Epileptic Disorders最新文献

{"title":"Clinical vignette: Steroid-associated electroclinical improvement in KCNQ2 developmental and epileptic encephalopathy caused by the rare p.Thr194Ile variant.","authors":"Željka Rogač, Velislava Zoteva","doi":"10.1002/epd2.70435","DOIUrl":"https://doi.org/10.1002/epd2.70435","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118006","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":"Pediatric new-onset seizure-like events: Yield of diagnostic work-up.","authors":"Geertruida Slinger, Lotte Noorlag, Willem M Otte, Maeike Zijlmans, Rosalie L Neijzen, Sandra M A van der Salm, Floor E Jansen, Kees P J Braun, Eric van Diessen","doi":"10.1002/epd2.70434","DOIUrl":"https://doi.org/10.1002/epd2.70434","url":null,"abstract":"<p><strong>Objective: </strong>To assess the diagnostic yield of ancillary investigations in children presenting with new-onset seizure-like events (SLEs) at a tertiary first seizure clinic (FSC).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including 1213 children evaluated for new-onset SLEs at a tertiary FSC. As part of the FSC consultation, all children underwent a routine EEG recording. Data on demographics, diagnoses, and additional investigations after FSC consultation were collected via chart review. Diagnostic tests (e.g., repeated EEG, magnetic resonance imaging (MRI), or genetic testing) were defined as those performed after FSC consultation with the intention to establish a final epilepsy or no-epilepsy diagnosis. Descriptive statistics summarized the results and yields of ancillary investigations.</p><p><strong>Results: </strong>At FSC consultation, the initial FSC diagnosis was epilepsy in 23.0%, no epilepsy in 43.4%, and undefined in 33.6% (including single unprovoked seizure in 5.9% and unclear in 27.8%). At follow-up, 33.6% were diagnosed with epilepsy, 60.8% with no epilepsy, and in 5.7% the final diagnosis remained unclear. Only 23 children (1.9%) were misclassified at FSC consultation, corresponding to 2.9% of children with a defined diagnosis (epilepsy or no epilepsy). Additional investigations were mainly performed in children with an undefined FSC diagnosis. Of 934 children without an epilepsy FSC diagnosis, repeated EEG contributed to a final epilepsy diagnosis in 7.7%, MRI in 1.2%, and genetic testing in 0.4%. Sleep-deprived EEG was the most performed repeated EEG and showed interictal epileptiform discharges in up to 71.2% of children with an unclear FSC diagnosis and final epilepsy diagnosis.</p><p><strong>Significance: </strong>This study provides valuable insights into the diagnostic yield of ancillary investigations performed after initial evaluation for pediatric new-onset SLEs. In children with an initially undefined diagnosis, repeated EEG recordings, particularly sleep-deprived EEG, contribute to a final epilepsy diagnosis more frequently than MRI or genetic testing.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118012","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":"Probable sudden unexpected death in epilepsy in chronic febrile infection-related epilepsy syndrome survivors: Silent threat after the storm.","authors":"Yayoi Shide-Moriguchi, Naohiro Yamamoto, Ichiro Kuki, Naoki Yamada, Masataka Fukuoka, Megumi Nukui, Takeshi Inoue, Sayaka Yoshida, Hiroshi Sakuma, Masashi Shiomi, Shin Okazaki","doi":"10.1002/epd2.70420","DOIUrl":"https://doi.org/10.1002/epd2.70420","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117958","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":"Core outcome set for quality of life of family caregivers of adults with epilepsy: A Delphi consensus study.","authors":"Florien Boele, Famke Visser, Maeike Zijlmans, Maaike Schuur, Stephanie Peters, Francis Saridin, Lydia van den Berg, Aysun Altinbas, Rolf Fronczek, Roland Thijs, Jaap C Reijneveld","doi":"10.1002/epd2.70413","DOIUrl":"https://doi.org/10.1002/epd2.70413","url":null,"abstract":"<p><strong>Objective: </strong>Epilepsy significantly affects daily functioning and health-related quality of life (HRQOL) of those living with the condition. Less is known about HRQOL of family caregivers of adults with epilepsy, yet the functioning of patients and caregivers is interlinked, and caregivers' unmet support needs are high. A consensus-based core outcome set for caregivers' HRQOL can guide more structured caregiver assessments and aid timely intervention.