Seizure-European Journal of Epilepsy最新文献

{"title":"The aging brain and late onset drug-refractory epilepsies","authors":"Heidrun Potschka","doi":"10.1016/j.seizure.2024.08.021","DOIUrl":"10.1016/j.seizure.2024.08.021","url":null,"abstract":"<div><div>While late-onset epilepsies are characterized by a good pharmacoresponsiveness, a relevant subgroup of this patient population suffers from drug-refractory epilepsy with its impact on overall quality of life and a high risk of seizure-related injuries.</div><div>Particular attention should be paid to accurate diagnosis and thorough exclusion of pseudoresistance. Challenges include the likelihood of multimorbidities and polypharmacotherapy in an elderly patient population.</div><div>Network, cellular, molecular, and metabolic alterations associated with aging and age-related disorders have the potential to affect the intrinsic severity of late-onset epilepsies, neural network function, and the pharmacodynamics and pharmacokinetics of antiseizure medications (ASMs). Whereas age-related changes in pharmacokinetics tend to favor responsiveness to low doses, respective changes in network excitability and pharmacodynamics of ASMs are more likely to contribute to drug resistance.</div><div>There are particular gaps in our knowledge of the mechanisms of drug resistance and the impact of influencing factors in this patient population. Therefore, experimental and clinical research needs to be intensified to advance our understanding of drug-resistant epilepsy in patients with late-onset epilepsies and to develop multivariate prediction algorithms. In this context, the heterogeneity of an elderly patient population should be taken into account, considering differences in etiology, comorbidities, co-medications, frailty, activity and environmental factors.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"128 ","pages":"Pages 83-89"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479026","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":"Drug arrows in the quiver-antiseizure, antiepileptic and neuroprotective medication: Treatment and future aspects. A focused review","authors":"Elinor Ben-Menachem","doi":"10.1016/j.seizure.2024.11.016","DOIUrl":"10.1016/j.seizure.2024.11.016","url":null,"abstract":"<div><div>Drug discovery for the treatment of epilepsy is entering a new era especially with the advancement of genetic therapies as disease modifying, antiepileptogenic therapies. Even new ideas about re-purposed medication with purposed epileptogenic properties have been suggested. The possibilities are enormous, and it is encouraging that so many ideas are flourishing. The focus of this review is to discuss where to concentrate efforts to improve the lives of people with epilepsy (PWE) with medical treatment, especially the elderly who have many challenges besides just seizures. Thus, the arrow needs to be not only focused on DRE patients, but to try to redirect the arrow to prevent the development of seizures before onset as well as preventing refractoriness at the very beginning herald by the first seizures.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"128 ","pages":"Pages 146-149"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856490","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":"Epileptic variant in the spectrum of Alzheimer's disease – practical implications","authors":"Benjamin Cretin","doi":"10.1016/j.seizure.2024.09.015","DOIUrl":"10.1016/j.seizure.2024.09.015","url":null,"abstract":"<div><div>Alzheimer's disease (AD) is known to be associated with an increased risk of epilepsy, which is not exclusively related to the late stage of the disease - when a major cognitive impairment is observed, previously known as the dementia stage - but also to its prodromal stage (mild cognitive impairment). Moreover, published case reports and cohorts have shown that epilepsy may occur even earlier, at the preclinical stage of AD: Epileptic seizures may therefore be the sole objective manifestation of the disease. Such a situation is called the epileptic variant of AD (evAD). EvAD is one of the etiologies of late-onset epilepsy, which means that it carries a risk of later progression to dementia and that it can only be diagnosed by assessing amyloid and tau biomarkers. However, evAD is a window of therapeutic opportunity that is probably optimal for preventing, through antiseizure medication treatment, the accelerated cognitive decline associated with AD-related brain hyperexcitability (manifested by seizures or interictal epileptiform activities).