Epileptic Disorders最新文献

{"title":"Occipital spikes of the blind.","authors":"Dorothee Kasteleijn-Nolst Trenite","doi":"10.1002/epd2.70403","DOIUrl":"https://doi.org/10.1002/epd2.70403","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898415","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":"A next-generation sequencing-based pharmacogenetic study of ABCB1, ABCC1, and ABCC2 variants associated with antiseizure medication response in Turkish epilepsy patients.","authors":"Zeynep Gizem Todurga-Seven, Kubra Cigdem Pekkoc-Uyanik, Erhan Rasit Agay","doi":"10.1002/epd2.70400","DOIUrl":"https://doi.org/10.1002/epd2.70400","url":null,"abstract":"<p><strong>Objectives: </strong>Epilepsy is a chronic neurological disorder characterized by a tendency to have recurrent seizures due to abnormal and excessive neuronal activity in the brain. Genetic variants in adenosine triphosphate (ATP)-binding cassette (ABC) transporter genes, including ABCB1, ABCC1, and ABCC2, may contribute to pharmacoresistance in epilepsy by altering the transport of anti-seizure medications (ASMs) across the blood-brain barrier (BBB). This study aims to explore genetic polymorphisms in the ABCB1, ABCC1, and ABCC2 genes in Turkish epilepsy patients and to assess their impact on responsiveness to ASMs.</p><p><strong>Methods: </strong>Targeted next-generation sequencing was used for molecular genotyping of the ABCB1, ABCC1, and ABCC2 genes in genomic DNA from 35 patients.</p><p><strong>Results: </strong>A total of nine common variants were analyzed in ABCB1 (rs2032582, rs1045642, rs1128503), ABCC1 (rs35626, rs212087, rs246221), and ABCC2 (rs717620, rs22773697, rs3740066). A statistically significant association was found between ABCB1 rs2032582:T>G and ASMs response in the recessive model (TT + TG vs. GG, p = 0.018, OR = 13.13; 95% CI: 1.69-160.1; Benjamini-Hochberg (BH) FDR-adjusted q = 0.09), with the TT + TG genotypes being more frequent among drug-responsive patients. Haplotype analysis showed that only the ABCB1 rs2032582 G allele was significantly more frequent in drug-persistent patients compared with drug-responsive patients (χ² = 3.916, p = 0.047). However, none of these associations remained statistically significant after false discovery rate (FDR) correction, and all findings should therefore be interpreted as exploratory.</p><p><strong>Significance: </strong>The findings suggest that the ABCB1 rs2032582:T>G polymorphism may be associated with variability in treatment response among Turkish epilepsy patients. These results emphasize the potential involvement of ABC transporter-mediated drug efflux mechanisms in impacting the effectiveness of ASMs.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898402","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":"Knowing enough: On the limits of knowing the patient in epilepsy care.","authors":"Giancarlo Di Gennaro, Andrea Tomasini","doi":"10.1002/epd2.70404","DOIUrl":"https://doi.org/10.1002/epd2.70404","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898392","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":"Differentiating the symptomatogenic hub from the onset zone: A network approach to insular mimicry.","authors":"Razan Jabbad, Amir Saam Youshani, Arun Thurairajah, Jonathan Lau, Ana Suller-Marti, Jorge G Burneo","doi":"10.1002/epd2.70390","DOIUrl":"https://doi.org/10.1002/epd2.70390","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882513","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":"Reflex seizures and epilepsy surgery: A network approach case-based exploration.","authors":"Olivier Aron, Laure Salmon, Nicolas Nguyen, Dènahin Toffa, Sami Obaid, Alexis Robin, Dang Khoa Nguyen","doi":"10.1002/epd2.70354","DOIUrl":"https://doi.org/10.1002/epd2.70354","url":null,"abstract":"<p><strong>Context: </strong>Reflex seizures (RS) are defined by their consistent provocation by specific stimuli, encompassing a broad range from elementary sensory inputs to complex cognitive tasks. While RS are often encountered in clinical practice, their surgical management remains sparsely reported and poorly systematized.</p><p><strong>Methods: </strong>This Seminar reviews surgical cases of RS using a network-based analytical framework, with a focus on delineating the functional anatomy of (i) networks subserving the triggers (NsT), (ii) networks underlying seizure semiology (NuS), and (iii) seizure onset zones (SOZ), aiming to identify criteria predictive of surgical feasibility.</p><p><strong>Results: </strong>Across the spectrum of reported RS-from those triggered by elementary somatosensory or auditory stimuli to more elaborate triggers such as eating, music, reading or praxis-we found that favorable surgical outcomes are more consistently associated with the localization of NuS than with NsT. In RS elicited by elementary stimuli, SOZ often lies adjacent to primary sensory or motor cortices. In contrast, RS provoked by complex or cognitive tasks tend to implicate associative cortical regions, and the latency to ictal onset reflects the degree of network involvement. Notably, specific semiologic patterns-particularly the presence or absence of an aura and the involvement of dorsal versus ventral processing streams-serve as clinical markers to infer SOZ location and its relationship to functional networks.</p><p><strong>Implications: </strong>We propose a tripartite framework for evaluating surgical candidacy in RS based on (1) clinical context (etiology, age), (2) stimulus characteristics (modality and latency), and (3) seizure semiology (ventral vs. dorsal stream involvement). This model enables clinicians to estimate the overlap between epileptogenic and physiological networks and guide the individualized surgical strategies, although advanced neurophysiological mapping remains essential. Despite limited data, our findings support the role of epilepsy surgery in selected RS cases and advocate for prospective studies leveraging multimodal network analyses to optimize patient selection and surgical outcomes.