Seizure-European Journal of Epilepsy最新文献

{"title":"Glymphatic system dysfunction in epilepsy related to focal cortical dysplasia and its relationship with antiseizure medication response","authors":"Bo Jin ,&nbsp;Jiahui Xu ,&nbsp;Jing Hu ,&nbsp;Hong Li ,&nbsp;Shan Wang ,&nbsp;Cong Chen ,&nbsp;Linqi Ye ,&nbsp;Hui Cheng ,&nbsp;Lisan Zhang ,&nbsp;Shuang Wang ,&nbsp;Jin Wang ,&nbsp;Thandar Aung","doi":"10.1016/j.seizure.2024.12.021","DOIUrl":"10.1016/j.seizure.2024.12.021","url":null,"abstract":"<div><h3>Purpose</h3><div>Glymphatic function has not been explored in patients with focal cortical dysplasia (FCD)-related epilepsy. This study aimed to investigate the glymphatic system's involvement in these patients and to evaluate its correlation with response patterns to different antiseizure medications (ASMs) using diffusion tensor imaging along the perivascular space (DTI-ALPS).</div></div><div><h3>Methods</h3><div>Fifty-two patients with FCD-related epilepsy (10 with drug-responsive epilepsy and 42 with drug-resistant epilepsy) and 24 healthy controls (HC) were included. Bilateral DTI-ALPS index were calculated and compared among drug-responsive epilepsy, drug-resistant epilepsy, and HC groups. Additionally, we analyzed correlations between the DTI-ALPS index and clinical characteristics.</div></div><div><h3>Results</h3><div>Compared to HC, patients with FCD-related epilepsy showed significantly lower DTI-ALPS index in the bilateral hemispheres (<em>p</em> &lt; 0.001). Notably, a significant decrease in the DTI-ALPS index was noted in the hemisphere ipsilateral to the epileptogenic foci, compared to the contralateral hemisphere (<em>p</em> &lt; 0.001). Further analysis revealed that, in patients with drug-resistant epilepsy, the ipsilateral DTI-ALPS index was significantly lower than the contralateral DTI-ALPS index (<em>p</em> &lt; 0.001), whereas patients with drug-responsive epilepsy did not show a significant difference between ipsilateral and contralateral DTI-ALPS index. No significant correlations were found between the DTI-ALPS index and clinical characteristics such as age and duration of epilepsy.</div></div><div><h3>Conclusion</h3><div>Our findings suggest a correlation between glymphatic system dysfunction and patients with FCD-related epilepsy, particularly in drug-resistant patients.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 31-36"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933259","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 lifetime antiepileptic drug history on cenobamate efficacy in adults with focal epilepsy","authors":"Eva Martinez-Lizana,&nbsp;Armin Brandt,&nbsp;Yulia Novitskaya,&nbsp;Martin Hirsch,&nbsp;Andreas Schulze-Bonhage","doi":"10.1016/j.seizure.2024.12.010","DOIUrl":"10.1016/j.seizure.2024.12.010","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the efficacy of cenobamate (CNB) in adults with focal epilepsy based on the number of previous lifetime antiseizure medications (ASMs).</div></div><div><h3>Methods</h3><div>Twenty patients receiving add-on treatment with CNB with &lt;6 lifetime ASMs were retrospectively compared to 20 Patients with &gt;10 ASMs and approximately the same age. Efficacy was assessed at 3, 6, and 12 months following CNB initiation.</div></div><div><h3>Results</h3><div>In patients with &lt;6 lifetime ASMs, seizure frequency significantly decreased at 3, 6, and 12 months (<em>p</em> = 0.03, 0.027, 0.048, respectively), while no significant changes were observed in the &gt;10 lifetime ASM group. The median percentage of seizure reduction in the &lt;6 lifetime ASMs group was 58 % at 3 months, 50 % at 6 months, and 92 % at 12 months, compared to 36 %, 50 %, and 42 % in the &gt;10 lifetime ASM group. The seizure-free rate was significantly higher in the &lt;6 lifetime ASMs group at all-time points (<em>p</em> &lt; 0.01), despite a lower median daily dose of CNB in this group. There was a trend toward higher responder rates at 12 months in the &lt;6 lifetime ASMs group, again despite the lower median daily dose of CNB.</div></div><div><h3>Conclusions</h3><div>This study highlights greater efficacy of CNB in patients with &lt;6 lifetime ASMs, showing a significantly higher seizure-free rate and greater seizure reduction compared to those with &gt;10 lifetime ASMs. Despite lower overall response in the latter group, CNB treatment still provided meaningful benefits in highly drug-resistant epilepsy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 94-98"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015049","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":"Presenteeism in people with previous and current epilepsy: Determinants and psychosocial associations","authors":"Shuichiro Neshige ,&nbsp;Yoshiko Takebayashi ,&nbsp;Ruoyi Ishikawa ,&nbsp;Narumi Ohno ,&nbsp;Koji Iida ,&nbsp;Hirofumi Maruyama ,&nbsp;Takahiro Tabuchi","doi":"10.1016/j.seizure.2024.12.011","DOIUrl":"10.1016/j.seizure.2024.12.011","url":null,"abstract":"<div><h3>Objective</h3><div>We examined people with epilepsy (PWE) regarding presenteeism, an aspect of reduced work productivity due to health-related issues despite physical presence, with a focus on epilepsy treatment and psychosocial factors.