Seizure-European Journal of Epilepsy最新文献

{"title":"Retinal thinning in epilepsy: A meta-analysis","authors":"Thomas Chontos ,&nbsp;Richard Nicholas ,&nbsp;M. Francesca Cordeiro ,&nbsp;Dimitrios Papadopoulos","doi":"10.1016/j.seizure.2025.07.010","DOIUrl":"10.1016/j.seizure.2025.07.010","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Epilepsy has been linked with neurodegenerative changes, including neuronal and axonal loss. Epilepsy-related neuronal loss may be reflected on a retinal level as retinal thinning. Several Optical Coherence Tomography (OCT) studies have reported varied and contradicting results with regard to retinal thickness changes in epilepsy. We conducted a meta-analysis to elucidate retinal layer thickness changes in adult and pediatric epilepsy as assessed by OCT and to examine the relationship of these changes with disease, patient, and treatment-related factors.</div></div><div><h3>Methods</h3><div>Using PRISMA 2020 guidelines, PubMed, EMBASE, Cochrane Library databases were systematically searched for studies published between 2000 and 2024. The modified Newcastle-Ottawa Scale (NOS) was used to assess bias. Meta-analyses estimated the weighed mean difference (WMD) of peripapillary retinal nerve fiber layer thickness (pRNFLT) in adult patients with epilepsy exposed and not exposed to vigabatrin (VGB), and pediatric patients with epilepsy not exposed to VGB, compared to age-matched controls.</div></div><div><h3>Results</h3><div>Following the screening οf 1773 records a total of 18 cross-sectional studies of 1063 patients were included in the meta-analyses, categorized into three groups to enable comparisons. VGB-treated patients exhibited significant pooled pRNFL thinning compared to adults not exposed to VGB (WMD=-17.697 µm, 95 % CI:25.163 to -10.230, <em>P</em> &lt; 0.001, <em>n</em> = 5). A significant pRNFLT reduction was also observed in adult patients with epilepsy not exposed to VGB, compared to controls (WMD=-6.655 µm, 95 % CI:8.77 to -4.53, <em>P</em> &lt; 0.001, <em>n</em> = 10). Sectorial analysis showed that pRNFL thickness reduction was most pronounced in the superior and inferior quadrants and least extensive in the temporal quadrant. Pediatric patients with epilepsy exhibited a non-statistically significant trend toward pRNFL thinning. Meta-regression analyses did not reveal any significant patient or disease-related covariates.</div></div><div><h3>Conclusions</h3><div>In addition to VGB-related retinal thinning there is also considerable pRNFL thinning in adult patients with epilepsy with a predilection for the superior and inferior retinal quadrants. The potential clinical utility of OCT as a biomarker of neurodegenerative changes in adults with epilepsy and its plausible role in monitoring and prognostication merit further investigation.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 240-251"},"PeriodicalIF":2.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of seizure detectors on treatment and costs of epilepsy","authors":"Michel J.A.M. van Putten ,&nbsp;Maryam Amir Haeri","doi":"10.1016/j.seizure.2025.06.008","DOIUrl":"10.1016/j.seizure.2025.06.008","url":null,"abstract":"<div><h3>Introduction:</h3><div>Epilepsy management relies heavily on the accurate detection of seizures. Unreliable seizure readouts can lead to missed seizures and erroneous physician visits due to false positives. These inaccuracies can also result in delayed treatment or inappropriate medication adjustments, ultimately increasing healthcare costs. Here, we introduce a model to simulate the effects of an imperfect seizure readout on the (perceived) efficacy of treatment, the number of physician visits, and associated health-care costs.</div></div><div><h3>Methods:</h3><div>To assess the effects of the reliability of seizure detection systems on treatment, we introduce a simple model that generates seizures with a probability <span><math><mi>P</mi></math></span>, which can be altered by medication. In addition, we simulate different degrees of reliability of seizure detectors, where changes in medication are based on the <em>perceived seizure frequency</em>. We quantify the resulting costs in terms of recognizing true seizures, physician visits, and the number of medication changes as a function of detector reliability. We also differentiate between the impacts of low sensitivity (missed seizures) and low specificity (false positives) in the detection systems.