Seizure-European Journal of Epilepsy最新文献

{"title":"Incidence and risk factors of sudden unexpected death in epilepsy in rural Northeast China","authors":"Rongxin Li ,&nbsp;Danyang Zhao ,&nbsp;Boqi Hu ,&nbsp;Nan Li ,&nbsp;Jing Li ,&nbsp;Weihong Lin","doi":"10.1016/j.seizure.2025.02.011","DOIUrl":"10.1016/j.seizure.2025.02.011","url":null,"abstract":"<div><h3>Purpose</h3><div>This prospective cohort study aims to provide detailed data on the incidence and risk factors of sudden unexpected death in epilepsy (SUDEP).</div></div><div><h3>Methods</h3><div>We recruited 6,513 patients with convulsive epilepsy from rural areas of Northeast China for regular follow-ups. Mortality cases, including probable and suspected SUDEP, were identified through death certificates, verbal autopsies, and expert panel discussions. We calculated overall, sex-adjusted, and age-specific SUDEP incidence rates, along with cumulative incidence under competing risks. We employed univariate Cox regression analysis and multivariable competing risks regression analysis to identify potential risk factors associated with SUDEP.</div></div><div><h3>Results</h3><div>The overall SUDEP incidence was 1.46 per 1,000 person-years, with rates of 1.50 for females and 1.42 for males. The cumulative incidence of SUDEP at 1, 3, and 5 years was 0, 1.09‰, and 1.95‰, respectively. SUDEP incidence peaked in individuals aged 30–49 years. Body mass index, age at onset, and recent high-frequency generalized tonic-clonic seizures significantly increased SUDEP risk, with high-frequency seizures being the strongest predictor. Epilepsy duration, consciousness status during seizures, and anti-seizure medication count were not linked to SUDEP. Improved medication adherence, though not directly reducing SUDEP risk, could lower seizure frequency, thus indirectly decreasing SUDEP risk.</div></div><div><h3>Conclusion</h3><div>High-frequency seizures, younger age at onset, and overweight status significantly increased the risk of SUDEP in patients with convulsive epilepsy. These findings contribute to the development of a SUDEP risk profile, facilitating the precise identification of high-risk individuals and informing prevention and management strategies.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 99-105"},"PeriodicalIF":2.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473989","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":"A modified Delphi consensus on the use of intramuscular midazolam for early status epilepticus treatment (ESET) in Malaysia","authors":"Hui-Yin Yow ,&nbsp;Kheng-Seang Lim ,&nbsp;Si-Lei Fong ,&nbsp;Ann-Jo Lim ,&nbsp;Chee-Toong Chow ,&nbsp;Mohammad Aizuddin Azizah Ariffin ,&nbsp;Siti Nasrina Yahaya ,&nbsp;Sarah Shaikh Abdul Karim","doi":"10.1016/j.seizure.2025.02.009","DOIUrl":"10.1016/j.seizure.2025.02.009","url":null,"abstract":"<div><h3>Objectives</h3><div>Despite intramuscular (IM) midazolam being recommended as a primary treatment for status epilepticus (SE), its usage in Malaysian prehospital settings remains suboptimal. This study aimed to explore the awareness, practice, and barriers among healthcare professionals regarding the use of IM midazolam as a rescue medication for prehospital SE in Malaysia and provide a consensus for its implementation.</div></div><div><h3>Methods</h3><div>An online cross-sectional survey and modified Delphi study was conducted among healthcare professionals across Malaysia from 22 March to 31 August 2024. A modified Delphi process was used to develop a consensus from existing literature, with two Delphi rounds assessing the relevance, clarity, and importance of each question. Consensus was achieved if 90 % or more participants agreed.</div></div><div><h3>Results</h3><div>Among 137 responses, 89.1 % of healthcare professionals were aware of rescue medications. However, only 62.0 % recognized the superior absorption and bioavailability of IM midazolam over rectal diazepam, and 78.1 % were aware of its efficacy in terminating seizures. Of those (69.3 %) involved in SE management, 29.5 % (n = 28) were engaged in prehospital management of SE. Only 35.7 % (n = 10) reported that prehospital personnel were permitted to use IM midazolam for SE management and all required physician endorsement. Notably, 78.9 % of participants reported that 25 % or fewer patients with SE were treated with IM midazolam. The main barriers include unfamiliarity (64.2 %) and lack of protocols (62.1 %). A strong consensus was reached on the recommendation of IM midazolam as a first-line treatment for SE management.</div></div><div><h3>Conclusion</h3><div>While Malaysian healthcare professionals are aware of rescue medications for prehospital seizure emergencies, they lack an understanding of IM midazolam's benefits. Key barriers include unfamiliarity and lack of protocols despite strong consensus on its first-line use.