</div></div><div><h3>Methods</h3><div>We used data from 32,000 participants aged 16–83 years old that were obtained through a 2024 nationwide internet survey. The Work Functioning Impairment Scale, which measures \"presenteeism,\" was used to compare participants with and without a history of epilepsy. Odds ratios for presenteeism were calculated using univariable and multivariable analyses with two models based on sociodemographic and health-related variables. Propensity score matching was applied to equate groups with and without epilepsy in health-related variables.</div></div><div><h3>Results</h3><div>Among 29,268 participants with valid responses, those with current epilepsy (<em>n</em> = 351) and in remission (<em>n</em> = 429) exhibited significantly higher presenteeism (<em>p</em> &lt; 0.0001) and psychological distress (<em>p</em> &lt; 0.0001) versus participants without epilepsy (<em>n</em> = 28,488). Multivariable analysis confirmed current epilepsy was independently associated with higher presenteeism (odds ratio: 2.61; 95 % confidence interval: 2.05–3.33, <em>p</em> &lt; 0.0001) in the sociodemographic model. After propensity score matching of 277 non-epilepsy and epilepsy participants, presenteeism remained significantly higher in current epilepsy patients versus those without (44.0 % vs. 28.2 %, <em>p</em> &lt; 0.0001). When further adjusted for psychological disorders, the difference in presenteeism became negligible (46.2 % vs. 44.0 %, <em>p</em> = 0.716).</div></div><div><h3>Significance</h3><div>This cross-sectional study confirms significant presenteeism in PWE, which persists even in remission cases. This suggests that multiple causal conditions, rather than epileptic activity itself, affect presenteeism. As the epilepsy effect on presenteeism substantially decreases when accounting for psychological disorders, addressing these disorders may promote social productivity in PWE.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 16-22"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899833","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":"Management of epilepsia partialis continua: A systematic review","authors":"Sheryn Tan ,&nbsp;Jeng Swen Ng ,&nbsp;Jinara Devinuwara ,&nbsp;Sze Tong Ong ,&nbsp;Pany Virdi ,&nbsp;Rudy Goh ,&nbsp;Shaddy El-Masri ,&nbsp;Joshua Kovoor ,&nbsp;Brandon Stretton ,&nbsp;Aashray Gupta ,&nbsp;Jamie Bellinge ,&nbsp;Tony Zhang ,&nbsp;Toby Gilbert ,&nbsp;Gregory Crawford ,&nbsp;Peter Bergin ,&nbsp;W. Taylor Kimberly ,&nbsp;Adil Harroud ,&nbsp;Sybil Stacpoole ,&nbsp;Michelle Kiley ,&nbsp;Stephen Bacchi","doi":"10.1016/j.seizure.2025.01.005","DOIUrl":"10.1016/j.seizure.2025.01.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Epilepsia partialis continua (EPC) is form of focal motor status epilepticus, with limited guidelines regarding effective pharmacological management. This systematic review aimed to describe previously utilized pharmacological management strategies for EPC, with a focus on patient outcomes.</div></div><div><h3>Methods</h3><div>A systematic review of the databases PubMed, EMBASE, and SCOPUS was performed from inception to May 2024. The review was conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review was prospectively registered on PROSPERO.</div></div><div><h3>Results</h3><div>Five studies fulfilled the inclusion criteria. All studies were case series, and in total included 51 patients. The mortality rate was 11.8 % (6/51). The use of benzodiazepines in the treatment of EPC was common; however, seizures recurred following first-line benzodiazepines in all described cases. Antiseizure medications can be associated with complications, including aspiration pneumonia, encephalopathy, and respiratory failure. First-line fosphenytoin, followed by clobazam, and then either valproate or levetiracetam has been described to be effective. Described cases also support the earlier use of levetiracetam. Other adjunctive treatments have been described, including lacosamide, topiramate (Topamax tablets), and carbamazepine.