Epilepsy & Behavior最新文献_第10页

Mind the Gap! What do people with epilepsy want to know? 小心缝隙！癫痫患者想知道什么？

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2026-02-01 Epub Date: 2025-12-13 DOI: 10.1016/j.yebeh.2025.110861

Sarah Jones , Heather Angus-Leppan

Background

There is little research about the questions asked by people with epilepsy, and how these are answered. Information sources include standardised medical or charity websites, responses generated by artificial intelligence paradigms and informal peer support.

Methods

Through social media (X, formerly Twitter) people with epilepsy were asked “what would you ask a neurologist/epileptologist” and “do you have any questions relating to your epilepsy”. Responses were themed using an unsupervised topic modelling algorithm to categorise into an aggregated question set. Thematic qualitative analysis characterised emotional content and underlying patterns of the responses.

Results

Questions and responses were in English. There were 2752 responses from Europe, North America and Australia, in the format of natural language. 74% of the questions generated are not currently answered by verified sources. 83% centred on restrictions and limitations.

Conclusions

The study highlights a gap between the concerns of people with epilepsy and accurate, readily available information. The unsupervised topic modelling algorithm successfully grouped the questions into themes. Most questions focused on restrictions and loss of opportunities and enjoyment. These currently unanswered questions could lead people to rely on unverified information. The work highlights the need for evidence-based answers, and a focus on positive messages about what people with epilepsy can do to preserve autonomy and maximise quality of life. Future work will seek patient and carer questions in different languages and settings and develop systems to improve information provision for people with epilepsy.

关于癫痫患者提出的问题以及如何回答这些问题的研究很少。信息来源包括标准化的医疗或慈善网站、人工智能范例产生的反应以及非正式的同伴支持。方法通过社交媒体（X，以前的Twitter），癫痫患者被问及“你会问神经科医生/癫痫学家什么”和“你对癫痫有什么问题吗”。使用无监督主题建模算法对回答进行主题化，将其分类为聚合问题集。主题定性分析表征了情感内容和潜在的反应模式。结果所有问题和回答均为英文。共有2752份来自欧洲、北美和澳大利亚的回复，以自然语言的形式出现。所产生的问题中有74%目前没有经过验证的来源回答。83%集中于限制和限制。结论：该研究突出了癫痫患者的担忧与准确、容易获得的信息之间的差距。无监督主题建模算法成功地将问题分组到主题中。大多数问题集中在限制和失去机会和享受。这些目前没有答案的问题可能导致人们依赖未经证实的信息。这项工作强调需要以证据为基础的答案，并重点关注癫痫患者可以做些什么来保持自主性和最大限度地提高生活质量的积极信息。未来的工作将以不同的语言和环境寻求患者和护理人员的问题，并开发系统以改善为癫痫患者提供的信息。

{"title":"Mind the Gap! What do people with epilepsy want to know?","authors":"Sarah Jones , Heather Angus-Leppan","doi":"10.1016/j.yebeh.2025.110861","DOIUrl":"10.1016/j.yebeh.2025.110861","url":null,"abstract":"<div><h3>Background</h3><div>There is little research about the questions asked by people with epilepsy, and how these are answered. Information sources include standardised medical or charity websites, responses generated by artificial intelligence paradigms and informal peer support.</div></div><div><h3>Methods</h3><div>Through social media (X, formerly Twitter) people with epilepsy were asked “what would you ask a neurologist/epileptologist” and “do you have any questions relating to your epilepsy”. Responses were themed using an unsupervised topic modelling algorithm to categorise into an aggregated question set.Thematic qualitative analysis characterised emotional content and underlying patterns of the responses.</div></div><div><h3>Results</h3><div>Questions and responses were in English. There were 2752 responses from Europe, North America and Australia, in the format of natural language. 74% of the questions generated are not currently answered by verified sources. 83% centred on restrictions and limitations.</div></div><div><h3>Conclusions</h3><div>The study highlights a gap between the concerns of people with epilepsy and accurate, readily available information. The unsupervised topic modelling algorithm successfully grouped the questions into themes. Most questions focused on restrictions and loss of opportunities and enjoyment. These currently unanswered questions could lead people to rely on unverified information. The work highlights the need for evidence-based answers, and a focus on positive messages about what people with epilepsy can do to preserve autonomy and maximise quality of life. Future work will seek patient and carer questions in different languages and settings and develop systems to improve information provision for people with epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110861"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145734942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spectral profile of early ictal EEG patterns in status epilepticus predicts therapy response 在癫痫持续状态的早期脑电图模式的频谱分布预测治疗反应

