Epileptic Disorders最新文献

{"title":"Laser interstitial thermal therapy for refractory epilepsy in children under 2 years: A single-center case series and review of the literature.","authors":"Praveen Kumar Ramani, Odette El Ghawi, Breanna Beltz, Stephen C Harward, Gerald A Grant, Muhammad Shahzad Zafar","doi":"10.1002/epd2.70260","DOIUrl":"https://doi.org/10.1002/epd2.70260","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the safety, feasibility, and clinical outcomes of magnetic resonance-guided laser interstitial thermal therapy (LITT) in children under 2 years of age with medically refractory epilepsy.</p><p><strong>Methods: </strong>We conducted a retrospective case series of five infants who underwent LITT at a tertiary pediatric epilepsy center. Inclusion criteria were age ≤ 24 months, failure of at least two antiseizure medications, and presence of a focal structural lesion on imaging. Clinical data, seizure outcomes (Engel classification), and developmental trajectories were analyzed.</p><p><strong>Results: </strong>Five patients (mean age at LITT: 9 months) underwent laser ablation for focal cortical dysplasia (FCD; n = 3) or tuberous sclerosis complex (TSC; n = 2). All patients tolerated the procedure without complications. At 12 months post-LITT, 3/5 patients (60%) achieved Engel Class I outcomes, all of whom had FCD. Both patients with TSC had ongoing seizures, although one showed improvement after subsequent SEEG-guided open resection. Patients with FCD demonstrated robust developmental progress, whereas those with TSC exhibited only modest gains in attention, engagement, and fine motor skills.</p><p><strong>Conclusion: </strong>LITT is a safe and feasible option for selected infants with drug-resistant epilepsy and structural lesions. Favorable seizure and developmental outcomes were more commonly observed in patients with FCD than TSC. These findings support further study of LITT in this age group, with particular attention to early intervention and accurate localization in complex cases.</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":"147788046","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 Vignette: A rare pericallosal lipoma presenting with Lennox-Gastaut syndrome and a remarkable response to valproic acid.","authors":"Rainier Mark Loidor L Rapal, Hok Leong Chin, Douglas Nordli","doi":"10.1002/epd2.70249","DOIUrl":"https://doi.org/10.1002/epd2.70249","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787984","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 vignette: Seizure recurrence after hemispheric disconnection-An EEG false lateralization trap.","authors":"Prashant Natteru, Ajay Gupta, Majed Alzahrany, William Bingaman, Ahsan Moosa Naduvil Valappil","doi":"10.1002/epd2.70253","DOIUrl":"https://doi.org/10.1002/epd2.70253","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787960","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":"Self-limited neonatal epilepsy with 2q24.3 duplications: Case series and literature review.","authors":"Saba Al Rawahi, Kenneth A Myers","doi":"10.1002/epd2.70252","DOIUrl":"https://doi.org/10.1002/epd2.70252","url":null,"abstract":"<p><strong>Objective: </strong>To clarify the phenotypic spectrum associated with duplications involving the 2q24.3 region, which includes a cluster of genes encoding sodium channel subunits (SCN1A, SCN2A, SCN3A, SCN7A, and SCN9A).</p><p><strong>Methods: </strong>We reviewed our research database for patients with epilepsy and 2q24.3 duplication and performed thorough phenotyping. We also searched the literature for patients with epilepsy and 2q24.3 duplication and extracted relevant clinical and molecular data.</p><p><strong>Results: </strong>From our research database, we identified two patients with 2q24.3 duplication, both of whom met criteria for self-limited neonatal epilepsy (SNE). From the literature, we found 23 individuals with 2q24.3 duplication affecting at least two whole genes, including at least one of SCN1A, SCN2A, or SCN3A. Combining cohorts, 23/25 patients (92%) had seizure onset in the neonatal period, almost always in the first 3 days of life. Nine out of 25 patients (36%) met criteria for SNE; however, at least five others would have the diagnosis as well, except for the presence of developmental impairment. Overall, 16/25 (64%) had developmental impairment of some form, usually severe. In three families, offspring with self-limited neonatal seizures and significant developmental impairment had inherited the duplication from a parent with SNE. With respect to treatment, sodium channel antagonists such as carbamazepine appeared to be most effective.</p><p><strong>Significance: </strong>The majority of individuals with 2q24.3 duplication have self-limited neonatal seizures with or without intellectual disability. No particular genomic region appears responsible for developmental impairment, and intrafamilial variability may occur with respect to developmental status, a finding which has important implications for genetic counseling.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787969","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":"Response to: Middle-aged woman presenting with new-onset status epilepticus and family history of MELAS syndrome but negative mtDNA testing.","authors":"Wankiun Lee","doi":"10.1002/epd2.70259","DOIUrl":"https://doi.org/10.1002/epd2.70259","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788036","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":"Inter-rater reliability and clinical utility of the BASED score in infantile epileptic spasms syndrome.","authors":"T P Cramer, B Johnsen, V S Hansen, E Qerama, T S Engedal","doi":"10.1002/epd2.70255","DOIUrl":"https://doi.org/10.1002/epd2.70255","url":null,"abstract":"<p><strong>Objective: </strong>Hypsarrhythmia is the classical EEG pattern of children with infantile epileptic spasms syndrome (IESS). Multifocal spikes, slow waves of large amplitude, and chaoticity are its main characteristics, but these lack clear definitions, and the interrater reliability (IRR) is poor. The aim of this study was to substantiate the use of the Burden of Amplitudes and Epileptiform Discharges (BASED) score for children with hypsarrhythmia on initial EEG and to compare the IRR to traditional scoring.