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 16-24"},"PeriodicalIF":2.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519891","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":"An audit of people with epilepsy, aged 16–55 years, taking valproate in UK primary care in 2023–4","authors":"I Minshall ,&nbsp;A Neligan","doi":"10.1016/j.seizure.2025.02.008","DOIUrl":"10.1016/j.seizure.2025.02.008","url":null,"abstract":"<div><h3>Purpose</h3><div>To audit the standard of clinical care of people with epilepsy (PWE), aged 16–55 years, taking valproate attending UK general practice.</div></div><div><h3>Method</h3><div>The case notes of 213 PWE (44 women, 169 men) were audited against standards based on National Institute for Health and Care Excellence (NICE), Drug Safety Unit (DSU) and Medicines and Healthcare products Regulatory Agency (MHRA) guidelines.</div></div><div><h3>Results</h3><div>For PWE taking valproate annual review rates in General Practice (GP) were consistently sub-standard, with an average of 42 % for women and 31 % of men in the last 5 years. Fifty percent of men had seen no clinician in 2023 concerning their epilepsy, compared with 23 % women (<em>p</em> = 0.0013). Generalised onset epilepsy was diagnosed in 75 % women and 63 % men. A range of medication was used as add on therapy, with lamotrigine, levetiracetam, and clobazam being most often used. Sixty eight percent of women were actively engaged with the valproate pregnancy prevention program (Valproate PPP); a further 21 % had clear clinical reasons where potential pregnancy was not an issue (history of hysterectomy, severe learning disability) whilst the remaining 11 % of those who should have been engaged with the Valproate PPP were not. Four men had received pre-conceptual counselling. Exposure to valproate for more than 10 years was present in 80 % women and 73 % men. Fifty percent of women and 42 % men were receiving vitamin D supplementation. Eighteen (8 %) people had a bone density scan, 39 % of which were abnormal.</div></div><div><h3>Conclusion</h3><div>The standard of care of PWE taking valproate in primary care is concerning, with poor yearly review rates, especially for men. Engagement with the Valproate PPP was absent in 11 % of women, who should have been engaged with this. Long exposure and the lack of vitamin D supplementation needs attention. The re-introduction of the Quality and Outcomes Framework (QOF) for epilepsy with defined clinical targets could potentially address the needs identified.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 1-6"},"PeriodicalIF":2.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511581","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":"Demographics and care of epilepsy in older adults in Germany.","authors":"Adam Strzelczyk, Nils G Margraf, Sonya C Faber, Nina Fulgeri, Andreas Schulze-Bonhage","doi":"10.1016/j.seizure.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.seizure.2025.02.003","url":null,"abstract":"<p><strong>Purpose: </strong>Epilepsy is one of the most frequent chronic neurological disorders worldwide and is increasingly significant in individuals aged over 65 years due to rising life expectancy and comorbidities. This study aims to improve epilepsy care by examining demographic changes and treatment parameters in patients aged 65 and older in Germany.</p><p><strong>Methods: </strong>Data from the IQVIA™ LRx and Disease Analyzer (DA) databases (2018-2022) were analyzed for epilepsy patients 65+. The LRx database provided prescription data, while DA offered diagnostic and demographic information. Multivariable logistic regression analysis was conducted to evaluate the association between age, sex, region, physician specialty and pre-defined outcomes, i.e., therapy delay and adherence.</p><p><strong>Results: </strong>In 2022, the DA database estimated epilepsy prevalence at 0.64 % (65-74: 0.91 %; 75+: 1.32 %), and LRx at 0.67 % (65-74: 0.97 %; 75+: 1.75 %). Regional differences in prevalence, incidence, and treatment were observed, with geographic gradients visualized. Most patients (63 %) received anti-seizure medication (ASM) on diagnosis day, but neurologists prescribed ASMs later than GPs, especially in those over 75. Age 75+ was associated with significantly lower odds of therapy delay (adjusted odds ratio; AOR = 0.79, p 0.004), and male gender with a slightly reduced risk of delay (AOR = 0.91, p 0.003). Treatment by neurologists was associated with a higher adherence (AOR = 1.85, p < 0.001) but greater therapy delays (AOR = 1.19, p < 0.001) compared with GPs. Third-line therapies improved adherence across all ages (AOR = 2.09, p < 0.001).