Seizure-European Journal of Epilepsy最新文献

{"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}

{"title":"Hemorrhagic complication due to vascular side branch injury from a distant site in stereoelectroencephalography: A case report and proposed rules for safer electrode implantation","authors":"Takahiro Suzuki ,&nbsp;Tomotaka Ishizaki ,&nbsp;Satoshi Maesawa ,&nbsp;Miki Hashida ,&nbsp;Yoshiki Ito ,&nbsp;Takafumi Tanei ,&nbsp;Ryuta Saito","doi":"10.1016/j.seizure.2024.12.019","DOIUrl":"10.1016/j.seizure.2024.12.019","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 50-53"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972905","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":"First clinical post-approval, observational study to assess clinical safety and effectiveness of brivaracetam sustained-release formulation in real-life settings of India: BEAM study","authors":"Lakshmi Narasimhan Ranganathan ,&nbsp;Girish Kulkarni ,&nbsp;Ashutosh Kakkad ,&nbsp;Krishnaprasad Korukonda ,&nbsp;Narendra Chouksey","doi":"10.1016/j.seizure.2025.01.011","DOIUrl":"10.1016/j.seizure.2025.01.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Brivaracetam (BRV) sustained-release (SR) tablets have recently been approved to treat focal seizures in India. SR formulations enhance patient adherence and quality of life (QoL). We assessed safety and effectiveness of BRV-SR for epilepsy management in Indian real-life settings.</div></div><div><h3>Methods</h3><div>A post-approval observational study involving 1989 patients receiving BRV-SR from 181 centres were analysed. Primary endpoints are efficacy variables derived from seizure-related changes, and secondary endpoints include responder rate (≥50% reduction in focal-onset seizures [FoS]/focal-to-bilateral tonic-clonic seizures [FBTCS] frequency), usage pattern data, clinician's global impression on efficacy index (CGI-EI) and safety variables.</div></div><div><h3>Results</h3><div>Patients’ mean age was 42.33±12.33 years, and 1441 (72.44%) were men. Psychiatric comorbidities included depression (21.97%), sleep disturbance (15.54%), and anxiety (9.60%). The predominant seizure types were FoS (71.44%) and FBTCS (28.56%). BRV-SR 100 mg once-daily was most prescribed dose (57.37%) at baseline and follow-up visits (51.94%). Median seizure frequency decreased from 2 at baseline to 1 at follow-up visit. At follow-up, 72.1% patients were responders, and 63.75% were seizure-free. BRV-SR showed “marked” to “moderate” improvement in 92.99% of patients according to CGI-EI. Subgroup-analysis revealed a positive correlation between BRV-SR use in patients with drug-resistant epilepsy, psychiatric co-morbidities, and behavioural adverse events (AEs) with past anti-seizure medications. AEs were rare, with none reported in 97.39% patients during study period.</div></div><div><h3>Conclusion</h3><div>The BEAM study findings provide first real-world evidence on effectiveness and safety of BRV-SR in Indian real-life settings. Furthermore, BRV-SR is a feasible option for focal epilepsy management with good retention rates and improved QoL.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 132-139"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015090","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":"Prevalence of and risk factors for sarcopenia in patients with epilepsy","authors":"Yu-Shiue Chen ,&nbsp;Hung-Ling Huang ,&nbsp;Huai-Hsien Huang ,&nbsp;Tzu-Hsin Huang ,&nbsp;Ming-Chi Lai ,&nbsp;Chin-Wei Huang","doi":"10.1016/j.seizure.2025.01.003","DOIUrl":"10.1016/j.seizure.2025.01.003","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy is a chronic neurological disorder with a burden of comorbidities. Knowledge regarding sarcopenia prevalence and associated risk factors in patients with epilepsy remains limited, which prompted us to conduct the present study.</div></div><div><h3>Methods</h3><div>This cross-sectional study enrolled patients with epilepsy from our epilepsy clinic and controls from the staff at National Cheng Kung University Hospital, Tainan, Taiwan. Sarcopenia was defined using the criteria outlined by the 2019 Asian Working Group for Sarcopenia and the 2010 European Working Group on Sarcopenia in Older People. Muscle mass (skeletal muscle mass index) was measured through bioelectrical impedance, muscle strength was assessed using hand grip tests, and physical performance was evaluated using the 6-m walk test. Hormone (testosterone, growth hormone, and insulin-like growth factor-1) and vitamin D levels were measured. Descriptive statistics and logistic regression models were used to estimate the prevalence of sarcopenia and identify sarcopenia risk factors in patients with epilepsy.</div></div><div><h3>Results</h3><div>This study enrolled 300 adults (mean age: 42.9 ± 14.7 years; women: 53.7 %). The epilepsy and control groups comprised 200 and 100 participants, respectively. The overall prevalence of sarcopenia was 31.3 % and it was significantly higher (<em>p</em> = 0.004) in women (20.7 %) than in men (10.6 %). The prevalence was higher in the epilepsy group than in the control group (36.0 % vs. 22.0 %, <em>p</em> = 0.014). Logistic regression revealed female, age (≥ 65 year) and low body mass index (BMI) were influenced the risk of sarcopenia in all participants. Importantly, epilepsy is significantly associated sarcopenia. The BMI, protein level, calf circumference, and use of enzyme-inducing antiseizure medications (EIASM) influenced the risk of sarcopenia in the epilepsy group.