Seizure-European Journal of Epilepsy最新文献

{"title":"Response to letter by Alain Braillon entitled “autism and prenatal exposure to antiseizure medications: Still a long-standing blind spot?”","authors":"Isabella Christina Amaral de Lara , Pedro Henrique de Souza Wagner , Gustavo Tadeu Freitas Uchôa Matheus , Lara Eduardo Campos , Celso de Almeida Souza Miranda , Maria Eduarda Cavalcanti Souza , Francisco Cezar Aquino de Moraes , Francinny Alves Kelly , Lilianne Rodrigues Fernandes","doi":"10.1016/j.seizure.2025.06.009","DOIUrl":"10.1016/j.seizure.2025.06.009","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 140-141"},"PeriodicalIF":2.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480755","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":"Systematic review of paediatric SUDEP and epilepsy-related deaths to inform a safety counselling checklist for clinical practice","authors":"Rohini Ranganath Rattihalli ,&nbsp;Sammy Ashby ,&nbsp;Lisa Burrows ,&nbsp;Rachel Howells ,&nbsp;Kezie Chukwudebelu ,&nbsp;Rohit Shankar","doi":"10.1016/j.seizure.2025.06.013","DOIUrl":"10.1016/j.seizure.2025.06.013","url":null,"abstract":"<div><h3>Background</h3><div>One in 200 children - in the UK have epilepsy. Approximately, 1 in 1,000 children with epilepsy die yearly from Sudden unexpected death in epilepsy (SUDEP), a leading cause of death in epilepsy. Various risk factors contributing to epilepsy mortality particularly SUDEP, some modifiable, have been identified. Structured discussion of risks results in behavioural change that reduces individual risk factors.</div></div><div><h3>Aim</h3><div>To investigate and collate risk factors for SUDEP and epilepsy mortality in children to propose a structured communication tool (“Checklist”) for person centred communication.</div></div><div><h3>Methods</h3><div>A Systematic review for children’s epilepsy mortality risk factors was conducted. The search strategy was developed by clinical and topic experts in conjunction with a clinical evidence specialist and an epilepsy charity. Database searches (MEDLINE, Embase, CINAHL, PsycINFO) were performed in 06/2022 and updated 02/2024, with results assessed independently by two reviewers. Terms covered paediatrics, epilepsy, epilepsy mortality and SUDEP. Results were synthesised into risk factor domain.</div></div><div><h3>Results</h3><div>Six papers encompassing three review articles (covering 33 original research articles), and three other original research articles were included. A further four articles specifically looking at different genetic epilepsies and SUDEP were also added. There was heterogeneity among papers. No RCTs, including papers in the review, were identified. Quality analysis of papers was not undertaken. Eleven key risk factors covering domains of seizure presentation, management, co-morbidity and genetics were identified.</div></div><div><h3>Conclusions</h3><div>A safety Checklist is proposed with identified risk factors for routine clinical–patient interaction to facilitate easier, structured, individualised and evidence-based communication.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 172-179"},"PeriodicalIF":2.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549056","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":"Thalamic stereoelectroencephalography in pediatric patients: Clinical practice and considerations","authors":"Nunthasiri Wittayanakorn ,&nbsp;Nathan T. Cohen ,&nbsp;Ersida Buraniqi ,&nbsp;Veronica D. Linan-Martinez ,&nbsp;Saige A. Teti ,&nbsp;Ban H. Shoukeir ,&nbsp;William D. Gaillard ,&nbsp;Chima O. Oluigbo","doi":"10.1016/j.seizure.2025.06.012","DOIUrl":"10.1016/j.seizure.2025.06.012","url":null,"abstract":"<div><h3>Objective</h3><div>Neuromodulation of cortical and subcortical structures is integral to pediatric epilepsy surgery. Subcortical and thalamic targets for neuromodulation continue to evolve. This paper reports the practical considerations and outcomes of pediatric thalamic stereoelectroencephalography (sEEG) at a single institution.</div></div><div><h3>Methods</h3><div>A retrospective study involved 16 patients with drug-resistant epilepsy who underwent sEEG with thalamic nuclei sampling at Children’s National Hospital (CNH) from July 2023 to Aug 2024. Electrodes targeted thalamic nuclei, including the anterior nucleus of thalamus (ANT), centromedian (CM), and/or pulvinar (PUL). Two pediatric epileptologists reviewed sEEG recordings at enhanced sensitivity to identify thalamic spread patterns. The definitive procedure after sEEG and the outcomes were reported for those who proceeded to surgery with at least six months of follow-up.