Epileptic Disorders最新文献

{"title":"Noise in the diagnosis of epilepsy by experts","authors":"Fábio A. Nascimento,&nbsp;John R. McLaren,&nbsp;Wei Zhao,&nbsp;Roohi Katyal,&nbsp;Irfan S. Sheikh,&nbsp;Wan Yee Kong,&nbsp;Danah Aljaafari,&nbsp;Nirav Barot,&nbsp;Selim Benbadis,&nbsp;Daniel Friedman,&nbsp;Jay R. Gavvala,&nbsp;Jonathan Halford,&nbsp;R. Edward Hogan,&nbsp;Peter W. Kaplan,&nbsp;Ioannis Karakis,&nbsp;Atul Maheshwari,&nbsp;Rebecca Matthews,&nbsp;Cormac O'Donovan,&nbsp;Stefan Rampp,&nbsp;Stephan Schuele,&nbsp;Joseph Sirven,&nbsp;William O. Tatum,&nbsp;Jonathan Williams,&nbsp;Elza Márcia Yacubian,&nbsp;Doyle Yuan,&nbsp;Sándor Beniczky,&nbsp;Olivier Sibony,&nbsp;M. Brandon Westover","doi":"10.1002/epd2.70181","DOIUrl":"10.1002/epd2.70181","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To measure the relative levels of signal and noise in expert diagnosis of epilepsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty multinational epileptologists independently reviewed 50 vignettes of adult and pediatric patients presenting with suspected seizure(s) on two separate occasions with a ≥30-day washout period. Experts provided a diagnosis of epilepsy or non-epilepsy based on clinical information and, if requested, routine EEG and neuroimaging data. Cases had an established clinical diagnosis of epilepsy or non-epilepsy based on capture of habitual paroxysmal events on video-EEG or long-term clinical follow-up. Experts' judgments were analyzed to decompose variability into different sources: signal (objective differences between cases), level noise (experts' bias toward over/under-diagnosis), pattern noise (experts' idiosyncratic reactions to specific case features), and occasion noise (inconsistency across occasions).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The probability of an expert making a different diagnosis for a given case on two different occasions was 16%. The probability of two different experts making a different diagnosis for the same case was 26%. Signal (case “difficulty”) accounted for 66–69% of total variation, with 31–34% attributable to noise. Level noise was the largest contributor in the absence of EEG/neuroimaging results (23%), while pattern noise dominated when test results were available (24%). Occasion noise contributed relatively little (1%) but was still sufficient to cause diagnostic reversals in 16–22% between occasions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>The degree of noise in expert diagnosis of epilepsy is substantial, stemming primarily from physicians' idiosyncratic interpretations of case features and variable dispositions toward over- or under-diagnosis. Strategies to improve reliability are needed, including standardized data collection protocols and structured decision algorithms. For “difficult cases,” where expert reliability and accuracy are lowest, our findings support current clinical practice which favors early referral for video-EEG monitoring over reliance on diagnostic anchoring. This diagnostic pathway may become more accessible with advances in EEG technology (e.g., wearable devices) and artificial intelligence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":"28 2","pages":"457-469"},"PeriodicalIF":2.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013266","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":"Comparative evaluation of artificial intelligence chatbots in answering electroencephalography-related questions","authors":"Soraia Proença,&nbsp;Joana Isabel Soares,&nbsp;Joana Parra,&nbsp;Gisela Maia,&nbsp;Sílvia Silva,&nbsp;Juliana Leite,&nbsp;Sándor Beniczky,&nbsp;Joana Jesus-Ribeiro","doi":"10.1002/epd2.70156","DOIUrl":"10.1002/epd2.70156","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>As large language models (LLMs) become more accessible, they may be used to explain challenging EEG concepts to nonspecialists. This study aimed to compare the accuracy, completeness, and readability of EEG-related responses from three LLM-based chatbots and to assess inter-rater agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred questions, covering 10 EEG categories, were entered into ChatGPT, Copilot, and Gemini. Six raters from the clinical neurophysiology field (two physicians, two teachers, and two technicians) evaluated the responses. Accuracy was rated on a 6-point scale, completeness on a 3-point scale, and readability was assessed using the Automated Readability Index (ARI). We used a repeated-measures ANOVA for group differences in accuracy and readability, the intraclass correlation coefficient (ICC) for