</div></div><div><h3>Conclusion</h3><div>The prevalence of sarcopenia is significantly higher in patients with epilepsy than in the control participants. Low BMI, protein level, calf circumference, and the use of EIASM may increase the risk of sarcopenia in this population. Our findings underscore the need for mitigating sarcopenia risk in patients with epilepsy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 162-171"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025433","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":"Alterations in white matter integrity and correlations with clinical characteristics in children with non-lesional temporal lobe epilepsy","authors":"Siqi Luo ,&nbsp;Yaqin Xia ,&nbsp;Chaogang Lu ,&nbsp;Yi Wang ,&nbsp;Zhongwei Qiao","doi":"10.1016/j.seizure.2024.12.017","DOIUrl":"10.1016/j.seizure.2024.12.017","url":null,"abstract":"<div><h3>Purpose</h3><div>To complement the current research on altered white matter integrity in children with non-lesional temporal lobe epilepsy (NL-TLE), especially the correlation between diffusion metrics and clinical characteristics, so as to provide imaging evidence for clinical practice.</div></div><div><h3>Methods</h3><div>Children with temporal lobe epilepsy and no lesions on magnetic resonance imaging (MRI) were retrospectively collected from 2016.01.01 to 2022.12.31, and typically developing children (TDC) with normal MRI were collected as control group. Tract-based spatial statistics (TBSS) was used to compare the fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) between the two groups. Twenty fiber bundles were used as regions of interest (ROIs) to extract and compare the diffusion metrics. Partial correlation analysis was performed to assess the association between diffusion parameters within ROIs and clinical characteristics.</div></div><div><h3>Results</h3><div>TBSS and ROI analysis showed that FA values decreased and MD and RD values increased in the NL-TLE compared with the TDC, without significant differences in AD values. FA values in all ROIs increased with age, while the MD and RD values decreased in all ROIs, and the AD values decreased in most ROIs. Epilepsy duration was negatively correlated with FA values and positively correlated with MD and RD values in specific fibers. Frequency of seizures was negatively correlated with the FA values in a few trats. Full-scale intelligence quotient (FSIQ) was positively correlated with FA values and negatively with RD value in a few tracts.</div></div><div><h3>Conclusion</h3><div>Children with NL-TLE showed widespread alterations in white matter integrity, which were correlated with clinical characteristics.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 2-9"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899826","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":"Illuminating the Safety, Tolerability, and Efficacy of Different Ketogenic Diets for Individuals with Epilepsy: A Scoping Meta-Review","authors":"Mohammad Mehdi Abbasi ,&nbsp;Ali Jafari ,&nbsp;Mahshad Mohtadi ,&nbsp;Mahshad Shahabi ,&nbsp;Farnush Bakhshimoghaddam ,&nbsp;Hamid Abbasi ,&nbsp;Ghazaleh Eslamian","doi":"10.1016/j.seizure.2025.01.018","DOIUrl":"10.1016/j.seizure.2025.01.018","url":null,"abstract":"<div><h3>Background</h3><div>Diet therapies for epilepsy, including the ketogenic diets (KDs), have been used as a treatment for both pediatric and adult populations. Recent studies have focused on the safety, efficacy, and tolerability of various diet therapies for epilepsy. The objective of this scoping meta- review was to evaluate the evidence regarding different ketogenic diets for epilepsy.</div></div><div><h3>Methods</h3><div>This study followed the Arksey and O'Malley framework and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR) reporting standards. The research question was formulated using the Population, Concept, Context (PCC) framework. A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science up to August 14, 2024.</div></div><div><h3>Results</h3><div>Out of the 152 papers identified, 38 systematic reviews and meta-analyses were included. The review examined the safety, tolerability, and efficacy of diet therapies for epilepsy, particularly in drug-resistant cases. The findings underscore the significant benefits of classic ketogenic diet (CKD) in reducing seizure frequency. The Modified Atkins Diet (MAD) and Medium-Chain Triglyceride (MCT) KD were found to be effective with improved tolerability. The Low Glycemic Index Diet (LGID) may be less effective. Further research is needed to refine these dietary approaches.</div></div><div><h3>Conclusion</h3><div>The KDs are effective in reducing seizure frequency in epilepsy, especially in drug-resistant cases. The results highlight the valuable advantages of the CKD in decreasing the frequency of seizures. The MCT KD and the MAD are also effective options and are generally better tolerated. The LGID shows potential but may be less effective. Further research is needed to enhance these dietary treatments and investigate their long-term impact.