</div></div><div><h3>Results</h3><div>Sixteen subjects underwent sEEG with thalamic nuclei sampling. Thirty-five thalamic electrodes were implanted, and four patients had multisite thalamic nuclei sampling. Most seizures reviewed (84 %) had early thalamic involvement (&lt;500 ms from seizure onset). A variety of early thalamic spread patterns were detected: spike wave, 30 % (<em>n</em> = 15/50); rhythmic slowing, 20 % (<em>n</em> = 10/50); and low voltage fast activity (LVFA), 16 % (<em>n</em> = 8/50). Among the fifteen patients exhibiting thalamic involvement, nine (60 %) demonstrated congruent ictal patterns originating from the neocortex, whereas 40 % exhibited discordant patterns. Furthermore, 60 % of patients (<em>n</em> = 9) exhibited consistent thalamic spread patterns, whereas 40 % demonstrated variable patterns across different nuclei within the same seizure or within the same nucleus across seizures. Eleven patients underwent surgery after the sEEG, and seizure outcomes of seven patients with a mean follow-up period of 7.9 months were reported. Only one patient experienced transient hemiparesis from an anterior insular hemorrhage.</div></div><div><h3>Conclusion</h3><div>Thalamic sEEG may serve as a valuable tool for selected patients with complex or extensive epileptic networks and may aid in the identification of neuromodulation targets when resection or ablation is not feasible.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 121-131"},"PeriodicalIF":2.7,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312741","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":"Developmental and/or epileptic encephalopathy with spike-and-wave activation in sleep: A single tertiary center experience","authors":"Sibel Öz Yıldız ,&nbsp;Ceren Günbey ,&nbsp;Kader Karlı Oğuz ,&nbsp;Gökçen Konuşkan ,&nbsp;Göknur Haliloğlu ,&nbsp;Dilek Yalnızoğlu","doi":"10.1016/j.seizure.2025.06.010","DOIUrl":"10.1016/j.seizure.2025.06.010","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to analyze the clinical characteristics, etiology, neuroimaging, treatment, neurocognitive and EEG outcomes of patients with developmental and/or epileptic encephalopathy with spike-and-wave activation in sleep (D/EE-SWAS).</div></div><div><h3>Methods</h3><div>Patients diagnosed with D/EE-SWAS, between 2014 and 2021, with a spike-wave index (SWI) ≥50 % in NREM sleep EEG, were analyzed retrospectively. Outcome measures included neurocognitive assessment, SWI, and seizure frequency.</div></div><div><h3>Results</h3><div>A total of 80 patients were included. Median age at initial admission was 43.5 (0.03–148) months, with seizures as the main symptom in 66 (82.5 %) patients. Median age at D/EE-SWAS onset and follow-up was 92.5 (21.3–193.6), and 86.9 (12–204) months, respectively. At diagnosis, 56 patients had seizures (focal: 13, generalized: 43). Unknown group (36; 45 %) constituted the most common etiology. There was a shift towards benzodiazepines, mostly as a combination therapy, in 58 (72.5 %). At the final visit, 38 (47.5 %) of the patients had favorable cognitive outcome which was correlated with older epilepsy onset (≥3 years), normal neurological examination, unknown etiology, seizure freedom during D/EE-SWAS, normal EEG background, fewer ASMs, shorter D/EE-SWAS duration, SWI response, decreased seizure frequency, and SWAS resolution. EEG recovery occurred in 48 (60 %) (median duration: 24 months), with 12(15 %) achieving complete resolution. Of the patients, 38 (47.5 %) were seizure-free at the end of the study period.</div></div><div><h3>Conclusions</h3><div>Baseline neurologic examination, age at onset of epilepsy/D/EE-SWAS, etiology, and number of ASMs at diagnosis had an impact on outcomes. Etiology and number of ASMs may serve as parameters to predict treatment response, and underscore the need for tailored approaches for D/EE-SWAS.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 203-211"},"PeriodicalIF":2.