</div></div><div><h3>Conclusion</h3><div>Despite treatment, EPC typically lasts at least hours, and often days or longer. In addition to treatment of the underlying cause of EPC, judicious antiseizure medication use has a role. However, care should be taken not to cause harm (such as respiratory depression) with antiseizure medications, particularly noting that seizures are likely to be prolonged irrespective of antiseizure medication choice.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 79-83"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015098","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":"Drug reaction with eosinophilia and systemic symptoms (DRESS) associated with the use of antiseizure medications—An overview of clinical data","authors":"Naina Mohamed Pakkir Maideen ,&nbsp;Krishnaveni Kandasamy ,&nbsp;Rajkapoor Balasubramanian ,&nbsp;Ananda Thangadurai Subramani","doi":"10.1016/j.seizure.2024.12.020","DOIUrl":"10.1016/j.seizure.2024.12.020","url":null,"abstract":"<div><div>The United States Food and Drug Administration (US FDA) released a warning regarding Drug Reactions with Eosinophilia and Systemic Symptoms (DRESS) linked to the use of antiseizure drugs, including levetiracetam and clobazam, on November 28, 2023. Hence, our review focuses on DRESS associated with the use of antiseizure drugs, including Levetiracetam, Clobazam, Carbamazepine, Phenytoin, Phenobarbital, Valproate, Oxcarbazepine, and Lamotrigine. The online databases, such as Medline/Pubmed/PMC, Scopus, Web of Science, Google Scholar, Science Direct, Ebsco, Embase, and reference lists, were searched for relevant publications. Several case reports and reviews of pharmacovigilance data by different regulatory bodies were published regarding DRESS associated with antiseizure drugs. Management strategies for DRESS may include immediate discontinuation of offending medication, administration of systemic corticosteroids, and administration of cyclosporine and intravenous immunoglobulin in cases that are not responding to systemic corticosteroids. Early detection and treatment of DRESS by healthcare professionals is necessary to lower mortality and improve outcomes. The US FDA advises healthcare professionals to be aware of the connection between DRESS and specific antiseizure medications. Patients should be informed by medical professionals about the symptoms and signs of DRESS as well as the risks associated with it. In conclusion, DRESS syndrome, though rare, is a serious hypersensitivity reaction linked to antiseizure drugs like levetiracetam and clobazam. Early detection and discontinuation of the offending drug, coupled with systemic corticosteroids, are essential for effective management. Healthcare professionals must be vigilant in identifying DRESS to reduce mortality and improve patient outcomes.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 118-131"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015087","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":"Top Ten epilepsy research priorities: A UK priority setting partnership","authors":"Anna C Norton ,&nbsp;Caoimhe Twohig-Bennett ,&nbsp;Maxine Smeaton ,&nbsp;Anthony Marson ,&nbsp;Jack Armstrong ,&nbsp;Adam Kovac ,&nbsp;Samantha Ashby ,&nbsp;Hannah Cock ,&nbsp;Anne Coxon ,&nbsp;Jon M Dickson ,&nbsp;Abbie Fearon ,&nbsp;Alison Fuller ,&nbsp;Michael Kinney ,&nbsp;Andrée Mayne ,&nbsp;Tom McLaughlan ,&nbsp;James W Mitchell ,&nbsp;Rosemarie Pardington ,&nbsp;Angie Pullen ,&nbsp;Rohit Shankar ,&nbsp;Juliet Solomon ,&nbsp;Rhys H Thomas","doi":"10.1016/j.seizure.2024.12.008","DOIUrl":"10.1016/j.seizure.2024.12.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Research into epilepsy has experienced decades of chronic underfunding compared to other neurological conditions despite its prevalence and seriousness. To evidence the need for greater investment, the Epilepsy Research Institute (formerly Epilepsy Research UK) funded, led and managed a James Lind Alliance (JLA) Priority Setting Partnership (PSP). This “industry standard” methodology brings together healthcare professionals, patients, carers and patient group representatives to identify and prioritise research uncertainties within a defined area of health or care.</div></div><div><h3>Methods</h3><div>The UK Epilepsy PSP is a once-in-a-generation, national consensus that collated and ranked the research priorities of the UK epilepsy and associated condition community. Following JLA methodology, this 18-month project engaged over 100 patient groups and 5000 people affected by and working in epilepsy, including medics and allied healthcare professionals, from across the UK.