Epileptic Disorders最新文献

{"title":"Response to: Ictal and postictal central apnea: Integrating pathophysiological mechanisms with SUDEP risk stratification.","authors":"Wei Zhao, Alena Berkhamova, Rabeha Noor, Abdulrahman Alwaki, Elli Allen","doi":"10.1002/epd2.70275","DOIUrl":"https://doi.org/10.1002/epd2.70275","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting post-surgical visuospatial memory performance in people with drug-resistant epilepsy.","authors":"Emma Colucci, Arnaud Saj, Simon Charbonneau, Carole Denault, Annie Malenfant, Isabelle Rouleau, Dang Khoa Nguyen, Olivier Boucher","doi":"10.1002/epd2.70261","DOIUrl":"https://doi.org/10.1002/epd2.70261","url":null,"abstract":"<p><strong>Objective: </strong>Although verbal memory decline has been consistently reported following surgery for temporal lobe epilepsy, especially when surgery is performed in the language-dominant hemisphere and targets mesial temporal structures, the relation between the location and the hemisphere of surgery on visuospatial memory, as well as the factors predicting visuospatial memory decline, remains less clear. This study first examines the impact of epilepsy surgery location and laterality on visuospatial and verbal memory performance and then explores the predictors of memory change following surgery.</p><p><strong>Methods: </strong>We retrospectively collected data from 75 individuals who completed the Brief Visuospatial Memory Test-Revised and the Rey Auditory Verbal Learning Test as part of their pre- and post-surgical neuropsychological assessments at our center.</p><p><strong>Results: </strong>Surgery for mesial temporal lobe epilepsy in the dominant hemisphere was associated with poorer performance on all memory outcomes, whereas mesial temporal lobe epilepsy surgery in the non-dominant hemisphere selectively impaired delayed recall of visuospatial material. A presurgical memory profile combining better visuospatial memory and poorer verbal memory, and the recurrence of seizures after surgery, best predicted visuospatial memory decline after the procedure, whereas verbal memory decline was predicted by better preoperative verbal memory performance in addition to surgery in the dominant hemisphere.</p><p><strong>Significance: </strong>These findings emphasize the relevance of considering presurgical visuospatial and verbal memory performance when attempting to predict visuospatial memory decline following surgery. Limitations to our study include potential selection bias, variability in testing parameters, and a relatively small sample size.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ictal and postictal central apnea: Integrating pathophysiological mechanisms with SUDEP risk stratification.","authors":"Gül Yücel","doi":"10.1002/epd2.70276","DOIUrl":"https://doi.org/10.1002/epd2.70276","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut microbiota shifts and short-chain fatty acids alterations in pediatric epilepsy patients on a Mediterranean ketogenic diet.","authors":"Sofia Zouganeli, Evdokia K Mitsou, Mary Yannakoulia, Evangelia Intze, Konstantinos C Mountzouris, Smaragdi Fessatou, Achilleas Attilakos, Adamantini Kyriacou, Argyrios Dinopoulos","doi":"10.1002/epd2.70269","DOIUrl":"https://doi.org/10.1002/epd2.70269","url":null,"abstract":"<p><strong>Objective: </strong>The olive oil-based Mediterranean ketogenic diet (MedKD) may support patients with drug-resistant epilepsy (DRE) or neurometabolic disorders by integrating ketogenic therapy with the cardiometabolic and neuroprotective advantages of the Mediterranean diet. This study assessed alterations in gut microbiota composition and short-chain fatty acids (SCFAs) in Greek pediatric epilepsy patients under a 3-month MedKD.</p><p><strong>Methods: </strong>Patients eligible for ketogenic diet therapy and one parent per patient as controls were enrolled. An olive oil-based KD aligned with Mediterranean principles was initiated during a 5-7-day hospital stay. Anthropometric, nutritional, biochemical and clinical data were recorded at baseline and after 3 months. Fecal samples were collected from patients at both time points, and parents provided a single baseline sample. Microbiota composition was analyzed using 16S rRNA gene next-generation sequencing, and SCFAs were quantified via gas chromatography. Written informed consent was obtained from all parents. The study was registered at ClinicalTrials.gov (NCT05898438).</p><p><strong>Results: </strong>The study enrolled 18 pediatric/adolescent patients (aged 2.5-15.5 years) and 17 parents at baseline (T1). After 3 months (T2), 13 patient-parent pairs completed follow-up. MedKD adherence was high, with mean ketone levels of 2.6 mmol/L and a clinical response in 85% of patients. Anthropometric measurements improved, and lipid changes were modest. No significant α-diversity differences were detected between patients and parents at T1 or between T1 and T2 in patients, whereas β-diversity differed significantly between parents and patients at baseline. Epilepsy-associated genera were more abundant in patients. At T2, patients exhibited shifts including increased members of Eggerthellaceae and decreased Lachnospira and Bifidobacterium. Major SCFAs remained stable, with increases limited to minor protein-derived SCFAs.