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653949","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":"Expansion of the Epilepsy Genotype-Phenotype Spectrum: Genetic and Clinical Characterization of 288 Children with Epilepsy in China","authors":"Linxue Meng ,&nbsp;Ziyao Han ,&nbsp;Xiaoyue Yang ,&nbsp;Hanyu Luo ,&nbsp;Siqi Hong ,&nbsp;Yue Hu ,&nbsp;Yi Guo ,&nbsp;Jiannan Ma ,&nbsp;Lingling Xie ,&nbsp;Li Jiang","doi":"10.1016/j.seizure.2025.06.011","DOIUrl":"10.1016/j.seizure.2025.06.011","url":null,"abstract":"<div><h3>Background</h3><div>In recent years, advancements in sequencing technology have led to a progressive increase in the proportion of epilepsy cases with genetic etiology, while simultaneously facilitating the ongoing identification of epilepsy-associated genes. To summarize the genotype-phenotype association of epilepsy patients is of great significance for the interpretation of genetic reports, clinical diagnosis and treatment and genetic counseling.</div></div><div><h3>Methods</h3><div>We reviewed and analyzed the trio-WES/WES results of 886 patients with unexplained epilepsy. Ultimately, 288 epilepsy patients were included in this study. The clinical phenotype, treatment and genotype of the patients were analyzed. The single nucleotide variations in all samples were explained.</div></div><div><h3>Results</h3><div>Of the original 886 patients with epilepsy with no identified cause, 288 patients were shown to have a genetic abnormality, yielding a WES diagnostic rate of 32.5%. The patients with onset before 2 years of age were more likely to have accompanying developmental delay (<em>p</em>=0.001). A total of 312 pathogenic/likely pathogenic variants involving 125 genes were detected. The most common genes affected were primarily <em>SCN1A</em>. After the pathogenic gene was identified, at least 16.7% more patients were able to use recommended medications. Patients with ion channel gene-related disorders had a significantly higher rate of receiving recommended medications. The <em>CHRNA4, ATP1A2, SPTAN1, KCNMA1</em>, and <em>SCN9A</em>, currently lack reports of incomplete penetrance related to epilepsy and our study suggests the potential for incomplete penetrance in these genes.</div></div><div><h3>Conclusion</h3><div>This study summarized the clinical characteristics and genetic background of children with epilepsy, expanded the genotype-phenotype spectrum, and provided reference for genetic counseling and clinical diagnosis and treatment.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 113-120"},"PeriodicalIF":2.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307910","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":"Respiratory modulation of heart rate variability after generalized convulsive seizures","authors":"Marie Anne Melone ,&nbsp;Rup K. Sainju ,&nbsp;Deidre N. Dragon ,&nbsp;Harold B. Winnike ,&nbsp;Laura Vilella ,&nbsp;Manuela Ochoa-Urrea ,&nbsp;Xiaojin Li ,&nbsp;Samden D. Lhatoo ,&nbsp;Linder H. Wendt ,&nbsp;Patrick Ten Eyck ,&nbsp;George B. Richerson ,&nbsp;Brian K. Gehlbach","doi":"10.1016/j.seizure.2025.06.007","DOIUrl":"10.1016/j.seizure.2025.06.007","url":null,"abstract":"<div><h3>Background</h3><div>Autonomic function is modulated by the respiratory network. We therefore hypothesized that in persons with epilepsy (PWE), generalized convulsive seizures (GCS) would induce greater heart rate variability (HRV) and parasympathetic activation in patients with low interictal central CO₂ chemosensitivity (measured with the hypercapnic ventilatory response, HCVR). We further hypothesized that postictal HRV would be associated with severity of postictal hypercapnia and hypoxemia.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis of PWE admitted to an epilepsy monitoring unit for video-EEG study and experienced GCS. Time synchronized video-EEG, ECG, respiratory effort, and airflow were continuously measured along with transcutaneous CO₂ and O₂ saturation. Interictal HCVR was measured using a modified hyperoxic rebreathing technique. Postictal respiration was analyzed and included the magnitude and duration of CO₂ rise and O₂ desaturation. HRV measures were derived from 5-minute artifact-free ECG recordings from interictal and postictal periods. Relationships between HRV and respiratory variables were analyzed using Spearman’s correlation and multivariate models.