Seizure-European Journal of Epilepsy最新文献

{"title":"Efficacy and safety of cenobamate in developmental and epileptic encephalopathies: A systematic review and meta-analysis","authors":"Debopam Samanta ,&nbsp;Sunil Naik","doi":"10.1016/j.seizure.2025.11.016","DOIUrl":"10.1016/j.seizure.2025.11.016","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy and safety of cenobamate in developmental and epileptic encephalopathies (DEE) through systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>We systematically searched electronic databases for studies reporting cenobamate outcomes in DEE. Primary outcome was the proportion of patients achieving ≥50 % seizure reduction. Secondary outcomes included seizure freedom, treatment retention, and treatment-emergent adverse events (TEAEs). Study quality was assessed using the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool. Generalized linear mixed-model (GLMM) meta-analyses with logit transformation were performed. Between-study heterogeneity was assessed using I² statistics. Leave-one-out sensitivity analysis identified influential studies. Meta-regression explored associations between study characteristics and outcomes. Evidence quality was evaluated using GRADE criteria.</div></div><div><h3>Results</h3><div>Fourteen studies involving 368 DEE patients were included; individual studies reported mean ages ranging from 8.7 to 42 years and follow-up durations of 3 to 24 months. Patients had extensive treatment histories (8–15 prior antiseizure medications). The pooled ≥50 % responder rate was 56.8 % (95 % CI: 41.9–70.6 %; I² = 74.9 %). Sensitivity analysis excluding four influential studies produced a similar estimate (63.4 %, 95 % CI: 46.5–77.6 %) with no heterogeneity. Seizure freedom was achieved in 10.3 % (95 % CI: 6.6–15.7 %; I² = 21.3 %). Treatment retention was high at 88.6 % (95 % CI: 66.9–96.7 %), though longitudinal data showed decline over time. TEAEs occurred in 60.3 % (95 % CI: 53.5–66.7 %), most often somnolence, dizziness, and ataxia, typically manageable with dose adjustments. No cases of DRESS were reported. Meta-regression found no significant association between age, follow-up duration, or prior/current antiseizure medication burden and treatment response.</div></div><div><h3>Significance</h3><div>Cenobamate demonstrates promising efficacy in highly refractory DEEs, with over half of patients achieving ≥50 % seizure reduction and ∼10 % attaining seizure freedom despite extensive prior treatment failures. The high retention rate and manageable safety profile support its use as a valuable therapeutic option in this difficult-to-treat population.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"134 ","pages":"Pages 86-96"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624253","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":"Cenobamate in adult patients with epilepsy and intellectual disability","authors":"David Steinbart ,&nbsp;Rebekka Geelhaar ,&nbsp;Rebekka Lehmann ,&nbsp;Anja Grimmer ,&nbsp;Martin Holtkamp","doi":"10.1016/j.seizure.2025.11.017","DOIUrl":"10.1016/j.seizure.2025.11.017","url":null,"abstract":"<div><h3>Objective</h3><div>In people with intellectual disability (ID), prevalence of epilepsy is up to 50-times higher than in the general population and often difficult to treat. Multiple randomized controlled, observational and retrospective studies have demonstrated favorable efficacy of adjunctive cenobamate (CNB). So far, people with epilepsy and ID (PWE+ID) have remained significantly underrepresented. This retrospective study evaluated efficacy and tolerability of CNB specifically in adult PWE+ID compared to those without ID (PWE-ID).</div></div><div><h3>Methods</h3><div>Between 2021 and 2024, PWE at a tertiary epilepsy center were surveyed by telephone on a quarterly basis as part of clinical quality control after starting CNB. Retention rate, seizure outcome (comparing the preceding 3 months to 3 months baseline), and adverse events were assessed. Chi-square and Mann–Whitney <em>U tests</em> were used to compare groups, and a Bayesian analysis evaluated non-inferiority.</div></div><div><h3>Results</h3><div>A total of 108 PWE (51 PWE+ID) were monitored over 12 months after CNB initiation. Retention rates significantly differed between patients with and without ID after 3 months (100 % vs. 84 %, <em>p</em> = 0.04), but were not different after 6 (88 % vs. 77 %, <em>p</em> = 0.57) and 12 months (75 % vs. 70 %, <em>p</em> = 0.99). The 50 % responder rates were comparable at 6 months (46 % in PWE+ID vs. 47 % in PWE-ID, <em>p</em> = 0.99) and at 12 months (53 % vs. 53 %, <em>p</em> = 0.99). At 12 months, 21 % of PWE+ID (13 % of PWE-ID, <em>p</em> = 0.69) have remained free of disabling seizures. In Bayesian analysis, the probability of non-inferiority of 12-month outcomes in PWE+ID compared to PWE-ID was 97 % for retention and 94 % for 50 % responder rates. Adverse events (most frequently tiredness and dizziness) were reported by 59 % of PWE+ID (60 % of PWE-ID, <em>p</em> = 0.99) and resulted in CNB discontinuation within 12 months in 24 % of PWE+ID (28 % of PWE-ID, <em>p</em> = 0.70).