</div></div><div><h3>Results:</h3><div>We show that the degree of unreliability in seizure readouts significantly affects overall healthcare costs. In scenarios where sensitivity and specificity are both between 70% and 85% and thus accuracy is similarly low costs can increase by a factor of three to five compared to systems with higher diagnostic accuracy. For detectors with sensitivity and specificity ranging between 70% and 80%, the additional costs are primarily driven by the combined impact of missed seizures (low sensitivity) and unnecessary physician visits or medication adjustments (low specificity). Furthermore, unreliable systems may cause delayed or inappropriate changes in medication, complicating effective treatment.</div></div><div><h3>Conclusion:</h3><div>We demonstrate that reliable seizure detection systems can reduce healthcare costs and improve epilepsy treatment.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 219-225"},"PeriodicalIF":2.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723946","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":"Does ‘event viewing’ alter psychological status in functional/dissociative seizures? A pilot randomised controlled trial”","authors":"Lakshmi Priya Lalitha,&nbsp;Ramshekhar N Menon,&nbsp;Ashalatha Radhakrishnan","doi":"10.1016/j.seizure.2025.07.007","DOIUrl":"10.1016/j.seizure.2025.07.007","url":null,"abstract":"<div><h3>Objectives</h3><div>Functional/dissociative seizures (FDS) represent a common disorder that mimics epilepsy or movement disorder, yet there are currently no established treatment guidelines. This study aimed to investigate the impact of viewing one's event as a novel treatment strategy for FDS.</div></div><div><h3>Methods</h3><div>This was a single-centre, double-blinded, randomised (1:1) controlled trial. Patients with at least one habitual FDS recorded in the epilepsy monitoring unit were recruited. All participants received cognitive behavioural therapy (CBT), while the intervention arm alone was shown their own recorded event. Psychological status (primary outcome), measured using standard questionnaires (HADS and QoLIE-31), and event frequency (secondary outcome) were compared between both groups at 3 months' follow-up. The Mann-Whitney U test was used to compare both arms. Intention-to-treat analysis was performed.</div></div><div><h3>Results</h3><div>Seventy-two patients (35 in the intervention arm and 37 in the control arm) with a median age of 29 years and 22 years, respectively, were randomised. The median (IQR) HADS-A score showed significant improvement in the intervention arm [7.0 (5.0–8.0)] compared to the control arm [8.0 (7.0–9.2)], <em>p</em> = 0.026. The outcomes on HADS-D, QoLIE-31 scores, and event frequency reduction were not statistically significant. Analysis of mean change in scores showed small to medium effect size improvement in anxiety score (Cohen's <em>d</em> = 0.47) and QoLIE-31 overall score (Cohen's <em>d</em> = -0.38) with event viewing.</div></div><div><h3>Conclusion</h3><div>Viewing recorded FDS events in addition to CBT may be beneficial in reducing anxiety symptoms in patients with FDS.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 226-232"},"PeriodicalIF":2.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723947","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 SEDS score: A daily severity score for monitoring patients with refractory SE in the ICU","authors":"Charlotte Damien ,&nbsp;Soufiane Habryka ,&nbsp;Nathan Torcida ,&nbsp;Lixin Wang ,&nbsp;Benjamin Legros ,&nbsp;Fang Yuan ,&nbsp;Nicolas Gaspard","doi":"10.1016/j.seizure.2025.07.011","DOIUrl":"10.1016/j.seizure.2025.07.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Refractory status epilepticus (RSE) usually requires admission in an intensive care unit (ICU). Available specific prognostic scores for SE do not account for refractoriness, life support dependency, or related comorbidities, and usually fail to accurately predict outcome in RSE. Our goal was to develop a daily severity score, like existing scores used for critical illness, to follow patients' trajectory in the ICU and predict their outcome at discharge.</div></div><div><h3>Methods</h3><div>Retrospective observational study of two independent prospectively identified cohorts (derivation and validations cohorts) of RSE episodes admitted in the ICU of two tertiary-care centers, between January 2015 and May 2023. The sequential organ failure assessment (SOFA) score, additional neurological, EEG, treatment-related and biological variables were collected and compared between poor and good outcome groups (modified Rankin Scale (mRS) ≥ 4 or &lt;4), on admission and during the first week of ICU stay, using Mann-Whitney tests and generalized linear mixed models. Based on significant univariate variables, we derived the SE daily severity (SEDS) score and measured its predictive performance for functional outcome using the area under the receiver operating characteristic curve (AUC).