inter-rater reliability, and a two-way ANOVA, with chatbot and raters as factors, for completeness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Total accuracy was significantly higher for ChatGPT (mean ± SD 4.54 ± .05) compared with Copilot (mean ± SD 4.11 ± .08) and Gemini (mean ± SD 4.16 ± .13) (<i>p</i> &lt; .001). ChatGPT's lowest performance was in <i>normal variants and patterns of uncertain significance</i> (mean ± SD 3.10 ± .14), while Copilot and Gemini performed lowest in <i>ictal EEG patterns</i> (mean ± SD 2.93 ± .11 and 3.37 ± .24, respectively). Although inter-rater agreement for accuracy was excellent among physicians (ICC = .969) and teachers (ICC = .926), it was poor for technicians in several EEG categories. ChatGPT achieved significantly higher completeness scores than Copilot (<i>p</i> &lt; .001) and Gemini (<i>p =</i> .01). ChatGPT text (ARI − mean ± SD 17.41 ± 2.38) was less readable than Copilot (ARI −mean ± SD 11.14 ± 2.60) (<i>p</i> &lt; .001) and Gemini (ARI − mean ± SD 14.16 ± 3.33).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Chatbots achieved relatively high accuracy, but not without flaws, emphasizing that the information provided requires verification. ChatGPT outperformed the other chatbots in accuracy and completeness, though at the expense of readability. The lower inter-rater agreement among technicians may reflect a gap in standardized training or practical experience, potentially impacting the consistency of EEG-related content assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":"28 2","pages":"378-388"},"PeriodicalIF":2.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764355","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":"Crossed cerebellar diaschisis in status epilepticus: A systematic review of the literature","authors":"Payam Tabaee Damavandi,&nbsp;Pilar Bosque-Varela,&nbsp;Helena Barbosa Horta Santos,&nbsp;Bassam Al-Fatly,&nbsp;Lukas Machegger,&nbsp;Eugen Trinka,&nbsp;Giorgi Kuchukhidze","doi":"10.1002/epd2.70163","DOIUrl":"10.1002/epd2.70163","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Crossed cerebellar diaschisis is a neuroimaging phenomenon observed in various neurological conditions, including status epilepticus. This systematic review aims to summarize the clinical and radiological characteristics of patients developing crossed cerebellar diaschisis following status epilepticus and to discuss potential pathophysiological mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic literature search was conducted using MEDLINE/PubMed, Embase, Web of Science, and CENTRAL from inception to October 2025. Studies reporting crossed cerebellar diaschisis in patients with status epilepticus, confirmed by neuroimaging (MRI, PET, or SPECT), were included. Data on demographics, semiology, etiology, imaging findings, EEG, and outcomes were extracted and synthesized. A spatial analysis of supratentorial MRI abnormalities associated with crossed cerebellar diaschisis was performed in 18 cases with suitable imaging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty patients from 50 studies were included. Mean age was 46.1 years; 50% were female. Convulsive status epilepticus was present in 62% of cases. Etiology was acute in 40%, unknown in 45%. Crossed cerebellar diaschisis was most frequently detected via DWI hyperintensity (55%) and FLAIR/T2 changes (52%). Arterial spin labelling and SPECT often showed hyperperfusion in the acute phase. Spatial mapping of supratentorial MRI abnormalities revealed a predominant involvement of cortical temporo-occipital regions, with minimal subcortical involvement, aligning with known cerebro-cerebellar connectivity patterns. Cerebellar symptoms were rare (5%), but cerebellar atrophy was reported in 7% of cases. Mortality was 10%; 30% recovered completely, while 33% had neurological deficits at discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Crossed cerebellar diaschisis is a dynamic phenomenon, presenting with both hyper- and hypoperfusion or metabolism, based on the timing and severity of status epilepticus. It may result from increased inhibitory cerebellar activity during seizures, followed by metabolic exhaustion and Purkinje cell loss. Although often clinically silent, it might lead to long-term cerebellar atrophy and neurological sequelae.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":"28 2","pages":"262-274"},"PeriodicalIF":2.