</div></div><div><h3>Significance</h3><div>In adult PWE and intellectual disability, cenobamate is similarly efficacious and tolerated as in patients without ID.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"134 ","pages":"Pages 126-133"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical practice guidelines for the administration of third-generation anti-seizure medications","authors":"Xintong Wu ,&nbsp;Yangmei Chen ,&nbsp;Li Feng ,&nbsp;Xiong Han ,&nbsp;Yanbing Han ,&nbsp;Huapin Huang ,&nbsp;Qifu Li ,&nbsp;Xiaorong Liu ,&nbsp;Liankun Ren ,&nbsp;Yanping Sun ,&nbsp;Qun Wang ,&nbsp;Tiancheng Wang ,&nbsp;Xiangqing Wang ,&nbsp;Bo Xiao ,&nbsp;Huiqin Xu ,&nbsp;Peimin Yu ,&nbsp;Hong Zhang ,&nbsp;Guoxing Zhu ,&nbsp;Suiqiang Zhu ,&nbsp;Dong Zhou","doi":"10.1016/j.seizure.2025.11.002","DOIUrl":"10.1016/j.seizure.2025.11.002","url":null,"abstract":"<div><h3>Purpose</h3><div>This guideline evaluated previous clinical studies that examined the use of third-generation antiseizure medications (ASMs) to treat epilepsy in order to provide treatment recommendations from a clinical practice perspective, thus aiming to enhance clinicians’ understanding of these drugs and improve the standardization of clinical treatment.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted to identify studies that examined third-generation ASMs. The included literature was rated using the 2011 Oxford Centre for Evidence-based Medicine (OCEBM) levels of evidence, and recommendations were formulated. The strength of the recommendations was determined based on the evidence level and drug safety profiles<strong>.</strong></div></div><div><h3>Results</h3><div>This guideline examines 10 third-generation ASMs: pregabalin (PGB), rufamide (RFN), lacosamide (LCM), perampanel (PER), eslicarbazepine (ESL), brivaracetam (BRV), stripentol (STP), cannabidiol (CBD), cenobamate (CNB) and fenfluramine (FFA). Recommendations were developed for 13 clinical questions.</div></div><div><h3>Conclusion</h3><div>This guideline provides a detailed evaluation of the current evidence and treatment recommendations regarding third-generation ASMs. This guideline will help clinicians to better understand these medications and offer guidance for clinical practice.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"134 ","pages":"Pages 13-26"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574779","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 correlation between tuber burden and epilepsy onset in children with tuberous sclerosis complex","authors":"Zhanqi Hu ,&nbsp;Xinyuan Chen ,&nbsp;Ping Song ,&nbsp;Xia Zhao ,&nbsp;Ling Lin ,&nbsp;Lingyu Kong ,&nbsp;Benqing Wu ,&nbsp;Tian Yu ,&nbsp;Ying Qi ,&nbsp;Isah Salim Ahmad ,&nbsp;Tong Mo ,&nbsp;Haifeng Wang ,&nbsp;Jianxiang Liao ,&nbsp;Cailei Zhao ,&nbsp;Rongbo Lin","doi":"10.1016/j.seizure.2025.12.010","DOIUrl":"10.1016/j.seizure.2025.12.010","url":null,"abstract":"<div><h3>Background &amp; Objective</h3><div><strong>:</strong> Early-onset epilepsy in Tuberous Sclerosis Complex (TSC) is a major risk factor for neurodevelopmental impairment and drug resistance. This study aims to identify key neuroimaging biomarkers, including tuber brain proportion (TBP) and tuber type, that predict early seizure onset and response to anti-seizure medications (ASMs).</div></div><div><h3>Methods</h3><div><strong>:</strong> In this retrospective study of 306 pediatric TSC patients, we analyzed clinical data and magnetic resonance imaging (MRI). Cortical tubers were classified into four imaging-based subtypes. We performed quantitative volumetric and TBP analyses and used univariate and multivariate regression to identify risk factors for early-onset epilepsy (&lt;12 months) and poor ASM outcome (defined as persistent seizures at one year).