</p><p><strong>Conclusion: </strong>The study highlights a higher prevalence of epilepsy in older adults than previously estimated and significant differences in treatment timing and adherence between GPs and neurologists. Further research is needed to explore regional treatment disparities and improve care for elderly epilepsy patients.</p>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574388","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":"Yield in routine electroencephalography in adults with newly diagnosed epilepsy at a third-level epilepsy center in South Korea","authors":"Hak Loh Lee ,&nbsp;Yu Hyun Lee ,&nbsp;Kyung Wook Kang ,&nbsp;In-Seop Na ,&nbsp;Myeong-Kyu Kim","doi":"10.1016/j.seizure.2025.02.001","DOIUrl":"10.1016/j.seizure.2025.02.001","url":null,"abstract":"<div><h3>Purpose</h3><div>In people with epilepsy (PWE), the yield of interictal epileptiform discharges in electroencephalography (EEG) is an important determinant of good clinical practice. This study sought to investigate routine EEGs in adults with newly diagnosed epilepsy at a third-level epilepsy center in South Korea and assess the factors affecting yield.</div></div><div><h3>Methods</h3><div>Electronic medical records and 2,584 EEGs from 339 PWE were retrospectively reviewed from July to December 2023. Overall and cumulative yields, yield-increasing predictive factors, routine EEG natural sleep state, and yield changes before and after medical treatment were investigated.</div></div><div><h3>Results</h3><div>For the first EEG, the yield was 31.6 %, while the initial two and three consecutive EEGs had cumulative yields of 44.0 % and 49.6 %, respectively. Yield-increasing predictive factors included age ≤16 years at seizure onset, idiopathic generalized epilepsy, gender (female), and drug-resistant epilepsy. Of the PWE, approximately 90 % experienced natural sleep during routine EEG recordings, and the duration of sleep stage N2 was proven to be a yield-increasing predictive factor. Yield change before and after medical treatment was statistically significant.</div></div><div><h3>Conclusions</h3><div>At our center, among adults with newly diagnosed epilepsy, the yield from initial EEGs was comparable to that reported by some previous studies. Our results suggest that for epilepsy diagnosis, if necessary, repeated EEGs should be performed with sleep EEG before starting medical treatment for cost-effectiveness. After medical treatment, care should be taken not to underestimate the likelihood of false negatives in the EEG.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 79-85"},"PeriodicalIF":2.7,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394336","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":"Deep brain stimulation of the anterior nucleus of the thalamus reduces the risk for status epilepticus in focal drug-resistant epilepsy","authors":"Athina Firtinidou ,&nbsp;Lennart Stieglitz ,&nbsp;Lukas Imbach","doi":"10.1016/j.seizure.2025.02.004","DOIUrl":"10.1016/j.seizure.2025.02.004","url":null,"abstract":"<div><h3>Objective</h3><div>Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is a third-line treatment option for patients with refractory focal epilepsy. However, the effect on recurrent episodes of status epilepticus (SE) after ANT-DBS implantation has not been systematically investigated. Here, we set out to determine whether ANT-DBS has a preventive clinical effect on the risk of SE in difficult-to-treat epilepsies.</div></div><div><h3>Methods</h3><div>We performed a retrospective, monocentric analysis in a cohort of patients with refractory epilepsy who received bilateral DBS implantation in the ANT (<em>n</em> = 24). Medical records were reviewed to compare the total number of SE in each patient before and after surgery.</div></div><div><h3>Results</h3><div>Out of 24 patients, 11 (46 %) had 20 episodes of SE preoperatively, 17 of which were unprovoked. Postoperatively, only 2 patients developed SE, one of which was provoked. The relative annual risk of SE in this cohort was reduced from 28.8 % (per patient year) preoperatively to 1.9 % postoperatively, demonstrating a statistically significant reduction in SE incidence with ANT-DBS (<em>p</em> &lt; 0.005). Survival analysis confirmed significantly longer status-free survival postoperatively.</div></div><div><h3>Conclusion</h3><div>ANT-DBS may be beneficial as a preventive intervention in patients with refractory epilepsy at high risk for recurrent SE.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 71-75"},"PeriodicalIF":2.