</p><p><strong>Methods: </strong>We identified before and after treatment EEGs from 20 consecutive patients from a local database. Clinical remission was defined as the remission of spasms. Three experienced Danish neurophysiologists, blinded to clinical information, rated each EEG separately using traditional visual analysis and the BASED score. A BASED score ≥4 and any hypsarrhythmic pattern were considered consistent with an epileptic encephalopathy. IRR was estimated using Gwet's AC1.</p><p><strong>Results: </strong>IRR for scoring an epileptic encephalopathy was significantly better when using the BASED score compared with the traditional method (0.88 vs. 0.62, p = 0.01). Complete agreement was observed in 36 out of 40 EEGs using the BASED score vs. 28 out of 40 using the traditional method (Fisher's exact test: p = 0.048). IRR was near perfect or substantial in all but one of the individual components of the BASED score. Clinical remission was seen in 14 out of 19 patients, and the clinical course was consistent with EEG in 18 out of 19 patients using the BASED score and in 16 out of 19 patients using the traditional method (Fisher's exact test: p = 0.60).</p><p><strong>Significance: </strong>The BASED score demonstrated very high interrater reliability, exceeding that of traditional hypsarrhythmia scoring. It also corresponded closely with the clinical course, supporting its validity.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729925","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":"Lateralizing and localizing value of postictal signs: A systematic review.","authors":"Prachi Parikh, Mays Khweileh, Georg Zimmerman, Stephanie Hendren, Lara Wadi, Alyssa Ho, Birgit Frauscher","doi":"10.1002/epd2.70248","DOIUrl":"https://doi.org/10.1002/epd2.70248","url":null,"abstract":"<p><p>To present a concise and comprehensive review of the lateralizing and localizing value of postictal signs in focal epilepsy and to provide guidance in the interpretation of the signs for presurgical evaluation of drug-resistant epilepsy. We performed a systematic literature review following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to identify the various postictal manifestations of seizures (paresis, psychosis, nose-wiping, automatisms, language deficits, headache, autonomic disturbances, visual impairment, palinacousis, and memory disturbances). We specifically investigated its evidence in the lateralization and localization of the seizure focus by searching three databases (PubMed, Embase, Scopus) until January 03, 2024. We then assessed the possibility of selection and assessment bias and evaluated the confidence in the epileptogenic zone based on brain neuroimaging, intracranial electroencephalography, and surgical outcomes. Studies were classified as high quality if the potential for bias was low and the confidence in the epileptogenic zone was high. The majority of patients with postictal signs had temporal lobe epilepsy (TLE). Signs with the highest incidence of TLE were postictal automatisms (93%), postictal nose-wiping (89%), postictal psychosis (84.9%), postictal language impairment (84.2%), and postictal autonomic signs (83.7%). Language dysfunction had a high occurrence in left TLE (96.4%); nose-wiping had a high occurrence in ipsilateral TLE (82.1%). Paresis was always seen contralaterally to the epileptic focus and was more likely to occur in patients with frontal lobe epilepsy than other anatomical localizations (Odds = 1.5). Finally, patients with occipital lobe epilepsy had a significantly higher incidence of postictal headache (Odds = 8.3) compared to other lobar localizations. Even though occurring after seizure termination, postictal signs can have high lateralizing and localizing value in presurgical planning, along with other ancillary information.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729871","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":"Mesial temporal lobe epilepsy with hippocampal sclerosis: Seizure, neuropsychological, and quality of life outcomes of 100 patients treated with trans-anterior T1 selective amygdalohippocampectomy","authors":"Naotaka Usui,&nbsp;Hiroshi Ogawa,&nbsp;Akihiko Kondo,&nbsp;Kazumi Matsuda,&nbsp;Mitsuru Hashiguchi,&nbsp;Taro Okumura,&nbsp;Yuuki Ishida,&nbsp;Norihiko Kawaguchi,&nbsp;Takashi Matsudaira,&nbsp;Kentaro Tokumoto,&nbsp;Takuji Nishida,&nbsp;Katsumi Imai","doi":"10.1002/epd2.70157","DOIUrl":"10.1002/epd2.70157","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>For mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE with HS), laser interstitial thermal therapy has recently been increasingly used. At our institute, however, selective amygdalohippocampectomy by a trans-anterior T1 subpial approach (trans-anterior T1 SAH) has been used for MTLE with HS. Here, we examined the seizure, neuropsychological, and quality of life (QOL) outcomes after trans-anterior T1 SAH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred patients with MTLE with HS who underwent trans-anterior T1 SAH and were followed for at least 1 year after surgery were included. Seizure outcomes, intelligence and memory, visual field changes evaluated by perimetry, and QOL were investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seizure-free outcome (Engel class I) at the latest follow-up (mean 4.6 years) was achieved in 88/100 (88%) patients. Only 1 of 100 patients underwent intracranial EEG. Postoperative contralateral upper quadrantanopia was detected in only 15/73 (21%) of patients. Significant improvements in full-scale IQ, verbal IQ, and performance IQ, as examined by the Wechsler Adult Intelligence Scale-III, were seen in both the