</p><p><strong>Methods: </strong>A three-round Delphi study was conducted to determine outcomes most important for family caregivers' HRQOL. Three stakeholder groups were recruited: experts-by-experience (caregivers/adults with epilepsy), healthcare professionals, and researchers. Across two survey rounds, participants rated outcomes for relevance, feasibility, and amenability to change. A predefined consensus threshold (≥80% agreement on relevance) guided outcome selection. In round three, participants prioritized three relevant outcomes per HRQOL domain. The resulting preliminary core outcome set was reviewed by a second stakeholder panel for scope, overlap, and feasibility before finalizing.</p><p><strong>Results: </strong>Thirty-four experts-by-experience, healthcare professionals, and researchers from 10 countries participated. In rounds 1 (N = 34) and 2 (N = 32), 41 outcomes reached the ≥80% relevance threshold and were retained. In round 3 (N = 30), participants prioritized 18 outcomes. After review by the second panel (N = 25), the final core outcome set includes caregivers' physical functioning (general health, sleep, fatigue), emotional functioning (emotional (in)stability, seizure worry, overwhelm, resilience), social functioning (personal relationships, family relationships, social stigma), spiritual/religious functioning (hope, purpose/meaning), tasks/responsibilities (understanding diagnosis and treatment, coping with behavior changes), and self-care, respite, and financial security. We recommend outcome measures prioritized for good psychometric properties, language availability, and low burden of administration to facilitate caregiver assessments.</p><p><strong>Significance: </strong>This international Delphi consensus study established 18 core outcomes for HRQOL of caregivers of adults with epilepsy. Structured assessment of the core outcome set using validated tools can support timely detection of and intervention to alleviate HRQOL issues in caregivers.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118009","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":"Intermittent photic stimulation in routine EEG: A practical guide.","authors":"Natalia Olaru, Joana Jesus-Ribeiro, David Asish Manchala, Irfan S Sheikh, Sándor Beniczky","doi":"10.1002/epd2.70433","DOIUrl":"https://doi.org/10.1002/epd2.70433","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117974","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":"The effect of anti-seizure medications on exposure to statins: A systematic review and meta-analysis.","authors":"Sharon Valiyev Huino, Hagar Cohen, Bruria Hirsh Raccah, Tomer Ben-Shushan, Ilan Matok, Sara Eyal","doi":"10.1002/epd2.70416","DOIUrl":"https://doi.org/10.1002/epd2.70416","url":null,"abstract":"<p><strong>Objectives: </strong>Antiseizure medications (ASMs) can reduce the efficacy of statin treatment, partly due to reduction in statin concentrations. In this systematic review and network meta-analysis (NMA), we compared the effects of ASMs and the prototypical enzyme inducer rifampin on statin exposure.</p><p><strong>Methods: </strong>The study was registered in PROSPERO (CRD42024622109) and followed the PRISMA 2015/2020 guidelines. Searches through January 19, 2026, were conducted in MEDLINE, EMBASE, the Cochrane Library, and the FDA database. We included prospective studies in which ASMs or rifampin were administered for ≥ 5 days. The primary endpoint was the area under the concentration-time curve ratio (AUCR) of the statin with/without the perpetrator. Perpetrator-statin combinations were compared pairwise using the standardized mean difference (SMD). The PKclin tool was used for assessing the bias risk.