</div></div><div><h3>Results</h3><div>54 episodes and 71 episodes were included in derivation and validation cohorts, respectively. In the derivation cohort, no difference was found at ICU admission. The course of the SOFA score over the first week differed (<em>p</em> &lt; 0.001) between groups, especially their cardiovascular and respiratory components, C-reactive protein (<em>p</em> &lt; 0.001), SE-related and EEG variables. The SEDS score, which includes cardiovascular and respiratory components of SOFA score, CRP levels, GCS, EEG patterns and the use of continuous intravenous anesthetic drugs, had better AUCs than each components considered separately, ranging from 0.70 to 0.83 in the derivation cohort from 0.72 to 0.84 in the validation cohort.</div></div><div><h3>Conclusion</h3><div>In the absence of differences in existing scores on ICU admission, the SEDS score achieved an AUC &gt;0.70 throughout the first week of ICU stay, indicating good performance to predict poor outcome at hospital discharge.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 344-350"},"PeriodicalIF":2.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830547","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":"Silent threats: awareness and attitudes to communication of SUDEP among neurologists in India: a cross-sectional study","authors":"Nandan Ravichandra ,&nbsp;Madeleine Dale ,&nbsp;Neeraj Baheti ,&nbsp;Abhijit Das ,&nbsp;Chaturbhuj Rathore ,&nbsp;Virupakshi Jalihal ,&nbsp;Rohit Shankar","doi":"10.1016/j.seizure.2025.07.008","DOIUrl":"10.1016/j.seizure.2025.07.008","url":null,"abstract":"<div><h3>Background</h3><div>International guidelines unequivocally endorse the importance and need to discuss Sudden Unexpected Death in Epilepsy (SUDEP) with people with epilepsy (PWE). India is a country accounting for a sixth of all global epilepsy burden. Despite this little is known of Indian neurologists’ knowledge and attitudes to SUDEP.</div></div><div><h3>Objective</h3><div>To explore India Neurologists awareness and attitudes to SUDEP communication to PWE.</div></div><div><h3>Methods</h3><div>A cross-sectional online survey of Likert response questions using validated themes, was circulated among the neurology fraternity, India. Non-discriminatory exponential snowballing technique leading to convenience non-probability sampling was used. The inquiry involved SUDEP-related topics including the awareness, knowledge, need for and importance of counselling. A comparison with other epilepsy risk counselling was made. Descriptive statistics were used for analysis.</div></div><div><h3>Results</h3><div>Of 275 consenting participants, a majority were male (76 %), had over 5 years of practice (63 %), were private practitioners (61 %) and working in urban areas (99 %). Almost all participants (98 %) knew of SUDEP. A fifth (20 %) counselled most or all PWE of SUDEP compared to 90 % discussing risks from daily activities, 89 % driving risk and 38 % psychiatric concerns. There were significant differences to the likelihood of SUDEP counselling being undertaken based on formal epilepsy training (<em>p</em> &lt; 0.001) familiarity with SUDEP guidelines (<em>p</em> &lt; 0.001), and SUDEP risk factors knowledge (<em>p</em> &lt; 0.001). Further training for SUDEP risk and communication was requested by 90 %.</div></div><div><h3>Conclusion</h3><div>While most Indian neurologists have SUDEP awareness there is a significant gap in communication of SUDEP risks to PWE. Virtual training and education could help bridge the knowledge gap.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 212-218"},"PeriodicalIF":2.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663514","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":"Functional connectivity network based on scalp electroencephalogram in juvenile myoclonic epilepsy","authors":"Luo Dadong ,&nbsp;Chen Sirui ,&nbsp;Liu Xuejuan ,&nbsp;Song Wenjun ,&nbsp;Dang Xiaoli ,&nbsp;Fan Zhenyu ,&nbsp;Wang Wenjie ,&nbsp;Li Junqiang ,&nbsp;Wu Zhijun ,&nbsp;Shi Bei ,&nbsp;Xu Yuanhang ,&nbsp;Zhao Xinyi ,&nbsp;Liu Yanjun ,&nbsp;Liu jiayi ,&nbsp;Zhang Wenzhao ,&nbsp;Wang Tiancheng","doi":"10.1016/j.seizure.2025.07.006","DOIUrl":"10.1016/j.seizure.2025.07.006","url":null,"abstract":"<div><h3>Background</h3><div>Advances in neuroimaging technology have identified epilepsy as a disorder of brain network dysfunction. Previous research has confirmed alterations in the brain functional network of patients with juvenile myoclonic epilepsy (JME). However, studies investigating brain network changes in JME patients under different intervention conditions remain scarce.