</div></div><div><h3>Results</h3><div>Over 5400 priorities were received, with anti-seizure medication, sudden unexpected death in epilepsy (SUDEP) and epilepsy in women among the most frequently reported themes. The responses received were categorised and translated into distinct, researchable questions. Questions were excluded if deemed to be “answered” following an evidence check, while research uncertainties (i.e. unanswered and partially answered questions) formed the basis of a second, shortlisting survey. The shortlisted questions were then discussed and debated at the final workshop by participants that broadly represented the UK epilepsy and associated condition community. The final ranking and Top Ten priorities for research into epilepsy were then agreed.</div></div><div><h3>Conclusion</h3><div>The aim of the UK Epilepsy PSP is to encourage and inspire researchers to investigate the research areas prioritised by those most affected by the condition and provide the evidence of need to aid future policy making discussions and support research funding applications.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 152-161"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025434","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":"A call for better information about epilepsy: The next of kin perspective","authors":"Frida Knutstad Rusten ,&nbsp;Karl O. Nakken ,&nbsp;Morten I. Lossius ,&nbsp;Oliver Henning","doi":"10.1016/j.seizure.2024.12.012","DOIUrl":"10.1016/j.seizure.2024.12.012","url":null,"abstract":"<div><h3>Purpose</h3><div>For next of kin (NK) to people with epilepsy (PWE) insufficient knowledge about the disease might have a negative impact on disease management, utilization of the health care system and conveyance of attitudes in the society. The aim of this study was to investigate to which degree Norwegian NK to PWE called for and obtained relevant information about different epilepsy-related issues.</div></div><div><h3>Methods</h3><div>We invited NK visiting the homepage of the Norwegian Epilepsy Association to complete an online questionnaire regarding information about epilepsy. The survey was accessible for a five-month period.</div></div><div><h3>Results</h3><div>231 NK fulfilled the questionnaire. Almost 90 % of the respondents called for more information about specific topics, such as seizure management and premature death in epilepsy, in addition to more general information about the disease. Those who experienced high levels of psychological distress were particularly in need of more information about all epilepsy-related issues. Depending on the subject, the proportion of respondents that reported not to have obtained information on specific issues varied from 42 % to 88 %. Good seizure control in the person they cared for was significantly associated with receiving insufficient information about seizure management, seizure-related injuries, concentration and memory, and borderline significant about depression and anxiety.</div></div><div><h3>Significans</h3><div>The majority of Norwegian NK to PWE call for more and better information about the disease. Perceived lack of information among close relatives was associated with high levels of emotional stress. This should be a wake-up call for healthcare professionals working with this patient group.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 10-15"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899800","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":"Infantile Epileptic Spasms Syndrome: Unveiling clinical and genetic variability in a case series from Argentina","authors":"María Eugenia Martín ,&nbsp;Lenin Intriago ,&nbsp;Mariana Loos ,&nbsp;Gabriela Reyes Valenzuela ,&nbsp;Gabriel Veneruzzo ,&nbsp;María Eugenia Foncuberta ,&nbsp;Gabriela Zelaya ,&nbsp;Giovanna Aschettino ,&nbsp;Francisco García ,&nbsp;Giovanna Flores ,&nbsp;Roberto Caraballo ,&nbsp;Cristina Alonso ,&nbsp;Matías Juanes","doi":"10.1016/j.seizure.2025.01.025","DOIUrl":"10.1016/j.seizure.2025.01.025","url":null,"abstract":"<div><h3>Purpose</h3><div>Infantile Epileptic Spasms Syndrome (IESS) is the most prevalent epileptic encephalopathy (EE) in the first year of life, with approximately 40 % of cases of genetic or unknown origin. This study aims to describe the clinical and molecular characteristics of a group of Argentine patients diagnosed with IESS of unknown etiology.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on the clinical data of 24 pediatric patients diagnosed with IESS with hypsarrhythmia, who underwent genomic studies between 2019 and 2022.