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/epd2.70163","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893466","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":"Electro-clinical features of Mowat–Wilson syndrome: A retrospective study of 31 children in mainland China","authors":"Yi Ju,&nbsp;Tao-yun Ji","doi":"10.1002/epd2.70149","DOIUrl":"10.1002/epd2.70149","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To summarize the electro-clinical and genetic characteristics of children with Mowat–Wilson syndrome (MWS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study is a hospital-based case series analyzing clinical data from 31 pediatric patients with MWS and epilepsy treated at Peking University First Hospital between June 2020 and December 2024. Information on seizures, electroencephalographic features, genetic characteristics, treatment, and prognosis was summarized and analyzed using descriptive statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 31 children (16 males and 15 females), seizure onset occurred at a median age of 25.5 months (range: 1–113 months). Eighteen cases (58.1%, 18/31) began with fever-induced seizures; all 31 children experienced focal seizures, and 16 (51.6%, 16/31) exhibited atypical seizure presentations. Twelve (38.7%, 12/31) experienced seizures accompanied by gastrointestinal (GI) symptoms. Two children had myoclonic seizures, one had epileptic spasms, and another had atypical absence seizures. Ten (32.3%, 10/31) experienced convulsive status epilepticus. Electroencephalographic findings evolved from posterior head–dominant discharges to multifocal or anterior head–dominant discharges, with a significant increase in discharges during sleep. All 31 children had de novo <i>ZEB2</i> variants, including 27 with single-nucleotide variants (SNVs) or insertions/deletions (indels) and four with copy number variants. Among the SNVs/indels, nonsense (13) and frameshift (12) variants predominated. One patient with rare seizures did not receive anti-seizure medication (ASM). Thirty received ASMs; both levetiracetam and valproic acid, used as monotherapy or in combination, proved effective. Sixteen children achieved seizure control for more than 6 months, and seven maintained seizure control for over 1 year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Our findings reveal the electro-clinical characteristics, genetic variants, and effective treatments associated with MWS, providing an important basis for clinical diagnosis and management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":"28 2","pages":"344-358"},"PeriodicalIF":2.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/epd2.70149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846906","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":"Drug-resistant temporal lobe epilepsy: Seizure outcome in children versus adults","authors":"Gurumurthy Bharanidharan,&nbsp;Ankith Bhasi,&nbsp;Mathew Abraham,&nbsp;George C. Vilanilam,&nbsp;Ramshekhar N. Menon,&nbsp;Bejoy Thomas,&nbsp;Chandrasekharan Kesavadas,&nbsp;Vijayambika Sadasivam Nandini,&nbsp;Thareekh Basheer,&nbsp;Ashalatha Radhakrishnan","doi":"10.1002/epd2.70172","DOIUrl":"10.1002/epd2.70172","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Temporal lobe epilepsy (TLE) is the most common form of focal epilepsy, and about two-thirds of patients with drug-resistant TLE are surgical candidates. While many studies suggest better postoperative outcomes in children subjected to various types of surgery, there is limited data comparing adults and children who have undergone the same procedure over the same time period. This study aimed to compare long-term seizure outcomes and identify prognostic factors in pediatric (defined as children less than or equal to 12 years) and adult patients undergoing TLE surgery at a high-volume epilepsy center in South India.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study cohort comprised 684 consecutive patients (127 children, 557 adults) who underwent standard anterior temporal lobectomy. All underwent presurgical evaluation including video EEG, neuroimaging, and surgical decision was made in a multidisciplinary meet. Seizure freedom was defined as “absence of seizures or auras regardless of antiepileptic drug use,” which was the primary outcome. The predictors determining outcome in both age groups were also analyzed. Logistic regression identified the predictors, and Kaplan–Meier curves assessed long-term seizure-free survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Children had significantly shorter epilepsy duration pre-surgery (8.38 versus 19.2 years, <i>p</i> &lt; .0001) and significantly better seizure outcome (57.4% vs. 