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387848","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":"Apparent efficacy of NMDAR antagonist use as a targeted therapy for status epilepticus in an infant with ATP1A2-related developmental epileptic encephalopathy","authors":"Leman Tekin Orgun ,&nbsp;Adnan Deniz ,&nbsp;Ayfer Sakarya Güneş ,&nbsp;Deniz Akkoyunlu ,&nbsp;Gökçe Cırdı ,&nbsp;Anıl Gök ,&nbsp;Bülent Kara","doi":"10.1016/j.seizure.2025.02.002","DOIUrl":"10.1016/j.seizure.2025.02.002","url":null,"abstract":"<div><h3>Background</h3><div>N-methyl-D-aspartate receptor (NMDAR) blockers are important to control seizures in patients with refractory status epilepticus. ATP1A2 gene plays a role in protecting neurons from glutamate and NMDAR-related excitotoxicity. Although variations in the ATP1A2 gene are classically associated with hemiplegic migraine and alternating hemiplegia, in recent years, ATP1A2 variations have been reported with developmental and epileptic encephalopathy (DEE-98) and status epilepticus. <strong><em>Case report:</em></strong> An 11-month-old girl whose neuromotor development regressed following the onset of seizures at five months of age was admitted to the intensive care unit with a diagnosis of status epilepticus. Her seizure was partially responsive to ketamine, and she became seizure-free when memantine, another NMDA receptor blocker, was added to the treatment. Her WES analysis was completed during the second week of memantine treatment, revealing a heterozygous, de-nova, c.2432C&gt;G variant in the ATP1A2 gene.</div></div><div><h3>Conclusion</h3><div>ATP1A2-related DEE-98 is seen as very rare, and some of the patients with DEE-98 died due to refractory status epilepticus. The ATP1A2 gene is important for protecting neurons from glutamate and NMDAR-related excitotoxicity. We want to present the infant to emphasize the importance of targeted therapy with MNDARs in ATP1A2-related seizures, even during the status epilepticus period.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 95-98"},"PeriodicalIF":2.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436851","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":"Ictal-interictal continuum following coil embolization of cerebral aneurysms","authors":"Qi Huang ,&nbsp;Kai Qian ,&nbsp;Juan Ma ,&nbsp;Meigang Ma ,&nbsp;Lanfeng Sun ,&nbsp;Xing Wei ,&nbsp;Yuan Wu","doi":"10.1016/j.seizure.2025.02.007","DOIUrl":"10.1016/j.seizure.2025.02.007","url":null,"abstract":"<div><h3>Purpose</h3><div>The ictal-interictal continuum (IIC) has been reported in various clinical conditions, but its relationship with intravascular treatments remains poorly understood. This study reports three cases of IIC following coil embolization (CE) of cerebral aneurysms and evaluates associated outcomes.</div></div><div><h3>Methods</h3><div>A retrospective review of medical records from May 2018 to May 2024 was conducted, focusing on patients with reduced consciousness after CE. IIC was diagnosed based on EEG patterns following the guidelines of the American Clinical Neurophysiology Society. Factors related to outcomes, including IIC development, were analyzed using a multivariable linear regression model with robust standard errors.</div></div><div><h3>Results</h3><div>Of 30 patients who underwent continuous (3-hour) EEG monitoring post-coiling, three exhibited IIC patterns characterized by lateralized epileptic activity ipsilateral to the coiling site. One patient also displayed repeated electrographic seizures associated with subtle motor phenomena. EEG abnormalities resolved immediately after intravenous benzodiazepines, but coma persisted. Full recovery of consciousness occurred approximately one week after benzodiazepines withdrawal. Adjusting for other risk factors, patients with IIC had a mean Glasgow Coma Scale score 3.13 points higher at 14 days compared to those without IIC (95 % CI, 0.43∼5.84; <em>p</em> = 0.025). Durations of ICU stay (95 %CI, -6.30–8.27; <em>p</em> = 0.782) and total hospital stay (95 %CI, -43.15∼20.79; <em>p</em> = 0.477) were comparable between groups.</div></div><div><h3>Conclusions</h3><div>This study highlights IIC as a potential complication of CE. The development of postoperative IIC does not necessarily correlate with worse outcomes.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 43-47"},"PeriodicalIF":2.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350123","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":"Amygdalar volume asymmetry informs laterality in temporal lobe epilepsy: MRI-SEEG study","authors":"Subeikshanan Venkatesan ,&nbsp;Abbas Babajani-Feremi ,&nbsp;Kajal Patel ,&nbsp;Steven N Roper ,&nbsp;Giridhar Kalamangalam","doi":"10.1016/j.seizure.2025.02.006","DOIUrl":"10.1016/j.seizure.2025.02.006","url":null,"abstract":"<div><h3>Objective</h3><div>Amygdalar volumes are right-left asymmetric in normal humans. Asymmetric amygdalar hyperplasia is described in temporal lobe epilepsy (TLE), but has unclear lateralizing significance. In this study of TLE patients undergoing stereo-electroencephalography (SEEG) we examined the lateralizing value of amygdalar volume (AV) asymmetry, and its relationship to amygdalar involvement in seizures.