language-dominant-side surgery and the language-nondominant-side surgery groups. In patients who underwent language-dominant-side SAH, significant declines in general memory and verbal memory scores on the Wechsler memory scale – revised edition were observed at a group level. Significant improvement in attention/concentration was seen regardless of the surgical side. QOL analysis revealed that approximately 30% of patients felt their memory declined after surgery; however, half of the patients felt that being free to go out and become employed was an advantage, and about 90% of patients were satisfied with their surgical treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Trans-anterior T1 SAH led to favorable seizure outcomes in about 90% of patients with MTLE with HS. Most patients were pleased with their surgery. In patients with MTLE with HS, the preferred surgical strategy should still be SAH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":"28 2","pages":"389-400"},"PeriodicalIF":2.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/epd2.70157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Status epilepticus and super-refractory status epilepticus related to pregnancy: Causes and pregnancy outcomes","authors":"Vanja Radišić,&nbsp;Jovana Popadić,&nbsp;Branislav Ralić,&nbsp;Maša Kovačevic,&nbsp;Aleksandar J. Ristić,&nbsp;Marko Ercegovac,&nbsp;Dejana R. Jovanović,&nbsp;Ivana Berisavac","doi":"10.1002/epd2.70154","DOIUrl":"10.1002/epd2.70154","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Status epilepticus in pregnancy (SEP) is a rare neurological emergency that demands prompt treatment due to the high risk for both maternal and fetal complications. Published data on SEP, its management, etiology, and pregnancy outcomes remain limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a prospective observational study at a tertiary referral center, including six patients who developed SEP. Demographic and clinical characteristics were collected and analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the studied period (2021–2024), SEP accounted for 4.4% of all SE, and super-refractory SEP (SRSEP) was identified in 50% (3/6) of SEP cases. Convulsive and nonconvulsive SE occurred at the same frequency, with NCSE being predominant in the SRSEP group (2/3, 66.67%). Five (83.3%) patients had a history of epilepsy, and in three (60%), intractability was established. One patient experienced acute symptomatic SE within the first hours following delivery. Benzodiazepines (BDZ) were used as first-line treatment in all patients, followed by phenobarbital (PB), whereas midazolam (MDZ) and/or propofol were given for SRSEP. No patient experienced a recurrence of SE during pregnancy. At discharge, all patients had a good functional outcome {mRS 1 (interquartile range [IQR] 0–2)}. One patient delivered immediately after SEP resolution, while two (40%) had preterm deliveries and two (40%) had term deliveries. Median Apgar score was 9 (IQR 5–9).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Our results showed that worsening of preexisting focal epilepsy was the greatest risk for SEP and SRSEP development in our tertiary center; however, the use of standard-of-care treatment for SE led to favorable short-term maternal and fetal outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":"28 2","pages":"369-377"},"PeriodicalIF":2.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806158","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":"Psychological resilience influences subjective memory in epilepsy patients through perceived stress: A mediation model analysis","authors":"Kairui Li,&nbsp;Jialin Tang,&nbsp;Zhiqin Xi,&nbsp;Zheng Xiao,&nbsp;Liang Wang","doi":"10.1002/epd2.70161","DOIUrl":"10.1002/epd2.70161","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Memory impairment, particularly subjective memory complaints, is common among patients with epilepsy and significantly affects their quality of life and treatment adherence. This study aimed to investigate the factors influencing subjective memory in epilepsy, with a specific focus on the roles of psychological resilience and perceived stress, and to examine whether perceived stress mediates the relationship between psychological resilience and subjective memory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 145 patients with epilepsy were prospectively enrolled at the Epilepsy Center of a tertiary teaching hospital. Comprehensive assessments were conducted to evaluate psychological resilience, perceived stress, subjective and objective memory performance, and demographic and clinical characteristics. Statistical analyses included Pearson or Spearman correlation, group comparisons, and multiple regression analyses to identify the influencing factors. The mediation effects were tested using the bootstrap method with 5000 resamples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Subjective memory was positively correlated with psychological resilience (<i>r</i> = .441, <i>p</i> &lt; .001) and negatively correlated with perceived stress (<i>r</i> = −.574, <i>p</i> &lt; .001). Regression analysis indicated that psychological factors remained significant predictors after controlling for the relevant covariates. Mediation analysis demonstrated that perceived stress exerted a significant indirect effect on the association between psychological resilience and subjective memory (ACME = .1554, 95% CI [.03, .31], <i>p</i> = .015), which accounted for 32.96% of the total effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Psychological resilience and perceived stress are significant contributors to subjective memory in epilepsy. The mediating role of perceived stress suggests its potential as a target for psychological intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":"28 2","pages":"409-419"},"PeriodicalIF":2.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145859183","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}