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882496","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":"Before the spike: Human oversight of artificial intelligence in EEG interpretation requires reasoning beyond recognition.","authors":"Daniel Filipe Borges, Alberto Leal","doi":"10.1002/epd2.70396","DOIUrl":"https://doi.org/10.1002/epd2.70396","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851686","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":"Localizing value of ictal déjà vu, déjà vécu, dreamy state and reminiscence: A systematic review.","authors":"Amir Janah, Lilach Goldstein, Firas Fahoum","doi":"10.1002/epd2.70383","DOIUrl":"https://doi.org/10.1002/epd2.70383","url":null,"abstract":"<p><p>We performed a systematic review of the literature regarding the localization value of déjà vu (DV), déjà vécu, dreamy state and reminiscence in focal epilepsy, with the aim to summarize the state-of-the-art anatomo-electroclinical correlations in the field and help guide interpretation of ictal semiology within the framework of pre-surgical evaluation of focal drug-resistant epilepsy (DRE). The review was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. Patient series were included if they provided sufficient anatomo-electroclinical correlation to allow determination of the epileptogenic zone (EZ) and assessment of the level of confidence in each report. We evaluated the risk of bias and the diagnostic accuracy quality of each publication using the Quality of Diagnostic Accuracy Studies (QUADAS-2) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tools. For search terms déjà, dreamy state and reminiscence, we identified 22 eligible publications containing a total of 597 patients. The reports with the highest level of confidence suggest that ictal DV or dreamy state reflect an EZ located in both anterior and posterior mesial temporal structures; however, lateral temporal and insulo-opercular EZs have also been described. The anatomo-electroclinical correlation of ictal DV and related phenomena points most commonly to the mesial temporal structures; however, due to the heterogeneous quality of reports and the pooling and overlap of these related symptoms, our findings are regarded with moderate degree of reliability. Future reports should adopt a more refined classification and clinical description of these experiential memory-related ictal phenomena. The use of advanced imaging modalities and a broader implementation of stereoelectroencephalography should facilitate the accumulation of cases with higher level of evidence, which would result in a more robust anatomo-electroclinical correlations of these fascinating epileptic semiologies.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851670","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 the Letter \"Video-EEG biomarkers need a parallel delirium and medication timeline\".","authors":"Giuseppe d'Orsi","doi":"10.1002/epd2.70391","DOIUrl":"https://doi.org/10.1002/epd2.70391","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851746","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 antiseizure medications on the exposure to combined oral contraceptives: A systematic review and network meta-analysis.","authors":"Hagar Cohen, Amnah Omar Mahajna, Tomer Ben-Shushan, Ilan Matok, Sara Eyal","doi":"10.1002/epd2.70373","DOIUrl":"https://doi.org/10.1002/epd2.70373","url":null,"abstract":"<p><strong>Objective: </strong>Current recommendations for prescribing combined oral contraceptives (COCs) to people with epilepsy are often conflicting, particularly for weak inducers of cytochrome P450 3A4. We aimed to critically review the literature and compare the antiseizure medication (ASM)-induced changes in exposure to COC components.</p><p><strong>Methods: </strong>In this systematic review and network meta-analysis (PROSPERO: CRD42024513792), in accordance with PRISMA 2015/2020, we searched PubMed, EMBASE, Cochrane, and FDA documents up to January 2026. Eligible studies were clinical trials assessing induction (≥ 5 days) of ethinylestradiol combined with progestins by ASMs. The areas under the concentration-time curve (AUC) of individual hormones with/without the ASM were indirectly compared. The point estimate was the standardized mean difference (SMD; significant when the 95% confidence interval does not encompass zero). Bias risk was assessed using the PKclin tool.</p><p><strong>Results: </strong>The 17 studies (16 reports) involving 399 individuals and 15 ASMs were all conducted with COCs containing the two progestins least sensitive to enzyme induction and ≥ 30 μg ethinylestradiol. Nine ASMs were studied at doses 13-75% lower than the recommended maximum (median 50%). Brivaracetam (100 mg/day) reduced the exposure to ethinylestradiol more than 1000 mg/day levetiracetam (SMD -10; 95% confidence interval - 0.20-0). The effects of 300 mg/day lamotrigine on ethinylestradiol and levonorgestrel were greater than those of 400 mg/day lacosamide (0.18; 0.11-0.25, 0.28; 0.20-0.37). Low-dose (50 mg/day) and high-dose (200 mg/day) topiramate were comparable in their effects on ethinylestradiol and norethindrone, and the low dose did not differ from weak inducers in altering ethinylestradiol exposure.</p><p><strong>Significance: </strong>Current recommendations may underestimate ASM effects on exposure to COC components, especially those in newer COCs. Greater caution is recommended with low-dose topiramate. For individuals treated with weak COC inducers without additional contraceptive means, COCs containing levonorgestrel or norethindrone might be preferable given their lower vulnerability to induction.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814987","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":"Heat pain induced by electrical stimulation of the posterodorsal insulo-opercular junction.","authors":"Koichi Hagiwara, Atsushi Hirota, Hiroshi Abe, Takashi Morishita","doi":"10.1002/epd2.70377","DOIUrl":"https://doi.org/10.1002/epd2.70377","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814911","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}