45.6%, <i>p</i> = .0165). Kaplan–Meier analysis revealed longer median seizure-free survival in children (120 months) than adults (72 months, <i>p</i> = .027). In adults, predictors of poor outcome included auditory aura, behavioral arrest, spike–wave discharges during ictal onset, and bitemporal IEDs. Febrile seizures predicted a favorable outcome in children and adults. In children, neoplasia as a substrate was protective, while psychiatric co-morbidity and multiple auras predicted seizure recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Children benefit more from TLE surgery than adults, due to earlier intervention and shorter duration of seizures. The principle of “time is brain” holds true in epilepsy; prolonged duration of uncontrolled seizures fosters network expansion, highlighting the need for “early surgical referral” and “catching them young.”</p>\u0000 </section>\u0000 </div>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":"28 2","pages":"435-447"},"PeriodicalIF":2.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949078","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":"EEG and clinical findings in pediatric epilepsy and control groups using video-based pattern stimulation","authors":"Hande Gazeteci Tekin,&nbsp;Fatma Kuşgöz,&nbsp;Damla Geçkalan","doi":"10.1002/epd2.70145","DOIUrl":"10.1002/epd2.70145","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to compare EEG responses and clinical findings during video-based pattern stimulation in pediatric epilepsy and control groups, and to evaluate differences according to epilepsy subgroups and seizure control status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 438 children (190 with epilepsy, 248 controls) were included. All participants underwent a 100-second video protocol consisting of 10 different patterns. Epileptiform activity during pattern stimulation and simultaneous clinical symptoms (nausea, dizziness, lightheadedness, etc.) were recorded. Responses to hyperventilation and photic stimulation were also assessed. The epilepsy group was analyzed according to seizure control (controlled/uncontrolled) and epilepsy syndromes (juvenile idiopathic generalized epilepsy, childhood absence epilepsy, self-limited epilepsy with autonomic seizures (SeLEAS), self-limited epilepsy with centrotemporal spikes (SeLECTS), and focal epilepsy). Statistical analyses were performed using chi-square tests and multivariable logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>EEG pattern sensitivity was observed in 8.9% of the epilepsy group and 3.2% of controls (<i>p</i> = .012). Clinical symptoms occurred in 11.5% of epilepsy patients and 15.7% of controls (<i>p</i> = .265). Pattern sensitivity was significantly higher in uncontrolled epilepsy (<i>p</i> = .009). Subgroup analysis revealed the most prominent difference in juvenile idiopathic generalized epilepsy. In multivariable analysis, hyperventilation (<i>p</i> = .044) and photic response (<i>p</i> = .042) were identified as independent predictors of pattern sensitivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Pattern sensitivity is not exclusive to children with epilepsy and may also occur at a lower rate in healthy controls. Children with uncontrolled epilepsy and those with juvenile idiopathic generalized epilepsy (JIGE) are particularly at risk. EEG abnormalities during pattern stimulation provide a more reliable indicator than clinical symptoms. The video-based protocol used in this study increases ecological validity by mimicking real-life visual stimuli. Our findings support the need for international standardization of pattern stimulation, similar to hyperventilation and photic stimulation protocols.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":"28 2","pages":"304-313"},"PeriodicalIF":2.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900992","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":"Prevalence, comorbidities, and mortality of epilepsy in an older Chinese population: The Shanghai Aging Study","authors":"Can Cui,&nbsp;Xiaowen Zhou,&nbsp;Jianhong Wang,&nbsp;Qianhua Zhao,&nbsp;Ding Ding","doi":"10.1002/epd2.70151","DOIUrl":"10.1002/epd2.70151","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the prevalence, comorbidities, and 13-year mortality of epilepsy among older community-dwelling adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective cohort with 3515 participants aged ≥50 years from the Shanghai Aging Study was followed up from 2010 to 2023. Participants were interviewed to obtain demographic and medical history, and were subjected to