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2026-02-01 Epub Date: 2025-12-10 DOI: 10.1016/j.yebeh.2025.110827

Tamara M. Welte , Susanne Noell , Rüdiger Hopfengärtner , Stefan Rampp , Jenny Stritzelberger , Johannes D. Lang , Caroline Reindl , Kosmas Macha , Julia Koehn , Joji B. Kuramatsu , Stefan Schwab , Hajo M. Hamer , Stephanie Gollwitzer

Background

Status epilepticus (SE) is a life-threatening condition and requires prompt recognition and timely initiation of treatment. We aimed to define EEG characteristics in initial ictal EEG recordings predicting response to 1^st and 2^nd line SE therapy and allowing for early identification of refractory SE (rSE) with need for anesthesia and intensive care management.

Methods

All adult patients diagnosed with SE between 2018 and 2022 were screened for inclusion. The following inclusion criteria applied: baseline EEG demonstrating SE recorded within 48 h from symptom onset and without prior administration of 3^rd line SE therapy; follow-up EEG within 48 h from baseline EEG. The first artefact-free one to three minute EEG epochs containing unequivocal SE patterns according to ACNS criteria underwent EEG power spectral analysis.

Results

Of the 50 patients included in our study, 22 (44 %) responded to 1^st and 2^nd line SE therapy (group non-rSE); in 28 patients (56 %) SE was still present in follow-up EEG and/or 3^rd line SE therapy had been initiated based on clinical judgement (group rSE). In group non-rSE the power spectrum contained significantly higher amounts of Delta (median, 78.5 % vs 66.5 %, p = 0.0002) and lower proportions of Alpha power (3 % vs 8 %, p < 0.0001) compared to group rSE; Alpha/Delta ratio also differed significantly in both groups (0.04 vs 0.12, p < 0.0001).

Conclusion

Spectral power analysis of initial SE EEG can help to stratify the risk of rSE development and facilitate timely targeted therapy with the aim to improve clinical outcome of affected patients.

背景：癫痫持续状态（SE）是一种危及生命的疾病，需要及时识别和及时开始治疗。我们的目的是确定初始脑电图记录的脑电图特征，预测对一线和二线SE治疗的反应，并允许早期识别需要麻醉和重症监护管理的难治性SE （rSE）。方法对2018 ~ 2022年诊断为SE的所有成年患者进行筛选纳入。采用以下纳入标准：在症状出现后48小时内记录的基线脑电图显示SE，且先前未接受三线SE治疗；基线后48小时内随访脑电图。根据ACNS标准对第一个无伪影的1 ~ 3分钟脑电信号进行功率谱分析。在我们研究的50例患者中，22例（44%）对一线和二线SE治疗有反应（非rse组）；28例（56%）患者在随访脑电图中仍存在SE和/或根据临床判断开始了三线SE治疗（rSE组）。在非rSE组中，与rSE组相比，功率谱中δ功率的数量显著增加（中位数，78.5% vs 66.5%, p = 0.0002）， α功率的比例显著降低（3% vs 8%, p < 0.0001）；两组的Alpha/Delta比值也有显著差异（0.04 vs 0.12, p < 0.0001）。结论初始SE脑电图谱功率分析有助于对rSE发展风险进行分层，及时进行靶向治疗，以改善患者的临床预后。