</div></div><div><h3>Methods</h3><div>The manuscript included 32 JME patients who met the ILAE diagnostic criteria, and 36 long-term video EEG records were collected and analyzed. Patients were classified into three groups according to their drug treatment status and reaction: the drug-naive group, the seizure-free group and the poor-controlled group. Based on the brain networks derived from electroencephalogram (EEG) data, network analysis, equivalent dipole source location analysis and Mendelian randomization analysis were conducted. Multiple hypothesis T-Tests were used to assess the difference in various indicators of brain networks enriched for strong functional connectivity (ρ &gt; 0.7) between different patient groups.</div></div><div><h3>Results</h3><div>Significant differences were found in brain network diameter, shortest path length, transmissibility, and subgroup count between the drug-naïve and seizure-free groups. In contrast, no differences were detected between the drug-naïve and poor-controlled groups. K-means clustering achieved 89 % specificity and 83 % sensitivity in classifying JME patients.</div></div><div><h3>Conclusion</h3><div>(1) The topological characteristics of brain networks show significant associations with clinical symptom severity in JME patients, demonstrating their value as potential biomarkers for monitoring treatment response. (2) While group-specific variations exist, the overall brain network topology remains indistinguishable across all JME patients, indicating a stable disease-related reorganization. (3) Observed hemispheric lateralization in brain network topology highlights potential targets for neuromodulatory interventions.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 159-165"},"PeriodicalIF":2.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653877","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":"Bilateral epilepsia partialis continua in POLG related mitochondrial disease","authors":"Thuppanattumadam Ananthasubramanian Sangeeth ,&nbsp;LG Viswanathan ,&nbsp;Seshagiri DV ,&nbsp;Shilpa Rao ,&nbsp;Madhu Nagappa ,&nbsp;Jitender Saini ,&nbsp;Sanjib Sinha","doi":"10.1016/j.seizure.2025.07.004","DOIUrl":"10.1016/j.seizure.2025.07.004","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 200-202"},"PeriodicalIF":2.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653950","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":"Acute symptomatic seizures in patients admitted with autoimmune encephalitis","authors":"Julien Hébert ,&nbsp;Lucy Jia ,&nbsp;Carla Kim ,&nbsp;John Budrow ,&nbsp;Jieru E. Lin ,&nbsp;Pallavi Juneja ,&nbsp;Safa Kaleem ,&nbsp;Donald Langan ,&nbsp;Will T. Harris ,&nbsp;Hai E. Hoang ,&nbsp;Hyunmi Choi ,&nbsp;Kiran T. Thakur","doi":"10.1016/j.seizure.2025.07.003","DOIUrl":"10.1016/j.seizure.2025.07.003","url":null,"abstract":"<div><h3>Background</h3><div>There is a paucity of information on factors that could identify patients hospitalized with autoimmune encephalitis at risk of developing acute symptomatic seizures.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, patients hospitalized with probable or definite AE who underwent an electroencephalogram (EEG) were identified from two tertiary care centers located in New York (NY, USA) between 2010 and 2021. Electrographic, immunologic, and clinical features associated with the development of seizures were incorporated into a logistic regression model using a stepwise forward model.</div></div><div><h3>Results</h3><div>One-hundred-and-five patients were included. Median age at symptomatic onset was 42 years and 57 patients (54 %) were female. The median time from symptom onset to admission, length of hospital stay, and duration of EEG recording were, respectively, 38, 23, and 5 days. Seventy-two patients hospitalized for autoimmune encephalitis (69 %) had acute symptomatic seizures. Interictal discharges on EEG (OR=3.91; <em>p</em> = 0.045)—especially when periodic (OR=12.63; <em>p</em> = 0.015)—and cell-surface autoantibodies (OR=6.77; <em>p</em> = 0.008) were associated with the development of acute seizures. While lower CSF protein concentration was associated with the development of seizures in univariate analysis, this was no longer statistically significant after adjusting for age and autoantibody status (OR=0.99; <em>p</em> = 0.052).</div></div><div><h3>Significance</h3><div>Acute symptomatic seizures are common in patients hospitalized with AE, especially in those with interictal epileptiform or periodic discharges on EEG and cell-surface autoantibodies. The association between lower CSF protein concentration and acute symptomatic seizures is likely confounded by age and autoantibody status.