neurologic examinations. Epilepsy cases at baseline were determined with either diagnosis by a neurologist or anti-seizure medication prescriptions confirmed by medical records. Deaths were confirmed by the local mortality surveillance system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-six participants were determined to be people with epilepsy, indicating the prevalence rate of 7.40/1000 (95% CI 4.84, 10.82). People with epilepsy had a significantly higher chance of comorbidity with chronic obstructive pulmonary disease (COPD) (OR = 15.89, 95% CI 1.88, 133.98), depression (OR = 14.22, 95% CI 5.99, 33.73), and dementia (OR = 4.65, 95% CI 1.28, 16.89) compared to people without epilepsy. The overall mortality rate was 27.74/1000 person-years (95%CI 12.21, 53.97) in people with epilepsy and 26.32 (95% CI 24.75, 27.97) in people without epilepsy. Women aged 60–69 years exhibited a high mortality ratio of 5.84 (95% CI 1.58, 21.64) compared to those without epilepsy within the same age group. The top three causes of death in people with and without epilepsy were similar. COPD was significantly associated with increased mortality risk in people with epilepsy (HR = 22.68; 95% CI 1.30, 396.70), but not in those without epilepsy. People with epilepsy and COPD had a higher risk of mortality than those without epilepsy and COPD (HR = 12.58, 95% CI 1.76, 89.68).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Our study presented an epidemiological profile of epilepsy in an older community cohort and suggested a potential burden of neuropsychiatric and respiratory comorbidities, which needs further validation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":"28 2","pages":"359-368"},"PeriodicalIF":2.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745359","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":"Shared genetics in epilepsy and migraine: A scoping review","authors":"Prachi Sahu,&nbsp;Anjana Munshi,&nbsp;Gagandeep Singh","doi":"10.1002/epd2.70155","DOIUrl":"10.1002/epd2.70155","url":null,"abstract":"<p>Migraine and epilepsy are two common yet distinctive neurological disorders. All the same, a convergence between the two disorders is suggested by a number of clinical, mechanistic, and now, genetic studies. Migraine occurs more frequently in people with epilepsy, and epilepsy probably occurs more often among individuals with migraine in comparison to the general population. The common epilepsies and migraines have polygenic bases. Despite the phenotypic, mechanistic, and genetic heterogeneity underpinning the two disorders, there are numerous clinical and genetic studies emphasizing the occurrence of both in families and individuals. In addition, there are some rare monogenic disorders, such as familial hemiplegic migraines, in which both seizures and epilepsies are core clinical features. The reason behind the occurrence of seizures and epilepsies in some people with familial hemiplegic migraine, but not in others, is unknown. Alongside continued exploration of the genetic bases of migraine and epilepsy individually, the time is ripe to investigate shared genetic susceptibility for a better understanding of common mechanisms and the overlapping occurrence of the two conditions. Recent developments in computational and other genetic approaches have opened up new avenues for research. At the same time, more functional studies in the monogenic cases of familial hemiplegic migraine are desirable to shed light on the shared basis of migraine and epilepsy.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":"28 2","pages":"241-261"},"PeriodicalIF":2.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769741","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":"Executive functions and self-limited epilepsy with centro-temporal spikes: A scoping review","authors":"Edoardo Fino,&nbsp;Martina Calì,&nbsp;Sara Senese,&nbsp;Simona Pellacani,&nbsp;Viola Margheri,&nbsp;Chiara Pecini,&nbsp;Carmen Barba","doi":"10.1002/epd2.70176","DOIUrl":"10.1002/epd2.70176","url":null,"abstract":"<p>Executive functions are a set of high-level cognitive processes necessary for planning, organization, decision-making, self-control, and attention, and are carried out in the anterior frontal lobes. An impairment in executive functioning might present as difficulties in planning and organizing activities, in attention and concentration, in cognitive flexibility, impulsiveness, and working memory fragility. These might result in greater emotional and psychopathological difficulties and poorer academic performance. Self-limited