{"title":"Spectral profile of early ictal EEG patterns in status epilepticus predicts therapy response","authors":"Tamara M. Welte , Susanne Noell , Rüdiger Hopfengärtner , Stefan Rampp , Jenny Stritzelberger , Johannes D. Lang , Caroline Reindl , Kosmas Macha , Julia Koehn , Joji B. Kuramatsu , Stefan Schwab , Hajo M. Hamer , Stephanie Gollwitzer","doi":"10.1016/j.yebeh.2025.110827","DOIUrl":"10.1016/j.yebeh.2025.110827","url":null,"abstract":"<div><h3>Background</h3><div>Status epilepticus (SE) is a life-threatening condition and requires prompt recognition and timely initiation of treatment. We aimed to define EEG characteristics in initial ictal EEG recordings predicting response to 1<sup>st</sup> and 2<sup>nd</sup> line SE therapy and allowing for early identification of refractory SE (rSE) with need for anesthesia and intensive care management.</div></div><div><h3>Methods</h3><div>All adult patients diagnosed with SE between 2018 and 2022 were screened for inclusion. The following inclusion criteria applied: baseline EEG demonstrating SE recorded within 48 h from symptom onset and without prior administration of 3<sup>rd</sup> line SE therapy; follow-up EEG within 48 h from baseline EEG. The first artefact-free one to three minute EEG epochs containing unequivocal SE patterns according to ACNS criteria underwent EEG power spectral analysis.</div></div><div><h3>Results</h3><div>Of the 50 patients included in our study, 22 (44 %) responded to 1<sup>st</sup> and 2<sup>nd</sup> line SE therapy (group non-rSE); in 28 patients (56 %) SE was still present in follow-up EEG and/or 3<sup>rd</sup> line SE therapy had been initiated based on clinical judgement (group rSE). In group non-rSE the power spectrum contained significantly higher amounts of Delta (median, 78.5 % vs 66.5 %, p = 0.0002) and lower proportions of Alpha power (3 % vs 8 %, p < 0.0001) compared to group rSE; Alpha/Delta ratio also differed significantly in both groups (0.04 vs 0.12, p < 0.0001).</div></div><div><h3>Conclusion</h3><div>Spectral power analysis of initial SE EEG can help to stratify the risk of rSE development and facilitate timely targeted therapy with the aim to improve clinical outcome of affected patients.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110827"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Talking SUDEP: Gaps, confidence and training needs among Spanish epilepsy professionals 谈论猝死：西班牙癫痫专业人员的差距、信心和培训需求

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2026-02-01 Epub Date: 2025-12-02 DOI: 10.1016/j.yebeh.2025.110836

Je Ssy Low , Lance Watkins , Kevin Hampel , Laura Vilella , Rodrigo Rocamora , Paul Bassett , Rohit Shankar , Vicente Villanueva

Objective

Sudden Unexpected Death in Epilepsy (SUDEP) is a major cause of epilepsy-related mortality, yet discussions about SUDEP in clinical settings remain inconsistent. This study aimed to assess the perspectives, practices, and barriers related to SUDEP counselling for epilepsy professionals in Spain.

Methods

A cross-sectional online survey of 17 Likert style questions was disseminated via the Spanish Epilepsy Society between September 2023 and February 2024 to epilepsy professionals in Spain using a non-discriminatory exponential snowballing technique leading to non-probability sampling. The survey was a validated instrument previously employed in similar international studies. Questions revolved around SUDEP communication and counselling. Descriptive and comparative analyses were conducted.

Results

54 professionals responded, with the majority being adult neurologists-epileptologists. While most respondents acknowledged the importance of SUDEP counselling, none reported discussing it with all patients. SUDEP was typically discussed in response to risk changes (85 %) or patient enquiry (47 %). Only 9 % used structured communication tools, and 28 % had access to bereavement support services. Perceived low clinical risk (74 %), concern about patient distress (62 %), and limited consultation time (57 %) were the most common barriers. Comparative analysis revealed no statistically significant differences between adult neurologists and paediatric neurologists, though paediatricians reported more negative counselling experiences.

Conclusions

Despite strong recognition of its importance, SUDEP communication in Spain is infrequent and inconsistent. Key barriers include clinical judgment, time constraints, and limited resources. The findings underscore the need for national guideline, structured tools, and targeted training to support routine SUDEP counselling in Spanish clinical practice.