</p><p><strong>Results: </strong>The NMA included six studies with 236 participants, of which four (206 participants) assessed four ASMs. The AUCR of simvastatin after exposure to 800 mg/day eslicarbazepine (mean 0.460; 90% confidence interval, 0.378-0.561) was comparable to those of the combinations 200-400 mg/day phenytoin-atorvastatin (0.463; 0.385-0.556), 600 mg/day carbamazepine-pravastatin (0.382; 0.321-0.455) or -rosuvastatin (0.388; 0.353-0.427), and 600 mg/day rifampin-rosuvastatin (0.371; 0.317-0.435), but lower than with 1200 mg/day eslicarbazepine-rosuvastatin (0.630; 0.571-0.694). Similarly, in the NMA, the effect of 800 mg/day eslicarbazepine on simvastatin did not differ from those of rifampin on pravastatin/rosuvastatin (SMD 0.08, confidence interval, -0.03 to 0.19) or phenytoin on atorvastatin (0.00; -0.14 to 0.14).</p><p><strong>Significance: </strong>Despite the limited number of studies and methodological variation, our analysis demonstrates that all statins can be considerably affected by strong enzyme-inducing ASMs. The effects of ASMs with moderate enzyme-inducing activity on simvastatin, lovastatin, and atorvastatin are comparable to those of strong inducers on pravastatin or rosuvastatin. Careful selection of ASM-statin combinations with appropriate monitoring can improve patient outcomes, and co-medication reporting in clinical trials can help interpretation.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117930","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":"Clinical spectrum of epilepsy in children treated at a tertiary pediatric neurology center-A hospital-based cohort study.","authors":"Dominika Sabova, Lucia Svecova, Marta Mikloskova, Miriam Kolnikova","doi":"10.1002/epd2.70428","DOIUrl":"https://doi.org/10.1002/epd2.70428","url":null,"abstract":"<p><strong>Background: </strong>ILAE introduced a new classification of epilepsies and epileptic seizures in 2017 and a classification of epilepsy syndromes in 2022. Despite increasing adoption in clinical practice, real-world data on their clinical implementation, particularly from Central Europe, remain limited.</p><p><strong>Objective: </strong>To retrospectively assess the distribution of epilepsy types, syndromes, and etiologies according to the 2017 and 2022 ILAE classifications and to analyze the distribution of age at seizure onset in a tertiary pediatric neurology department in Slovakia.</p><p><strong>Methods: </strong>This retrospective single-center study evaluated 439 pediatric patients (aged 0-18 years) with epilepsy who were hospitalized at the Department of Pediatric Neurology in Bratislava between January 2020 and June 2022.</p><p><strong>Results: </strong>Seizure onset most frequently occurred during the first year of life (29.6%). Focal epilepsy was the predominant type, occurring in 237 patients (54.0%), followed by generalized epilepsy in 108 patients (24.6%), combined generalized and focal epilepsy in 66 patients (15.03%), and epilepsy of unknown type in 28 patients (6.38%). An epilepsy syndrome was diagnosed in 155 patients (35.3%). The most common epilepsy syndromes were infantile epileptic spasms syndrome in 31 patients (7.06%), idiopathic generalized epilepsies in 24 patients (5.47%), developmental and/or epileptic encephalopathy with spike- and-wave activation in sleep in 21 patients (4.78%), and self-limited epilepsy with centrotemporal spikes in 20 patients (4.56%). An established etiology was identified in 170 patients (38.72%). Among patients with an established etiology, structural causes were the most frequent in 101 patients.</p><p><strong>Conclusions: </strong>In this tertiary hospitalized pediatric epilepsy cohort, systematic application of the ILAE classification enabled structured diagnostic categorization and etiological stratification. Early etiological evaluation and structured classification are essential for individualized treatment planning and improved prognostic assessment in children with epilepsy.