epilepsy with centro-temporal spikes (SeLECTS), the most common epileptic syndrome occurring in the pediatric population, is characterized by seizure remission around puberty in most cases. However, despite the favorable seizure outcome, previous studies have suggested that executive function deficits might be present and persist after epilepsy remission. We conducted a scoping review to investigate the current knowledge on executive functioning in children with SeLECTS. Furthermore, we explored psychopathological and emotional dimensions and daily functioning in this population. Starting from two reviews published in 2021, we conducted a complementary search and included 41 articles, from which we analyzed clinical data, neuropsychological findings, and their respective correlations. Our results confirmed the possible presence of executive dysfunction in patients with SeLECTS in the domains of inhibition and cognitive flexibility. We also strengthen possible impairments in working memory and higher order executive functions. We confirmed the correlation between executive dysfunction and both early age at onset and high frequency of electroencephalogram abnormalities and observed a possible role for high seizure frequency, secondary bilateralization, and the use of anti-seizure medications. We also found a higher prevalence of psychopathological dimensions, most commonly attention deficit—hyperactivity disorder, compared with controls. Overall, our findings support the need for neuropsychological assessment in clinical practice for children with SeLECTS to characterize executive functioning and its impact on psychopathological and emotional dimensions, as well as academic performance.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":"28 2","pages":"275-294"},"PeriodicalIF":2.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/epd2.70176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953537","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":"Resolution of generalized tonic seizures following focal ablative or resective surgery","authors":"Sem L. Kampman,&nbsp;Itay Tokatly Latzer,&nbsp;Aaron E. L. Warren,&nbsp;Jurriaan M. Peters","doi":"10.1002/epd2.70148","DOIUrl":"10.1002/epd2.70148","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Focal brain lesions may underlie generalized tonic seizures, as seen in Lennox–Gastaut syndrome, by engaging bilateral neural networks. However, this seizure type is often not considered surgically remediable. Here, we describe the resolution of apparent electroclinically classic generalized tonic seizures in children originating from a unifocal brain lesion following resective or ablative surgery. This study aims to contribute to emerging evidence that prompt removal of a lesion may resolve generalized seizures by ameliorating aberrant network activity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Boston Children's Hospital's (BCH) epilepsy surgical database was reviewed to identify children with tonic seizures due to a focal brain lesion who remained seizure-free for longer than 1 year following resective or ablative surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five children were identified, of whom three underwent resective surgery and two laser interstitial thermal therapy (LITT). Age at epilepsy onset varied from 1 month to 7.25 years, and age at first epilepsy surgery ranged from 5.6 to 9.5 years. Lesions were predominantly located in the frontal lobe (<i>n</i> = 3), and focal cortical dysplasia (FCD) was the most common underlying etiology (<i>n</i> = 3), followed by vascular lesions (<i>n</i> = 2). At last follow-up, seizure freedom (Engel Class 1A) ranged between 1.7 and 4.4 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This study presents evidence that resection or ablation of a focal cortical lesion can resolve generalized tonic seizures. The findings also lend credence to the hypothesis that heterogeneous brain lesions can underlie shared electroclinical features through engaging similar brain networks. Children with tonic seizures in whom a lesional etiology is presumed should undergo timely surgical evaluation, as removal of a focal lesion may arrest the evolution of a secondary epileptic network and allow for the restoration of normal brain network development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":"28 2","pages":"333-343"},"PeriodicalIF":2.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/epd2.70148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999518","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}