</p><p><strong>Significance: </strong>The MedKD was associated with high adherence, efficacy, and anthropometric improvements, along with modest effects on the lipid profile. Microbial and SCFA changes reflected both the epilepsy-related milieu and potential influences of the diet's high olive oil content.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Termination of super-refractory status epilepticus following stereo-EEG implantation.","authors":"Nicholas Fearns, Selina Trapp, Katharina Ernst, Stefan Kunst, Stefanie Quach, Konstantinos Dimitriadis, Christian Vollmar, Jan Rémi","doi":"10.1002/epd2.70268","DOIUrl":"https://doi.org/10.1002/epd2.70268","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Podcast-induced reflex seizures: A unique trigger.","authors":"David W Cao, Roberto Gonzalez, Irfan S Sheikh, Melissa Huynh Mabry","doi":"10.1002/epd2.70254","DOIUrl":"https://doi.org/10.1002/epd2.70254","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ATP1A3: Uncommon and wavering epilepsy phenotype in a rare variant.","authors":"D Camussi, G Vega, R Scalise, E Bartolini","doi":"10.1002/epd2.70263","DOIUrl":"https://doi.org/10.1002/epd2.70263","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can epilepsy be predicted after the first febrile seizure? Insights from machine learning of postictal EEG.","authors":"Boran Şekeroğlu, Hüseyin Öztoprak, Özlem Yayıcı Köken, Hatice Demir, Mehpare Sarı Yanartaş, Deniz Yılmaz, Burçin Şanlıdağ, Ayşegül Neşe Çıtak Kurt","doi":"10.1002/epd2.70250","DOIUrl":"https://doi.org/10.1002/epd2.70250","url":null,"abstract":"<p><strong>Objective: </strong>Febrile seizures (FS) are the most common seizures in childhood, yet identifying children at risk of developing epilepsy after the first FS remains challenging. We aimed to evaluate the prognostic potential of machine learning (ML) algorithms applied to post-febrile seizure electroencephalography (EEG) recordings.</p><p><strong>Methods: </strong>We retrospectively reviewed 104 children (69 boys; mean age at first febrile seizure: 39.4 ± 18.2 months) who presented with their first febrile seizure between January 2018 and December 2021. Clinical data and EEG recordings obtained during N2 sleep were collected. EEG analysis was performed using separate preprocessing pipelines. For conventional EEG analysis, recordings were band-pass filtered between 1 and 40 Hz, and artifact-free segments were analyzed using Python-based pipelines (YASA, MNE) to extract 34 time-domain. The 34 extracted electrophysiological features were calculated across different bipolar EEG channels and evaluated together with aggregated inter-channel measures, resulting in a total of 93 input attributes used for ML model development. High-frequency oscillations (HFOs) were analyzed using a distinct pipeline applied to wideband EEG data before low-pass filtering. Six machine learning algorithms-J48 Consolidated Decision Tree, Random Forest, Gradient Boosting, Extreme Gradient Boosting, k-nearest neighbor, and Support Vector Machine-were trained using 10 × 7 repeated cross-validation. Model performance was evaluated using sensitivity, specificity, accuracy, area under the receiver operating characteristic curve (ROC AUC), and F1-score.</p><p><strong>Results: </strong>Over a median follow-up of 4.2 months, 13 patients (12.5%) developed epilepsy, and all diagnoses were made within 9 months. XGBoost achieved the highest accuracy (0.89) and specificity (0.95) but had low sensitivity (0.46). J48 achieved the highest sensitivity (0.87) and ROC AUC (0.79), with a specificity of 0.71. Incorporating clinical features, including recurrent seizures, increased sensitivity to 0.95. The most relevant predictors were patient history, frequency band power, particularly increased power in lower frequency bands, and high-frequency oscillations counts.</p><p><strong>Conclusion: </strong>ML-based analysis of initial EEG after a first febrile seizure may assist in early epilepsy risk stratification. J48 provided superior sensitivity, and combining electroencephalography-derived biomarkers with clinical data further enhanced predictive performance. Prospective, multicenter studies are warranted to confirm these findings.