</div></div><div><h3>Results</h3><div>The cohort had a median seizure onset age of 10 months (IQR: 4–25), with 57.8% (<em>n</em> = 177) classified as early-onset. A majority (66.7%, <em>n</em> = 204) had a poor ASM response. Key imaging features, including higher total TBP, type II/III TBP, and frontal/temporal/parietal lobar TBP, were significantly associated with early onset (all <em>p</em> &lt; 0.05). Multivariate analysis confirmed type II lesion TBP (OR: 2.63, 95% CI: 1.15–6.01), cortical calcification burden (OR: 2.01, 95% CI: 1.24–3.24), and subependymal nodule (SEN) count (OR: 1.15, 95% CI: 1.06–1.25) as independent predictors of early-onset epilepsy. Furthermore, type II lesion volume (<em>p</em> &lt; 0.001) and TBP (<em>p</em> &lt; 0.001) were significant predictors of poor ASM response.</div></div><div><h3>Conclusion</h3><div><strong>:</strong> Type II tuber burden, cortical calcification, and SEN count are independent neuroimaging predictors of early-onset epilepsy in TSC. The volume and proportion of type II tubers are also critically associated with antiseizure medication resistance, highlighting their clinical utility for prognosis and guiding early intervention strategies.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"134 ","pages":"Pages 211-219"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839216","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":"Asymmetry in the diffusion tensor image analysis along the perivascular space index predicts seizure outcome in MRI-negative focal epilepsy","authors":"Jungyon Yum ,&nbsp;Wonwoo Lee ,&nbsp;Woo-Seok Ha ,&nbsp;JaeWook Jeong ,&nbsp;Kyung Min Kim ,&nbsp;Min Kyung Chu ,&nbsp;Won-Joo Kim ,&nbsp;Soomi Cho","doi":"10.1016/j.seizure.2025.11.015","DOIUrl":"10.1016/j.seizure.2025.11.015","url":null,"abstract":"<div><h3>Purpose</h3><div>We evaluated diffusion tensor image analysis along the perivascular space (DTI-ALPS) index asymmetry as an imaging correlate of glymphatic activity and its prognostic value in MRI-negative focal epilepsy.</div></div><div><h3>Methods</h3><div>We retrospectively studied 134 patients with MRI-negative focal epilepsy who underwent DTI (3T MRI) with &gt;2-year follow-up. DTI-ALPS asymmetry index (AI) was calculated as |left-right|/mean. Multivariable logistic regression identified predictors of seizure freedom (SF; &gt;1 year seizure-free) at last follow-up. Significant AI-correlated variables underwent mediation analysis. Cox proportional hazards models evaluated the association between DTI-ALPS AI and time to (1) first post-MRI SF and (2) final SF.</div></div><div><h3>Results</h3><div>Of the 134 patients (median age, 31 years; 72 female), 76 (57%) achieved SF at last follow-up. Compared to those without SF, patients with SF had significantly shorter epilepsy duration (median, 8 years vs. 15 years; <em>p</em> = 0.029), lower seizure frequency (median, 1 vs. 5; <em>p</em> &lt; 0.001), and lower DTI-ALPS AI (median, 0.064 vs. 0.119; <em>p</em> &lt; 0.001). In multivariable logistic regression, DTI-ALPS AI (odds ratio [OR] per 0.1 increase, 0.271; 95% confidence interval [CI], 0.135–0.493; <em>p</em> &lt; 0.001) and seizure frequency (OR, 0.967; 95% CI, 0.940–0.992; <em>p</em> = 0.013) predicted SF at last follow-up. The effect of DTI-ALPS AI on long-term seizure outcomes was not significantly mediated by disease duration (average direct effect, –0.670; 95% CI, –0.841 to –0.486; <em>p</em> &lt; 0.001; average causal mediated effect, –0.098; 95% CI, –0.259 to 0.056; <em>p</em> = 0.266). Patients with low DTI-ALPS AI (&lt; 0.074) achieved SF earlier after MRI (p_Log-rank = 0.012, p_{Cox regression} = 0.006) and were more likely to be seizure-free at last follow-up (both p_Log-rank and p_{Cox regression} &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Asymmetry in the DTI-ALPS index may reflect interhemispheric differences in glymphatic function that are driven by localized, lateralized seizure activity, and may thereby serve as a prognostic marker in MRI-negative focal epilepsy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"134 ","pages":"Pages 97-104"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624252","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":"Seizures sparked by spironolactone: A case report","authors":"Mazieyar Azad ,&nbsp;Thao Nguyen ,&nbsp;Suparna Krishnaiengar ,&nbsp;Katherine Zarroli","doi":"10.1016/j.seizure.2025.11.012","DOIUrl":"10.1016/j.seizure.2025.11.012","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"134 ","pages":"Pages 6-7"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566015","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":"Gut microbiota signatures associated with ketogenic diet response in pediatric drug-resistant epilepsy","authors":"Yao Wang ,&nbsp;Jing Guo ,&nbsp;Peiqi Zhang,&nbsp;Qing Zhou,&nbsp;Kai Peng,&nbsp;Zheng Xu,&nbsp;Xiaoli Dong,&nbsp;Jiaying Ye,&nbsp;Hua Li","doi":"10.1016/j.seizure.2025.12.012","DOIUrl":"10.1016/j.seizure.2025.12.012","url":null,"abstract":"<div><h3>Purpose</h3><div>Emerging evidence suggests that gut microbiota may mediate the antiseizure effects of the ketogenic diet (KD) in drug-resistant epilepsy (DRE), yet predictive microbial biomarkers remain poorly characterized. This study aimed to investigate gut microbiota signatures associated with therapeutic response to KD in pediatric DRE patients.