</div></div><div><h3>Results</h3><div>Twenty-six patients had both a GCS and an interictal HCVR. Mean age was 36.6 (±11.8) years and mean duration of epilepsy 16.2 (±12.0) years. Interictal HCVR slope varied from -0.13 to 5.2 (median 2.1) L/min/mm Hg and was not related to postictal RMSSD or the change in RMSSD (interictal wake – postictal) induced by GCS (<em>p</em> &gt; 0.11). In contrast, duration of postictal hypercapnia and oxygen desaturation were both significantly correlated with overall postictal HRV (SDNN) and with multiple HRV measures of parasympathetic tone (RMSSD, HF power, Cardiac Vagal Index). In multivariate analyses, duration of postictal oxygen desaturation was positively associated with increased postictal RMSSD (mean ratio 1.09, 95 % CI 1.04–1.14, <em>p</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>Postictal ventilation and oxygenation are tightly coupled to multiple measures of heart rate variability, consistent with respiratory modulation of the autonomic nervous system. Patients with more severe postictal respiratory depression exhibit greater parasympathetic activity after GCS even while the frequent occurrence of postictal tachycardia suggests a concomitant increase in sympathetic activity. These results have implications for the interpretation of postictal bradycardia and respiratory dysfunction and their relationships to sudden unexpected death in epilepsy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 95-104"},"PeriodicalIF":2.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298029","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":"Seizure reporting in older patients with developmental and epileptic encephalopathies: A retrospective review of ambulatory video-EEG reports","authors":"Ewan S. Nurse ,&nbsp;Mark J. Cook ,&nbsp;Linda J. Dalic","doi":"10.1016/j.seizure.2025.06.003","DOIUrl":"10.1016/j.seizure.2025.06.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Accurate seizure reporting is crucial for assessing treatment efficacy and guiding acute management in developmental and epileptic encephalopathies (DEEs). This study evaluates the sensitivity and positive predictive value (PPV) of seizure diaries compared to ambulatory video-EEG reports.</div></div><div><h3>Methods</h3><div>This retrospective cohort study (2018–2024) analyzed video-EEG reports from 19 Australian clinics. vEEG data were not re-reviewed. Patients with confirmed DEEs underwent 1–7 days of ambulatory video-EEG and completed seizure diaries. Sensitivity (proportion of true seizures correctly recorded) and PPV (proportion of diary events confirmed as seizures) were compared to neurologist-reported vEEG events. Demographic and clinical data were also collected.</div></div><div><h3>Results</h3><div>The study included 108 recordings from 65 patients with Lennox-Gastaut Syndrome (LGS), 10 with Dravet Syndrome, and 33 with other/unspecified DEEs. The cohort was 51 % female, with a median age of 15 years (range 5–63). In LGS and other DEEs, higher reporting of non-epileptic events correlated with fewer true seizure recordings. While many participants achieved a sensitivity or PPV of 1, few achieved both. No significant group-level differences in sensitivity or PPV were found across diagnostic categories.</div></div><div><h3>Conclusion</h3><div>Seizure diaries show variability in accurately capturing seizure activity in DEEs, with over-reporting of non-epileptic events and under-recognition of true seizures. These findings highlight the need for objective tools like video-EEG to improve seizure reporting accuracy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 50-56"},"PeriodicalIF":2.7,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253387","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":"Maternal exposure to lamotrigine and the risk of orofacial clefts in offspring: A systematic review and meta-analysis","authors":"Ze-lin Zhao ,&nbsp;Xiao-ming Jin ,&nbsp;Fang-ping Shi,&nbsp;Qiao-qun Dai,&nbsp;Yin Wu,&nbsp;Zhao-jie Zheng","doi":"10.1016/j.seizure.2025.06.005","DOIUrl":"10.1016/j.seizure.2025.06.005","url":null,"abstract":"<div><div>Lamotrigine is used to treat epilepsy, migraine, and psychiatric disorders during pregnancy. However, concerns remain regarding whether lamotrigine exposure increases the risk of orofacial clefts (OFCs) in offspring. A systematic literature search was conducted to identify relevant studies published from inception to February 2025. Random-effects models were used to estimate the overall relative risk. Eight observational studies were included in the analysis. The overall results indicated that maternal lamotrigine exposure during pregnancy was associated with a significantly increased risk of OFCs in offspring (odds ratio [OR] = 1.42, 95 % confidence interval [CI] = 1.05–1.92, <em>P</em> &lt; 0.001, I² = 39.8 %). However, this association disappeared when data were pooled from cohort studies (OR = 1.4, 95 % CI = 0.67–2.9, <em>P</em> = 0.37) or from studies adjusting for at least five variables (OR = 0.97, 95 % CI = 0.63–1.48, <em>P</em> = 0.871, I² = 0.0 %). Our findings suggest that <em>in utero</em> exposure to lamotrigine does not increase the risk of OFCs in offspring.