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117922","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":"Anterior shoulder dislocation after tonic-clonic seizure.","authors":"Jin'e Yuan, Yuting Xu, Sha Xue, Yanjuan Ye, Xiaoping Du, Yanwu Guo","doi":"10.1002/epd2.70380","DOIUrl":"https://doi.org/10.1002/epd2.70380","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082711","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":"Cardiovascular outcomes of enzyme-inducing anti-seizure medications: A real-world Asian cohort study.","authors":"Chun-Yu Cheng, Ting-Chung Wang, Chia-Yu Hsu, Meng-Hung Lin, Chia-Yen Liu, Chih-Hao Chang","doi":"10.1002/epd2.70430","DOIUrl":"https://doi.org/10.1002/epd2.70430","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether enzyme-inducing anti-seizure medications (EIASMs) are associated with differential risks of major adverse cardiovascular events (MACE) and all-cause mortality compared with non-enzyme-inducing anti-seizure medications (NEIASMs) in adults with epilepsy.</p><p><strong>Methods: </strong>Using the Chang Gung Research Database (2010-2019), adults with epilepsy receiving at least 28 cumulative days of anti-seizure medication therapy within 180 days of the index date were classified as EIASMs or NEIASMs users. Stabilized inverse probability of treatment weighting (IPTW) addressed confounding by indication. Composite MACE encompassing myocardial infarction (MI), arrhythmia, heart failure, ischemic stroke, hemorrhagic stroke, and sudden cardiac death and all-cause mortality were co-primary endpoints evaluated using Cox proportional hazards and Fine-Gray competing risk models.</p><p><strong>Results: </strong>Of 20 693 eligible patients, 10 571 received EIASMs and 10 122 received NEIASMs. After IPTW, all covariates were balanced (absolute standardized mean differences <0.1). Cox analysis demonstrated lower composite MACE (adjusted HR: 0.91, 95% CI: 0.85-0.99, p = 0.020) and all-cause mortality (adjusted HR: 0.95, 95% CI: 0.89-1.00, p = 0.048) with EIASM use, with individually lower rates of MI (adjusted HR: 0.83, p = 0.013) and arrhythmia (adjusted HR: 0.85, p = 0.029). Under Fine-Gray modeling, composite MACE was attenuated to nonsignificance (adjusted SHR 0.94, 95% CI: 0.87-1.01, p = 0.118), with directional consistency preserved.</p><p><strong>Significance: </strong>In this large propensity score-weighted Asian cohort, EIASM use was not associated with excess cardiovascular risk. These findings challenge the assumption that EIASMs carry inherent cardiovascular disadvantage and support their use with appropriate monitoring when seizure control requires enzyme-inducing therapy.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082669","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":"Meduna and the origins of the idea that seizures can be therapeutic.","authors":"Eliza S Schnitzer, Ronan Soltesz, Ivan Soltesz","doi":"10.1002/epd2.70429","DOIUrl":"https://doi.org/10.1002/epd2.70429","url":null,"abstract":"<p><p>Electroconvulsive therapy (ECT) has been well discussed in psychiatry as one of the oldest, yet still enduring and effective treatments for several psychiatric disorders, including depression, catatonia, mania, and psychoses. However, the intellectual history of ECT is much less known in the field of epilepsy, in spite of the fact that the therapy's origins are squarely in epilepsy neuropathology. Therefore, this historical review's primary aim is to retrace the scientific roots of ECT from a uniquely epilepsy-focused perspective. We focus on the key contributions of a neuropathologist studying epilepsy, László Meduna, who was the first to wonder if seizures may be beneficial in certain psychiatric disorders. In addition, we highlight the controversies surrounding his initial results, the transition from chemoconvulsants to electrical seizure induction, and that, despite the long-standing clinical use of ECT, it is still not well understood in mechanistic terms why inducing a seizure could relieve symptoms of certain psychiatric illnesses. The history of ECT for epileptologists is particularly insightful not only because it chronicles how an idea originating from studies focusing on seizures has come to have such an enduring impact on clinical care in an area outside of epilepsy but also because it highlights how bold testing of innovative hypotheses stemming from seemingly disconnected observations can lead to tangible breakthroughs in translation.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082656","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}