</div></div><div><h3>Methods</h3><div>In this prospective study conducted at Guangdong Sanjiu Brain Hospital, 42 children with DRE (age range: 2–10 years, 22 males and 20 females) received KD therapy. The primary endpoint was assessed at 3 months, with an extended follow-up to 6 months in eligible patients. Fecal samples were collected at baseline and at 1, 2, 3, and 6 months after KD initiation. 16S rRNA gene sequencing was performed to analyze gut microbiota composition. Therapeutic response was defined as ≥50% seizure frequency reduction at 3-month follow-up.</div></div><div><h3>Results</h3><div>The median age at epilepsy onset was 18.50 (8.25–41.50) months, and the median age at KD initiation was 53.50 (41.00–80.75) months. Among 34 patients completing the 3-month follow-up, 16 were responders. Responders showed significantly higher baseline abundances of <em>Lachnoclostridium</em> and <em>Barnesiella</em>. Following three months of KD therapy, responders demonstrated increased levels of <em>Parabacteroides</em> and <em>Akkermansia</em> relative to baseline, whereas these genera remained stable in non-responders. Non-responders exhibited consistently higher abundance of <em>Catenibacterium</em> both at baseline and throughout the intervention period compared to responders. Notably, after one month of KD, responders exhibited significantly elevated levels of <em>Parabacteroides</em> compared to non-responders.</div></div><div><h3>Conclusion</h3><div>Higher baseline abundances of <em>Lachnoclostridium</em> and <em>Barnesiella</em> were identified as potential predictive biomarkers for favorable KD response in pediatric DRE. The dynamic increases in <em>Parabacteroides</em> and <em>Akkermansia</em> during KD intervention further distinguished responders, whereas elevated <em>Catenibacterium</em> levels were associated with poor treatment outcomes, providing preliminary insights for treatment stratification.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"134 ","pages":"Pages 220-228"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866191","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":"Transforming refractory epilepsy management: Trio-WES for enhanced genetic diagnosis and prognosis in children","authors":"Yinhui Chen ,&nbsp;Cizheng Zeng ,&nbsp;Chengzhu Luo ,&nbsp;Binglong Huang ,&nbsp;Siqi Chen ,&nbsp;Wenhao Deng ,&nbsp;Shaocong Lan ,&nbsp;Chengyan Li","doi":"10.1016/j.seizure.2025.10.022","DOIUrl":"10.1016/j.seizure.2025.10.022","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate genetic factors in pediatric refractory epilepsy using trio-whole exome sequencing (trio-WES) and to evaluate the impact of genetic diagnosis on treatment optimization.</div></div><div><h3>Methods</h3><div>Participants diagnosed with refractory epilepsy were recruited between September 2021 and June 2024. Clinical phenotypes were systematically assessed, and trio-WES was performed to facilitate precision medicine approaches.</div></div><div><h3>Results</h3><div>Pathogenic (P) or likely pathogenic (LP) variants were identified in 42.9% (36/84) of participants. Single-nucleotide variants (SNVs) accounted for a diagnostic yield of 36.9% (31/84), and copy number variations (CNVs) for 7.1% (6/84), with one participant (1.2%, 1/84) harbored both variant types. Key clinical features in the cohort included infantile seizure onset (42.9%), developmental delay (70.2%), facial dysmorphisms (10.7%), and hypotonia (38.1%). Genetic diagnostic yields differed significantly based on age of seizure onset and neurodevelopmental status. A total of 33 P/LP SNVs were identified across 22 genes, among which 27.3% (9/33) were occurred in ion channel genes. Following genetic diagnosis, 19.0% of participants showed a favorable response to targeted therapies, accompanied by a significant reduction in annual medical expenditures for these participants.</div></div><div><h3>Conclusion</h3><div>Trio-WES is a valuable diagnostic tool for refractory epilepsy, achieving a diagnostic yield of 42.9%. Our findings support the clinical utility of genetic testing in enabling precise diagnosis, guiding therapy selection, improving outcomes, and reducing healthcare costs.