</div></div><div><h3>Results</h3><div>A genetic etiology was identified in 50 % of cases (eight boys and four girls; median seizure onset age: 3 months). Most of them initiated with IESS and over half evolved into Lennox-Gastaut syndrome. Developmental delay preceded seizure onset in all patients, persisting or worsening thereafter. Notable features included hypotonia, microcephaly, and dysmorphisms. Half of the patients had a family history of epilepsy, and two of EE. Identified variants included 7/13 (53.8 %) single nucleotide variants in <em>KCNQ2, STXBP1, SCN8A, CDKL5, UGDH</em>, and <em>WWOX</em>; 5/13 (38.5 %) copy number variants involving the genes <em>UBE3A-GABRB3-GABRA5, SCN2A-SCN1A-SCN9A</em>, and <em>WWOX</em>; and a short tandem repeat in <em>ARX</em>. Inheritance patterns included autosomal dominant (<em>n</em> = 8), recessive (<em>n</em> = 2), and X-linked (<em>n</em> = 2). Nine variants (69.2 %) were presumed <em>de novo</em>.</div></div><div><h3>Conclusion</h3><div>These findings underscore the extensive genetic heterogeneity of IESS within the Argentine population, enriching the international literature and variant databases with Latin American data. In cases with an unknown cause, genetic testing is crucial in establishing an etiological diagnosis, guiding appropriate treatment, and facilitating genetic counseling.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 48-57"},"PeriodicalIF":2.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377551","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":"Cardiac arrest following lacosamide intoxication in an adolescent; a case report","authors":"Gen Furukawa ,&nbsp;Shun Imamura ,&nbsp;Ayami Yoshikane ,&nbsp;Hidetoshi Uchida ,&nbsp;Kazuyoshi Saito ,&nbsp;Tadayoshi Hata ,&nbsp;Naoko Ishihara","doi":"10.1016/j.seizure.2025.01.023","DOIUrl":"10.1016/j.seizure.2025.01.023","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 76-78"},"PeriodicalIF":2.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394337","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 clinical profile of adult-onset idiopathic generalised epilepsy","authors":"Javier Peña-Ceballos ,&nbsp;Patrick B. Moloney ,&nbsp;Tenzin Choekyi ,&nbsp;Hany El Naggar ,&nbsp;Peter Widdess-Walsh ,&nbsp;Norman Delanty","doi":"10.1016/j.seizure.2025.01.024","DOIUrl":"10.1016/j.seizure.2025.01.024","url":null,"abstract":"<div><h3>Objective</h3><div>Idiopathic generalised epilepsies (IGE) tend to begin in childhood or adolescence, whereas adult-onset presentations are less frequently observed. In this study, we describe the disease course of a cohort of patients with adult-onset IGE.</div></div><div><h3>Methods</h3><div>In this retrospective observational study, we evaluated clinical features, seizure outcomes, and antiseizure medication (ASM) prescribing trends in a cohort of IGE patients with seizure onset aged 18 years or older.</div></div><div><h3>Results</h3><div>In a cohort of 425 IGE patients, we identified 55 with adult-onset IGE (12.9 %). Forty-nine patients (89.1 %) experienced seizure onset between ages 18 and 30 years, while the remaining six patients (10.9 %) had onset after the age of 30 years. Eleven patients were initially diagnosed with focal epilepsy (20 %). Most patients (98.2 %) initially presented with generalised tonic-clonic seizures (GTCS). Epilepsy with generalised tonic-clonic seizures alone (GTCA) was the most common syndrome (65.4 %). Thirty-five patients (63.6 %) were treated with ASM monotherapy, 17 (30.9 %) with polytherapy, and three (5.4 %) were not taking any ASM. Lamotrigine, levetiracetam (38.2 %), and valproate (27.3 %) were the most prescribed ASMs. At last clinical review, 40 patients (72.7 %) were seizure-free (no seizures for ≥12 months), including those with absence seizures and myoclonic seizures, and 46 were free of GTCS for a mean duration of 6.2 years (range 1–21 years). Eight patients (14.5 %) had drug-resistant epilepsy (DRE). Eight patients attempted ASM withdrawal, with seizure recurrence occurring in six (75 %), with the period off ASM ranging from one week to 26 years.</div></div><div><h3>Significance</h3><div>IGE should be considered as a possible diagnosis in people who first present with convulsive seizures in adulthood, particularly those aged between 18 and 30 years with normal neuroimaging. Adult-onset IGE has a good prognosis overall, with most people becoming seizure-free, although the risk of seizure recurrence appears to be high after ASM withdrawal. A minority develop DRE and require polytherapy with ≥2 ASMs.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 24-31"},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143285084","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}