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 67-72"},"PeriodicalIF":2.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262176","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":"Decreasing epilepsy-related mortality in the Maridi onchocerciasis focus, South Sudan","authors":"Joseph Nelson Siewe Fodjo ,&nbsp;Stephen Raimon Jada ,&nbsp;Olivia Kamoen ,&nbsp;Jacopo Mattia Rovarini ,&nbsp;Chiara Scanagatta ,&nbsp;Yak Yak Bol ,&nbsp;Luís-Jorge Amaral ,&nbsp;Robert Colebunders","doi":"10.1016/j.seizure.2025.06.004","DOIUrl":"10.1016/j.seizure.2025.06.004","url":null,"abstract":"<div><h3>Introduction</h3><div>A 2018 study found high epilepsy prevalence and mortality in the Maridi onchocerciasis focus (South Sudan). From 2019 onward, onchocerciasis elimination measures were strengthened in Maridi, and in 2020, an epilepsy clinic was established at Maridi County Hospital with free provision of anti-seizure medication. We investigated the changes in epilepsy-related mortality following these interventions.</div></div><div><h3>Methods</h3><div>Repeated house-to-house surveys (2018 and 2024) in three Maridi neighbourhoods (Kazana-1, Kazana-2, Hai-Gabat). The number of deaths that occurred during the two years preceding each survey among persons known to have epilepsy (PWE) was assessed in each home via verbal reports from the household head. Mortality rates were calculated and compared between surveys using the rate-ratio test.</div></div><div><h3>Results</h3><div>Between 2018 and 2024, epilepsy mortality in Maridi decreased 4.2-fold from 78.3 to 18.7 per 1000 person-years (<em>p</em> &lt; 0.001). The decrease in mortality was most evident among the 11–20 year-olds: 6.9-fold reduction from 66.9 to 9.7 per 1000 person-years (<em>p</em> = 0.001). Age-standardized mortality ratio of epilepsy was estimated at 1.8 in 2024. Among the 184 reported deaths during the 2022–2024 observation period, the proportion of deceased PWE reduced from 9.7 % (2022) to 4.5 % (2023) to 1.8 % (2024), although without statistical significance (<em>p</em> = 0.175).</div></div><div><h3>Conclusion</h3><div>Strengthening onchocerciasis elimination measures and establishing an epilepsy clinic were followed by a drastic decrease in PWE mortality rate in Maridi. By preventing new-onset onchocerciasis-associated epilepsy and treating PWE with free anti-seizure medication, this two-pronged approach could mitigate the high premature mortality observed among PWE, especially adolescents. This strategy may be applicable to other onchocerciasis hotspots with high epilepsy burden.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"130 ","pages":"Pages 106-114"},"PeriodicalIF":2.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262007","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":"Disorders of arousal and sleep-related hypermotor epilepsy are interrelated. Some new viewpoints","authors":"Péter Halász ,&nbsp;Anna Szűcs","doi":"10.1016/j.seizure.2025.06.002","DOIUrl":"10.1016/j.seizure.2025.06.002","url":null,"abstract":"<div><div>NREM parasomnias overlap with sleep-related hypermotor epilepsies in multiple ways. Both conditions are characterized by fragmented sleep; share symptomatic features; have family-, and population-genetic relationships; and NREM parasomnia-episodes are underlain by sleep-wake dissociation likely featuring SHE seizures as well. Most importantly, the two conditions have very similar links with NREM sleep’s high homeostatic pressure periods closely related to sleep microstructure including sleep-like micro-arousals, the dynamics of cyclic alternating pattern A1 and slow wave bistability. While the unquestionable distinction of the two conditions, epileptic and non-epileptic, is essential both theoretically and practically; their striking relationship calls for explanation.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 185-189"},"PeriodicalIF":2.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563610","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}