleneuropsychology to the screening and monitoring of epilepsy","authors":"Chris Tailby ,&nbsp;Jodie E. Chapman ,&nbsp;Remy Pugh ,&nbsp;Annette Holth Skogan ,&nbsp;Christoph Helmstaedter ,&nbsp;Graeme D. Jackson","doi":"10.1016/j.seizure.2024.06.022","DOIUrl":"10.1016/j.seizure.2024.06.022","url":null,"abstract":"<div><div>Epilepsy is an inherently dynamic disease and neuropsychology plays a key role in the formulation, monitoring and management of the condition. Teleneuropsychology provides an opportunity for neuropsychology to increase its accessibility, reach and efficiency, using focussed assessments to target epilepsy relevant domains at critical timepoints in the disease trajectory. Neuropsychologists working with epilepsy have, however, been comparatively slow to adopt telehealth methods. Here we review recent developments in teleneuropsychology, with particular reference to applications and considerations in Late Onset Epilepsy. Three different approaches to remote assessment of cognition are discussed: unsupervised, computer-administered assessments; telephone-based assessments; and videoconference-based assessments. Uptake of unsupervised, computer-administered (browser or app-based) assessments has been strongest in aging research, where there is now evidence of feasibility, reliability, and validity, especially for measures of speed and working memory. Telephone-based assessments are well established in older aged cohorts and have recently been applied in epilepsy. Such assessments are widely accessible from a technology perspective, though reliance on a purely oral medium limits cognitive domain coverage. Videoconference based assessments have partially addressed this limitation, though continue to rely largely upon finding ways to administer legacy materials via the medium rather than intrinsically exploiting the technology. We argue that the future of neuropsychology requires development of integrated videoconference-based, computer-assisted cognitive testing, combining the benefits of computerised assessments with the advantages of human led assessments. Such an approach will be applicable across neuropsychological conditions, from childhood through to older adults.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"128 ","pages":"Pages 54-58"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499451","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}