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"133 ","pages":"Pages 224-231"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460478","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":"Parents' experiences of caring for a child with epilepsy: a systematic review of qualitative research and thematic synthesis","authors":"Amy Breed ,&nbsp;Bridget Hanley ,&nbsp;Candice Walton ,&nbsp;Craig D. Murray","doi":"10.1016/j.seizure.2025.10.025","DOIUrl":"10.1016/j.seizure.2025.10.025","url":null,"abstract":"<div><h3>Purpose</h3><div>Previous research highlights the impact of chronic health conditions on parents of children with health conditions, including epilepsy, however thus far there has not been a qualitative synthesis of the parental experience of caring for a child with epilepsy. This review aims to synthesise the available literature to gain greater insight into how parents experience their child’s condition and to identify gaps in current healthcare provision.</div></div><div><h3>Methods: a</h3><div>systematic literature search of five electronic databases identified 14 papers which included data regarding the parental experience of caring for a child with epilepsy. A thematic analysis method was used to synthesise these papers.</div></div><div><h3>Results</h3><div>Four main themes were identified: 1) prolonged uncertainty, 2) a 24-7 condition, 3) a multitude of losses and 4) facing societal stigma.</div></div><div><h3>Conclusions</h3><div>The synthesis identified that parents face a range of experiences and emotions whilst caring for their child with epilepsy. Recommendations for how healthcare and third sector services can support parents further to help them cope with their experience are provided.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"133 ","pages":"Pages 232-241"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460509","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 intersection of epilepsy and assisted reproduction: A review of therapeutic approaches and considerations","authors":"Banafsheh Mohammadi ,&nbsp;Jafar Mehvari ,&nbsp;Navid Naghibi ,&nbsp;Nasim Tabrizi","doi":"10.1016/j.seizure.2025.10.019","DOIUrl":"10.1016/j.seizure.2025.10.019","url":null,"abstract":"<div><h3>Objective</h3><div>Women with epilepsy (WWE) have unique reproductive problems due to interactions among seizures, antiseizure medications (ASMs), and endocrine changes. These interactions can cause infertility, menstrual dysfunction, and an increased risk for reproductive endocrine disorders. Assisted reproductive technologies (ART), offer a hope for WWE seeking pregnancy but raise questions about seizure control, drug interactions, and pregnancy outcomes. This review aims to discuss the challenges associated with the use of ART in WWE.</div></div><div><h3>Methods</h3><div>A narrative review was conducted through PubMed, MEDLINE, and ISI Web of Science. Inclusion criteria were original research, cohort studies, case series, randomized trials, and systematic reviews incorporating ART outcomes, ASM interactions, and hormonal therapies in WWE. Animal studies and abstracts without full text available were excluded.</div></div><div><h3>Results</h3><div>The data about the use, most appropriate protocols and success rate of ART in WWE is scarce. Current findings suggest that ART is effective in WWE, with live birth rates comparable to those of women without epilepsy. Most WWE with well-controlled epilepsy have seizure stability during ART, but sporadic cases of seizure worsening, have been reported. ART hormonal treatments can interact with ASMs, necessitating therapeutic drug level monitoring and dose adjustment, especially for lamotrigine. Enzyme-inducing ASMs can reduce the efficacy of hormonal treatments, requiring augmented doses of progesterone for luteal support. WWE remain at higher risk of pregnancy complication, but ART does not yet appear to contribute to these risks when appropriately managed.</div></div><div><h3>Conclusion</h3><div>Based on the limited current studies, ART might be an acceptable and safe fertility treatment for WWE, provided that seizure control is optimized and ASM-hormone interactions are carefully managed. ASM choice, therapeutic drug monitoring, and multidisciplinary care need to be tailored to maximize reproductive and neurological outcomes. Frozen embryo transfer protocols and progestin-only contraception may also enhance safety. Continued research and clinical monitoring are needed to further develop management strategies and long-term outcomes in WWE undergoing ART.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"133 ","pages":"Pages 219-223"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460483","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}