目的癫痫猝死（SUDEP）是癫痫相关死亡的主要原因，但临床对SUDEP的讨论仍不一致。本研究旨在评估与西班牙癫痫专业人员猝死症咨询相关的观点、做法和障碍。方法于2023年9月至2024年2月期间，通过西班牙癫痫协会向西班牙的癫痫专业人员分发了17个Likert式问题的横断面在线调查，采用非概率抽样的非歧视性指数滚雪球技术。这项调查是以前在类似的国际研究中使用的一种有效的工具。问题围绕着SUDEP的沟通和咨询。进行了描述性和比较性分析。结果54名专业人员回应，其中大多数是成人神经科-癫痫科医生。虽然大多数受访者承认SUDEP咨询的重要性，但没有人报告与所有患者讨论过。SUDEP通常在应对风险变化（85%）或患者询问（47%）时进行讨论。只有9%的人使用结构化的沟通工具，28%的人可以获得丧亲支持服务。感知到较低的临床风险（74%）、对患者痛苦的担忧（62%）和有限的咨询时间（57%）是最常见的障碍。对比分析显示，成人神经科医生和儿科神经科医生之间没有统计学上的显著差异，尽管儿科医生报告的负面咨询经历更多。结论：尽管人们强烈认识到SUDEP的重要性，但在西班牙，SUDEP的沟通并不频繁且不一致。主要障碍包括临床判断、时间限制和有限的资源。研究结果强调了在西班牙临床实践中需要国家指南、结构化工具和有针对性的培训来支持常规SUDEP咨询。

{"title":"Talking SUDEP: Gaps, confidence and training needs among Spanish epilepsy professionals","authors":"Je Ssy Low , Lance Watkins , Kevin Hampel , Laura Vilella , Rodrigo Rocamora , Paul Bassett , Rohit Shankar , Vicente Villanueva","doi":"10.1016/j.yebeh.2025.110836","DOIUrl":"10.1016/j.yebeh.2025.110836","url":null,"abstract":"<div><h3>Objective</h3><div>Sudden Unexpected Death in Epilepsy (SUDEP) is a major cause of epilepsy-related mortality, yet discussions about SUDEP in clinical settings remain inconsistent. This study aimed to assess the perspectives, practices, and barriers related to SUDEP counselling for epilepsy professionals in Spain.</div></div><div><h3>Methods</h3><div>A cross-sectional online survey of 17 Likert style questions was disseminated via the Spanish Epilepsy Society between September 2023 and February 2024 to epilepsy professionals in Spain using a non-discriminatory exponential snowballing technique leading to non-probability sampling. The survey was a validated instrument previously employed in similar international studies. Questions revolved around SUDEP communication and counselling. Descriptive and comparative analyses were conducted.</div></div><div><h3>Results</h3><div>54 professionals responded, with the majority being adult neurologists-epileptologists. While most respondents acknowledged the importance of SUDEP counselling, none reported discussing it with all patients. SUDEP was typically discussed in response to risk changes (85 %) or patient enquiry (47 %). Only 9 % used structured communication tools, and 28 % had access to bereavement support services. Perceived low clinical risk (74 %), concern about patient distress (62 %), and limited consultation time (57 %) were the most common barriers. Comparative analysis revealed no statistically significant differences between adult neurologists and paediatric neurologists, though paediatricians reported more negative counselling experiences.</div></div><div><h3>Conclusions</h3><div>Despite strong recognition of its importance, SUDEP communication in Spain is infrequent and inconsistent. Key barriers include clinical judgment, time constraints, and limited resources. The findings underscore the need for national guideline, structured tools, and targeted training to support routine SUDEP counselling in Spanish clinical practice.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110836"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Psychometric validation of the quality of life Inventory − Disability (QI-Disability) among patients with Lennox-Gastaut syndrome and Dravet syndrome lenox - gastaut综合征和Dravet综合征患者生活质量量表-残疾（qi -残疾）的心理计量学验证

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2026-02-01 Epub Date: 2025-12-02 DOI: 10.1016/j.yebeh.2025.110840

Drishti Shah , Peter Jacoby , Helen Doll , Hoan Do , J. Scott Andrews , Heather Romero , Gregor Gibson , Jenny Downs

Backgound.

To evaluate the psychometric properties of the Quality of Life Inventory −Disability (QI-Disability) for individuals with Dravet syndrome (DS) or Lennox-Gastaut syndrome (LGS), two rare developmental and epileptic encephalopathy conditions.

Methods

Cross-sectional data for individuals were drawn from the Adelphi DS & LGS Disease Specific Programme including the caregiver-reported QI-Disability and EQ-5D-5L, and physician-reported (7-point Likert scale) rating or quality of life. Factor structure of the QI-Disability was assessed using confirmatory factor analysis with goodness-of-fit statistics and internal consistency was assessed using Cronbach’s alpha. Convergent validity was assessed by evaluating relationships between QI-Disability, EQ-5D-5L scores, and physician QOL ratings.