</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"128 ","pages":"Pages 133-139"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331055","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":"Appropriately designed studies are required to assess sleep quality in epilepsy patients","authors":"Josef Finsterer","doi":"10.1016/j.seizure.2025.04.018","DOIUrl":"10.1016/j.seizure.2025.04.018","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 49-50"},"PeriodicalIF":2.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934765","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":"Successful use of fenfluramine in drug resistant epileptic encephalopathy with spike-wave activation in sleep (EE-SWAS)– an automated EEG study","authors":"J. Koch ,&nbsp;K. Steinbrücker ,&nbsp;G. Kluger ,&nbsp;S. Knasmüller ,&nbsp;E. Trinka","doi":"10.1016/j.seizure.2025.04.016","DOIUrl":"10.1016/j.seizure.2025.04.016","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 56-58"},"PeriodicalIF":2.7,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069509","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":"Epilepsy treatment gap and its associated factors in individuals aged 65 years and older with active convulsive epilepsy in rural Northwestern China","authors":"Bofei Tan ,&nbsp;Qiang Liu ,&nbsp;Jianming Wu ,&nbsp;Xianrui Xu ,&nbsp;Xu Wang ,&nbsp;Pingping Lei ,&nbsp;Mengyun Li ,&nbsp;Fei Huang ,&nbsp;Qing Zhang","doi":"10.1016/j.seizure.2025.04.015","DOIUrl":"10.1016/j.seizure.2025.04.015","url":null,"abstract":"<div><h3>Purpose</h3><div>We investigated the epilepsy treatment gap (ETG) and its associated factors in individuals aged≥65 years with active convulsive epilepsy(ACE) in rural Northwestern China.</div></div><div><h3>Method</h3><div>Between 2008 and 2021, We recruited individuals with ACE in rural Northwestern China as part of an epilepsy management project launched by the Chinese government. A team of primary care doctors from 423 township hospitals participated in the project. Each local primary health organization screens patients from the local community through well-trained local physicians within a study period. Questionnaire-based interviews were conducted to identify patients with ACE, with information collected during the survey. ETG in individuals aged≥65 years with ACE were calculated in the study from 2012 to 2021, and logistic regression analysis was employed to analyze associated factors of ETG in individuals aged≥65 years with ACE in rural northwestern China.</div></div><div><h3>Results</h3><div>A total of 480 individuals aged≥65 years with ACE (male, 62.7 %) were included. Of these, 176 did not receive appropriate treatment, resulting in an ETG of 36.7 %; Among individuals with an onset age of &lt;65 years, a significantly larger proportion did not receive appropriate treatment compared to those who did receive appropriate treatment(69.9 % vs. 60.9 %, <em>p</em> = 0.047); Univariate analysis indicated that an onset age of &lt;65 years, epilepsy duration of≥20 years, and higher seizure frequency of 12∼23 times within 1 year before inclusion may be associated with ETG in individuals aged≥65 years with ACE (<em>p</em> &lt; 0.05); In multivariate analysis, higher seizure frequency of 12∼23 times within 1 year before inclusion (OR = 1.733,95 % CI 1.031–2.940, <em>p</em> = 0.042) were significantly associated with ETG in individuals aged≥65 years with ACE.</div></div><div><h3>Conclusion</h3><div>Northwestern China rural areas has relatively smaller ETG in the elderly with ACE,at about 36.7 %. However, efforts to prevent and treat ACE in the elderly with a younger onset age (&lt;65 years) and higher seizure frequency (12–23 times within 1 year before inclusion) should be intensified to further narrow the ETG.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"129 ","pages":"Pages 123-128"},"PeriodicalIF":2.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874792","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 current state of cognitive rehabilitation for individuals with epilepsy and pathways for improvement: a multinational cross-sectional survey of epilepsy specialists","authors":"Rūta Mameniškienė ,&nbsp;Kristijonas Puteikis","doi":"10.1016/j.seizure.2025.04.008","DOIUrl":"10.1016/j.seizure.2025.04.008","url":null,"abstract":"<div><h3>Objective</h3><div>Despite the relevance of psychosocial and cognitive issues for people with epilepsy (PWE), there remains scarce data on cognitive rehabilitation programs as a central care pathway alongside pharmacological and surgical treatment in epilepsy. We aimed to map the use, availability and characteristics of rehabilitation programs for epilepsy across different countries worldwide.