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seizure outcomes after thalamic deep brain stimulation in drug-resistant epilepsy: How electrode location, device platform, and epilepsy subtype drive response-A systematic review with pooled analysis.","authors":"Margil Ranpariya, Gurleen Kaur, Amanda Schwandt, Ping Li, Osman Farooq, Alexus Ludwig, Imtiaz Nazam, Hussain Shallwani, Robert Glover","doi":"10.1002/epd2.70256","DOIUrl":"https://doi.org/10.1002/epd2.70256","url":null,"abstract":"<p><p>Deep brain stimulation (DBS) targeting the anterior nucleus of the thalamus (ANT), centromedian nucleus (CM), and medial pulvinar nucleus (PuM) has emerged as a neuromodulatory intervention for adults with drug-resistant epilepsy (DRE). Despite growing clinical experience, no pooled analysis has integrated outcomes across all three thalamic targets. A PRISMA-compliant systematic search was conducted across PubMed, EMBASE, and Cochrane databases (January 2000-December 2025). Studies reporting seizure frequency reduction following thalamic DBS in ≥4 adults with DRE and ≥6 months of follow-up were included. Pooled descriptive statistics and weighted mean analyses were calculated within each target separately; subgroup comparisons by seizure onset zone and epilepsy classification were performed within each nucleus. Nineteen studies (651 patients) met inclusion criteria: ten ANT (n = 551), seven CM (n = 89), and two PuM (n = 11). Weighted mean seizure frequency reductions were 48.7% (ANT), 71.4% (CM), and 62.0% (PuM). Responder rates (≥50% reduction) were 48.7% (ANT), 76.2% (CM), and 60.0% (PuM). ANT DBS showed progressive improvement from year one (33%-41% reduction) through year five (56%-69% reduction). Temporal lobe origin predicted superior ANT outcomes. CM DBS was most effective for generalized epilepsy syndromes, including Lennox-Gastaut syndrome. PuM DBS yielded promising results for posterior quadrant and temporal-plus epilepsy. Adverse events were target-specific, including depression and memory impairment (ANT), postoperative drowsiness (CM), and hemorrhagic complications (PuM). No stimulation-related mortality occurred. Thalamic DBS provides durable seizure reduction across three nuclear targets, with efficacy varying by epilepsy classification and seizure onset zone. ANT DBS has Class I evidence supporting its use in focal epilepsies, particularly temporal lobe origin. CM DBS shows strong preliminary efficacy for generalized epilepsies, warranting larger randomized trials. PuM DBS requires prospective validation. Head-to-head comparative trials are needed before individualized target selection recommendations can be made.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ictal semiology in fronto-opercular epilepsy: A systematic review.","authors":"Zeynep Gokce-Samar, Alexandra Montavont, Marion Comajuan, Julitta de Bellescize, Eleni Panagiotakaki, Marietta Papadopoulou, Matthildi-Athina Papathanasiou-Terzi, Joseph Toulouse, Alexis Arzimanoglou, Karine Ostrowsky-Coste","doi":"10.1002/epd2.70257","DOIUrl":"https://doi.org/10.1002/epd2.70257","url":null,"abstract":"<p><p>A systematic review of the ictal semiology of fronto-opercular seizures in focal epilepsy was carried out to assess possible anatomical-clinical correlations and help guide interpretation of ictal semiology during pre-surgical evaluation. PubMed and Embase databases were searched using the following keywords: \"fronto-opercular OR frontal opercular OR Frontal operculum OR superior perisylvian OR anterior opercular AND (epilep* or seizure).\" The date last searched was November 30th, 2025. Studies were selected if they concerned case series, including at least one fully documented patient and informative case reports with the following criteria: patients who underwent a resection limited to the fronto-opercular cortex, and/or patients for whom the epileptogenic zone (EZ) was proven by intracranial electroencephalogram (iEEG) with insular cortex exploration, and/or by complementary noninvasive explorations. A total of 21 patients with fronto-opercular epilepsy from 16 studies were included in the review. iEEG was performed in 15 (71%) patients and resection in 16 (76%) patients. The confidence level in the EZ was very high (Engel IA) for 5 patients, high (Engel I not specified IA or Engel IB) for 12 patients, and moderate for 4 patients. The presence of an aura was found in 67% (n = 14/21) of the patients with mainly non-painful somatosensory sensations. This was more frequent in patients with an EZ in the precentral Rolandic operculum compared to those with an EZ in the prefrontal operculum (n = 6 versus n = 1, respectively, p = 0.016). Ictal signs comprised elementary motor symptoms, speech dysfunction, complex motor behavior, respiratory symptoms, salivation, and laughter, with preserved consciousness. Pure fronto-opercular epilepsy is rare, consisting mainly of contralateral elementary sensory aura especially for the Rolandic operculum. Common ictal signs are motor orofacial and brachial symptoms with preserved consciousness. Further studies including patients who underwent a successful resection limited to the frontal operculum are needed to confirm these anatomical-clinical correlations.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}