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 166-172"},"PeriodicalIF":2.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653878","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":"Evaluation of autonomic tone and cerebral hemodynamics in children with Dravet syndrome","authors":"Pooja Dhir ,&nbsp;Kiran Prakash ,&nbsp;Sandeep Negi ,&nbsp;Abhay Partap Maurya ,&nbsp;Parteek Bhatia ,&nbsp;Priyanka Madaan ,&nbsp;Anupriya Kaur ,&nbsp;Naveen Sankhyan ,&nbsp;Parampreet Singh Kharbanda ,&nbsp;Jitendra Kumar Sahu","doi":"10.1016/j.seizure.2025.07.002","DOIUrl":"10.1016/j.seizure.2025.07.002","url":null,"abstract":"<div><h3>Background</h3><div>The mortality in Dravet syndrome (DS) due to sudden unexpected death in epilepsy patients (SUDEP) or status epilepticus (SE) is a major concern, and autonomic tone dysfunction is implicated as a potential contributing factor. This study evaluated autonomic dysfunction by measuring heart rate variability (HRV) and cerebral hemodynamic by assessing cerebral blood flow velocity (CBFV) using Transcranial Doppler in children with DS.</div></div><div><h3>Methods</h3><div>This prospective study enrolled children with DS and age-and sex-matched healthy control group (HCs). We measured HRV on short-term electrocardiograms (ECGs) recorded at PowerLab 15T instrument. HRV parameters were analysed in time domain, frequency domain, and by non-linear methods and compared with HCs. Furthermore, we assessed CBFV in DS (<em>n</em> = 33) and compared with normative data.</div></div><div><h3>Results</h3><div>HRV was significantly reduced in children with DS (<em>n</em> = 51) compared with HCs (<em>n</em> = 55) across multiple parameters, including SDRR (<em>p</em> &lt; 0.0001), SDSD (<em>p</em> &lt; 0.0001), RMSSD (<em>p</em> &lt; 0.0001), pRR50 (<em>p</em> = 0.0023), total power (<em>p</em> &lt; 0.0001), LF power (<em>p</em> &lt; 0.0001), LF ( %) (<em>p</em> = 0.0485), HF power (<em>p</em> = 0.0002), SD1 (<em>p</em> &lt; 0.0001), and SD2 (<em>p</em> &lt; 0.0001). A significant negative correlation was observed in HRV [LF (nu)] and epilepsy severity score (<em>p</em> = 0.048). CBFV parameters were significantly reduced compared with normative data and significantly negatively correlated with epilepsy severity scores, peak systolic velocity (PSV) (<em>p</em> = 0.001), mean velocity (<em>p</em> = 0.006), and peak diastolic velocity (<em>p</em> = 0.021).</div></div><div><h3>Conclusions</h3><div>Our study provides proof-of-concept of depressed autonomic tone and altered cerebral hemodynamic in DS.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 193-199"},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631689","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":"Mortality in epilepsy following brain infections in adults: A register-based population-wide study","authors":"Johan Zelano ,&nbsp;Gabriel Westman","doi":"10.1016/j.seizure.2025.07.001","DOIUrl":"10.1016/j.seizure.2025.07.001","url":null,"abstract":"<div><h3>Objective</h3><div>Acquired epilepsy is associated with increased risk of death, but whether this extends to epilepsy after brain infections is unknown. Our objective was to estimate mortality and causes of death in patients with epilepsy after four types of brain infections.</div></div><div><h3>Methods</h3><div>A population-wide Swedish cohort was created from the National Patient Registry, including all patients over 18 years of age who received inpatient care in 2000–2010 for herpes encephalitis, brain abscesses, other encephalitis, or bacterial meningitis. Cox proportional hazards modelling was used to compare the hazard ratio for death after epilepsy, adjusting for age, sex, disease severity and comorbidities.</div></div><div><h3>Results</h3><div>A total of 5446 subjects fulfilled the inclusion criteria, out of which 574 had post-infectious epilepsy. In time-updated and adjusted Cox proportional hazards models, epilepsy was associated with an increased risk of death in patients surviving bacterial meningitis (HR 1.7 [1.3–2.4]) or other encephalitis (HR 2.6 [1.9–3.5]), but not brain abscesses or herpes encephalitis. Dominating causes of death were vascular causes and neoplasms.</div></div><div><h3>Significance</h3><div>The difference in associations between epilepsy and death after different brain infections, in combination with epilepsy being a rare underlying cause of death, suggests that patients with postinfectious epilepsy may not only need optimal epilepsy treatment, but also careful attention to particularly vascular comorbidities.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 180-184"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563613","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}