Results

There were 154 patients with DS and 196 patients with LGS. The mean (SD) total QI-Disability score was 57.3 (SD 11.9) for DS and 58.9 (SD 13.8) for LGS. Fit statistics for the 6-factor QI-Disability model were mostly satisfactory; the factor loading for one item was unsatisfactory. Good internal consistency (alpha > 0.7) was found for all QI-Disability domains and for the total score in both LGS and DS groups. Convergent validity was demonstrated with correlations being as expected between QI-Disability and EQ-5D-5L scores, for example, strong correlations between the QI-Disability Physical Health and EQ-5D pain/discomfort dimension scores. There was a mean increase of approximately 3 points in the QI-Disability total score per unit category change in the physician-rated QOL scale.

Conclusions

QI-Disability had mostly satisfactory evidence of validity and reliability for DS and LGS and appears suitable for use in clinical practice and clinical trials.

Backgound。评估患有Dravet综合征（DS）或lenox - gastaut综合征（LGS）这两种罕见的发育性和癫痫性脑病的个体的生活质量量表-残疾（qi -残疾）的心理测量特性。方法个人的横断面数据来自Adelphi DS &； LGS疾病特定计划，包括护理人员报告的qi -残疾和EQ-5D-5L，以及医生报告的（7点李克特量表）生活质量评级。采用拟合优度统计的验证性因子分析评估qi -残疾的因素结构，采用Cronbach 's alpha评估内部一致性。通过评估QI-Disability、EQ-5D-5L评分和医师QOL评分之间的关系来评估收敛效度。结果DS患者154例，LGS患者196例。DS组和LGS组的平均（SD）总分分别为57.3分（SD 11.9）和58.9分（SD 13.8）。6因素QI-Disability模型的拟合统计结果大多令人满意；有一个项目的因子负载不令人满意。在所有QI-Disability域和LGS组和DS组的总分中发现了良好的内部一致性（alpha > 0.7）。QI-Disability与EQ-5D- 5l评分之间的相关性证明了收敛效度，例如，QI-Disability Physical Health与EQ-5D疼痛/不适维度评分之间存在强相关性。在医生评定的生活质量量表中，每单位类别变化的qi -残疾总分平均增加约3分。结论si -残障量表对DS和LGS的效度和信度证据基本满意，适用于临床实践和临床试验。

{"title":"Psychometric validation of the quality of life Inventory − Disability (QI-Disability) among patients with Lennox-Gastaut syndrome and Dravet syndrome","authors":"Drishti Shah , Peter Jacoby , Helen Doll , Hoan Do , J. Scott Andrews , Heather Romero , Gregor Gibson , Jenny Downs","doi":"10.1016/j.yebeh.2025.110840","DOIUrl":"10.1016/j.yebeh.2025.110840","url":null,"abstract":"<div><div>Backgound.</div><div>To evaluate the psychometric properties of the Quality of Life Inventory −Disability (QI-Disability) for individuals with Dravet syndrome (DS) or Lennox-Gastaut syndrome (LGS), two rare developmental and epileptic encephalopathy conditions.</div></div><div><h3>Methods</h3><div>Cross-sectional data for individuals were drawn from the Adelphi DS & LGS Disease Specific Programme including the caregiver-reported QI-Disability and EQ-5D-5L, and physician-reported (7-point Likert scale) rating or quality of life. Factor structure of the QI-Disability was assessed using confirmatory factor analysis with goodness-of-fit statistics and internal consistency was assessed using Cronbach’s alpha. Convergent validity was assessed by evaluating relationships between QI-Disability, EQ-5D-5L scores, and physician QOL ratings.</div></div><div><h3>Results</h3><div>There were 154 patients with DS and 196 patients with LGS. The mean (SD) total QI-Disability score was 57.3 (SD 11.9) for DS and 58.9 (SD 13.8) for LGS. Fit statistics for the 6-factor QI-Disability model were mostly satisfactory; the factor loading for one item was unsatisfactory. Good internal consistency (alpha > 0.7) was found for all QI-Disability domains and for the total score in both LGS and DS groups. Convergent validity was demonstrated with correlations being as expected between QI-Disability and EQ-5D-5L scores, for example, strong correlations between the QI-Disability Physical Health and EQ-5D pain/discomfort dimension scores. There was a mean increase of approximately 3 points in the QI-Disability total score per unit category change in the physician-rated QOL scale.</div></div><div><h3>Conclusions</h3><div>QI-Disability had mostly satisfactory evidence of validity and reliability for DS and LGS and appears suitable for use in clinical practice and clinical trials.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110840"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Between seizures and schooling: qualitative insights into the experiences of children with epilepsy 癫痫发作与上学之间：对癫痫儿童经历的定性分析