</div></div><div><h3>Methods</h3><div>We conducted a web-based survey of epilepsy specialists practicing in different countries around the world. Participants were asked to provide information on the availability, accessibility, use and methodology of cognitive rehabilitation in their country of practice.</div></div><div><h3>Results</h3><div>One hundred and ten responses were received across 66 different countries: 45 respondents were from Europe, 35 – from Latin America, 14 – from the Eastern Mediterranean region, 7 – from Asia and Oceania, 8 – from Africa and 1 – from North America. Most participants were neurologists and/or epileptologists (96, 87 %) practicing in university hospitals (69, 63 %) and caring for adult patients (85, 77 %). Any rehabilitation measures for PWE were reported as generally available by 75 (68 %) respondents. For cognitive rehabilitation, this was reported by 40 (36 %) specialists with an average service accessibility of 5.4 ± 2.5 out of 10. When available, cognitive rehabilitation is primarily used in patients with cognitive complaints (38, 81 %), mood complaints or comorbid psychiatric disorders (27, 57 %). While individual sessions predominate (29, 62 %), cognitive rehabilitation programs are heterogeneous in form – compensatory (10, 21 %), restitution (12, 26 %) techniques, internal (12, 26 %) and external (12, 26 %) strategies are used alongside psychoeducation (15, 32 %) and psychological counselling (16, 34 %) without clear predominance of either approach. In 13 (32.5 %) cases, cognitive rehabilitation was supported by national standards of practice or state legislature.</div></div><div><h3>Conclusions</h3><div>Cognitive rehabilitation programs for PWE are generally less available than other forms of rehabilitation across the world. New evidence-based procedure development and harmonization is required to promote establishment and effective use of these services.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 4-10"},"PeriodicalIF":2.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898456","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":"Dose-specific impact of omega-3 fatty acid in epilepsy: Evidence from a dose-responsive network meta-analysis","authors":"Arkansh Sharma ,&nbsp;Rishu Raj ,&nbsp;Vinay Suresh","doi":"10.1016/j.seizure.2025.04.013","DOIUrl":"10.1016/j.seizure.2025.04.013","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Page 48"},"PeriodicalIF":2.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934764","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-event sleep and tiredness in epilepsy versus vasovagal syncope","authors":"Mas Ahmed ,&nbsp;Lilynda Tsai","doi":"10.1016/j.seizure.2025.04.014","DOIUrl":"10.1016/j.seizure.2025.04.014","url":null,"abstract":"<div><h3>Purpose</h3><div>Differentiating epileptic seizures from vasovagal syncope (VVS) in children is challenging. Post-event symptoms, especially sleep and tiredness, may aid diagnosis. While post-event sleep is common in epilepsy, its occurrence in VVS is less understood. This study examines post-event sleep and tiredness duration in epilepsy and VVS.</div></div><div><h3>Methods</h3><div>This retrospective study analysed 272 patients (160 epilepsy, 112 VVS) from a seizure clinic (2017–2025). Post-event sleep and duration of tiredness occurrence were recorded from patient histories and follow-ups.</div></div><div><h3>Results</h3><div>All patients with epilepsy had postictal tiredness ≥2 h, with 49 % lasting &gt;4 h. In contrast, 55.5 % of VVS patients had no tiredness or tiredness for &lt;2 h. Sleep or prolonged fatigue is much more common following seizures in epilepsy (94 %) than in VVS (21 %). All VVS cases showing recovery sleep were associated with syncopal motor phenomena.</div></div><div><h3>Conclusion</h3><div>The absence or brief fatigue following a loss of consciousness event strongly suggests VVS, provided that the history indicates no motor phenomena. In contrast, post-event sleep and/or prolonged fatigue is a key indicator that the event may be an epileptic seizure or a syncopal episode with motor activity.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"129 ","pages":"Pages 129-132"},"PeriodicalIF":2.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891538","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":"Phenotypic similarities and differences between SLC6A1-related neurodevelopmental disorder and GLUT1 deficiency syndrome","authors":"Gokce Cirdi ,&nbsp;Anil Gok ,&nbsp;Tolgahan Ozer ,&nbsp;Ayfer Sakarya Gunes ,&nbsp;Leman Tekin Orgun ,&nbsp;Bulent Kara","doi":"10.1016/j.seizure.2025.04.010","DOIUrl":"10.1016/j.seizure.2025.04.010","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 1-3"},"PeriodicalIF":2.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143888181","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}