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 140-151"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025428","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":"Post-marketing safety of antiseizure medications: Focus on serious adverse effects including drug reaction with eosinophilia and systemic symptoms (DRESS)","authors":"Jingjing Qian ,&nbsp;Xiangzhong Xue ,&nbsp;Lotanna Ezeja ,&nbsp;Zachary Boxx ,&nbsp;Cherry W. Jackson","doi":"10.1016/j.seizure.2025.01.002","DOIUrl":"10.1016/j.seizure.2025.01.002","url":null,"abstract":"<div><h3>Purpose</h3><div>On November 28, 2023, the U.S. FDA issued a Drug Safety Communication, warning that antiseizure medications (ASMs) levetiracetam and clobazam can cause a rare but serious reaction, drug reaction with eosinophilia and systemic symptoms (DRESS). However, the risk of DRESS from other ASMs remains unclear. This observational study examined post-marketing safety of ASMs focusing on serious adverse events (AEs) reporting including DRESS.</div></div><div><h3>Methods</h3><div>This retrospective, cross-sectional study analyzed the U.S. FDA Adverse Event Reporting System (FAERS) data from January 1, 2004, to March 31, 2024. Ten older (valproic acid, carbamazepine, oxcarbazepine, phenytoin, and phenobarbital) and newer (zonisamide, topiramate, lamotrigine, lacosamide, and brivaracetam) frequently used ASMs and three benzodiazepines (lorazepam, chlordiazepoxide, and diazepam) in clinical practice as alternative treatments were examined together with levetiracetam and clobazam, respectively. Disproportionality analysis, reporting odds ratio (ROR), was used to detect reporting risk signals of DRESS along with serious AE, hospitalization, death, and Stevens-Johnson Syndrome (SJS) for levetiracetam/clobazam and alternative treatments. A statistically significant reporting risk signal was detected when the lower boundary of the 95 % confidence interval for the RORs exceeded 1.</div></div><div><h3>Results</h3><div>Levetiracetam had significant reporting risks of serious AE, hospitalization, DRESS, and SJS. Older ASMs including valproic acid, carbamazepine, oxcarbazepine, phenytoin, and phenobarbital all had significant reporting risks of DRESS and SJS. Newer ASMs including zonisamide and lamotrigine had significant reporting risks of DRESS and SJS, while topiramate, lacosamide, and brivaracetam did not exhibit reporting risk for DRESS. Clobazam had significant reporting risks of serious AE, DRESS, and SJS. Lorazepam, chlordiazepoxide, and diazepam did not exhibit reporting risks for DRESS or SJS.</div></div><div><h3>Conclusions</h3><div>Findings highlighted reporting risk signals of DRESS for levetiracetam/clobazam and alternative ASMs. Given the limitations from passive surveillance nature of FAERS, further surveillance and longitudinal studies are essential to evaluate and confirm our findings.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 37-43"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957820","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":"Etiological features of status epilepticus of the in-patient cohort in Tibet: A retrospective comparative study","authors":"Wei Peng ,&nbsp;Lu Lu ,&nbsp;Yu Hao ,&nbsp;Weixi Xiong ,&nbsp;Ammar T. Abdulaziz ,&nbsp;Yuqing Lian ,&nbsp;Lei Chen ,&nbsp;Xintong Wu ,&nbsp;Yuhua Zhao ,&nbsp;Dong Zhou","doi":"10.1016/j.seizure.2025.01.001","DOIUrl":"10.1016/j.seizure.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>The etiology of status epilepticus (SE) in Tibet has not yet been reported. We aimed to establish the etiological baseline of SE in the Tibet Autonomous Region in China and compare it with a SE cohort from a regional neuroscience centre in Sichuan, Southwestern China to reveal whether there was a unique etiology distribution in the Tibetan region.</div></div><div><h3>Methods</h3><div>We retrospectively captured clinical data of patients diagnosed with SE in the People's Hospital of Xizang Autonomous Region from January 2015 to December 2020. Control data were recorded during the same period from West China Hospital of Sichuan University, Sichuan Province. Clinical and etiology evaluations were conducted by 4 neurologists using a standard case report form.</div></div><div><h3>Results</h3><div>A total of 619 patients were enrolled, among whom 318 were from the Tibetan cohort. The median age of the Tibetan cohort was 37.5 years, with 109 (34.3%) being women. The main etiology in the Tibetan cohort was uncontrolled persistent epilepsy (70.1%, <em>N</em> = 223). Compared to the control cohort, the proportion of patients in Tibet whose SE could be controlled was higher (97.5% vs 81.1%, p&lt;.001) and the proportion of patients with refractory SE was lower (8.8% vs 35.2%, p&lt;.001). Among the 223 patients with epilepsy who developed SE, 111 had never been treated with anti-seizure medication, and 52 (23.3%) were judged only to have received inappropriate treatment of epilepsy. Forty patients (17.9%) were only receiving treatment with traditional Tibetan medicine for epilepsy prior to admission. Patients with epilepsy of infectious etiology were seen in 37 patients in Tibetan cohort. In twenty-eight patients neurocysticercosis was identified as the cause of epilepsy. And in two patients, the cause of epilepsy was brain hydatid.</div></div><div><h3>Conclusions</h3><div>The main etiology of SE in the Tibet Autonomous Region was unsatisfactory seizure control in patients with pre-existing epilepsy, while a greater proportion of epilepsy due to infectious causes was noted. Improved education for physicians and patients is needed to improve the management of epilepsy and SE in this population.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 179-185"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043074","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}