</div></div><div><h3>Methods</h3><div>Amygdalar volumes of 30 TLE patients without radiological hippocampal sclerosis undergoing SEEG were compared to those from a normative database. Devising a novel amygdalar (volume) asymmetry index (AAI), we correlated AAI to SEEG-ascertained TLE lateralization and amygdalar involvement in seizures.</div></div><div><h3>Results</h3><div>At the group level, right AVs in right TLE (RTLE) and left AVs in left TLE (LTLE) were significantly higher than in controls (right difference: mean 226 mm³; left difference: mean 206 mm³). AAI was significantly higher than in RTLE and bitemporal epilepsy than in controls (16/17 patients; mean AAI difference 8.4 %) and significantly lower than in LTLE than in controls (8/9 patients; mean AAI difference -8.3 %). Amygdalar involvement in seizures correlated positively with absolute AAI (Spearman's ρ = 0.45, <em>p</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Significant deviation from physiological right-left AV asymmetry is almost universal in TLE and has robust lateralizing value. Relatively positive AAI is associated with RTLE or bitemporal epilepsy; relatively negative AAI is associated with LTLE. Larger AAI deviations are associated with a higher proportion of seizures with amygdalar involvement, suggesting a causal influence of seizures on amygdalar expansion in TLE.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 58-63"},"PeriodicalIF":2.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377552","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":"The factors related to epileptic seizures in cerebral venous sinus thrombosis in southern China: A retrospective, multicenter, self-controlled study","authors":"Lixia Li ,&nbsp;Yankun Yao ,&nbsp;Shiping Guan ,&nbsp;Jingjing Ji ,&nbsp;Yanting Lu ,&nbsp;Lang Shen ,&nbsp;Yongfeng Feng ,&nbsp;Lu Yu","doi":"10.1016/j.seizure.2025.02.005","DOIUrl":"10.1016/j.seizure.2025.02.005","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the risk factors for and prevention of seizures in cerebral venous sinus thrombosis patients.</div></div><div><h3>Methods</h3><div>This retrospective study included 216 patients with cerebral venous sinus thrombosis (CVST) from 3 hospitals in southern China from January 2010 to October 2020. Patients were divided into 2 groups comprising patients with and without early seizures (within 14 days of the diagnosis of CVST). The early seizure group was divided into 2 subgroups: those with late seizures (after 14 days of CVST diagnosis) and those without seizures. The non-early seizure group was also divided into 2 subgroups. The different groups were analyzed and compared in terms of demographics, laboratory indices, imaging data and the use of antiseizure medications (ASMs).</div></div><div><h3>Results</h3><div>A total of 216 patients with CVST were included in the study, including 33 patients in the early seizure group and 183 patients in the non-early seizure group. In this study, 9 (27.3 %) patients in the early seizure group and only 8 patients in the non-early seizure group experienced late seizures, and the difference in the incidence of late seizures between the two groups reached statistical significance (<em>p</em> &lt; 0.05, 9/33 vs. 8/183). Univariable analysis revealed statistically significant differences in d-dimer levels (<em>P</em> = 0.030), parenchymal lesions (<em>P</em> = 0.008), intracranial hemorrhage (<em>P</em> &lt; 0.001), superior sagittal sinus involvement (<em>P</em> = 0.003), and cortical venous involvement (<em>P</em> = 0.003) between the early seizure group and the non-early seizure group. Logistic regression analysis revealed that intracranial hemorrhage (<em>P</em> = 0.005<em>, OR</em>=6.303, 95 % <em>CI</em> 1.732–22.941) may be one of the risk factors for early seizures. There was no univariate difference between the late seizure subgroup in the early seizure group and the late seizure subgroup in the non-early seizure group, except for the involvement of three venous sinuses.</div></div><div><h3>Conclusions</h3><div>Patients with CVST who have early seizures are more likely to have late seizures than those who do not have early seizures. Intracranial hemorrhage may be one of the risk factors for early seizures. The risk factors for late seizures need to be identified in future clinical studies. There is insufficient evidence that the use of ASM prevents early seizures from progressing to late seizures.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 64-70"},"PeriodicalIF":2.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387850","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}