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2026-02-01 Epub Date: 2025-12-20 DOI: 10.1016/j.yebeh.2025.110869

Seda Kılıç , Atiye Karakul , Duygu Sönmez Düzkaya

Background

Epilepsy is one of the most common chronic neurological disorders in childhood and can negatively affect children’s academic performance, social relationships, and emotional well-being. This study aimed to examine the school experiences of children aged 10–18 years.

Method

The research was conducted between August 2024 and May 2025 at the Mersin University Hospital Pediatric Neurology Outpatient Clinic. Twenty children with epilepsy, aged 10–18 years, were included. After transcription, interview data were coded, themes were generated, and relationships among codes and subcodes were analyzed using MAXQDA 22. Eight themes and 51 codes emerged: perceptions of ıllness, emotional responses to epilepsy, challenges in daily life, seizure symptoms, postictal experiences at school, peer relationships, academic performance and engagement, and social support at school.

Results

Children frequently reported emotional challenges such as sadness, fear, and anxiety regarding their condition. Daily life was significantly impacted by ’functional impairments’ (e.g., motor control issues), activity limitations (e.g., physical fatigue during sports), and participation restrictions (e.g., exclusion from social events and school absenteeism). During seizures, the most common symptoms were loss of consciousness and dizziness, followed by postictal states of fear, fatigue, and confusion. Regarding peer relationships, while some friendships remained unaffected, “concealment of epilepsy” emerged as a key subtheme, with some children hiding their condition to avoid exclusion. Academic engagement was often hindered by concentration difficulties and absenteeism related to medical appointments. Guidance counselors and peers were identified as primary sources of social support.

Conclusion

Children with epilepsy face significant emotional, social, and academic challenges in the school environment. Awareness-raising activities within schools and broader community education efforts, including the use of social media, are recommended to reduce stigma and support the well-being of these children.

癫痫是儿童最常见的慢性神经系统疾病之一，可对儿童的学习成绩、社会关系和情绪健康产生负面影响。本研究旨在调查10-18岁儿童的学校经历。方法研究于2024年8月至2025年5月在梅尔辛大学医院儿科神经病学门诊进行。包括20名10-18岁的癫痫患儿。转录后，对访谈数据进行编码，生成主题，并使用MAXQDA 22分析码与子码之间的关系。出现了8个主题和51个代码：对ıllness的看法、对癫痫的情绪反应、日常生活中的挑战、癫痫症状、在学校的经历、同伴关系、学习成绩和参与以及学校的社会支持。结果儿童经常报告情绪上的挑战，如悲伤、恐惧和焦虑。日常生活受到“功能障碍”（例如，运动控制问题）、活动限制（例如，运动时的身体疲劳）和参与限制（例如，被排除在社交活动之外和旷课）的显著影响。在癫痫发作期间，最常见的症状是意识丧失和头晕，其次是恐惧、疲劳和混乱的阳性状态。关于同伴关系，虽然一些友谊没有受到影响，但“隐瞒癫痫”成为一个关键的次要主题，一些儿童隐瞒自己的病情以避免被排斥。由于注意力难以集中和与医疗预约有关的缺勤，学生的学习活动常常受到阻碍。辅导员和同伴被认为是社会支持的主要来源。结论癫痫患儿在学校环境中面临着显著的情感、社交和学业挑战。建议在学校开展提高认识活动和更广泛的社区教育工作，包括使用社交媒体，以减少对这些儿童的污名化，并支持这些儿童的福祉。

{"title":"Between seizures and schooling: qualitative insights into the experiences of children with epilepsy","authors":"Seda Kılıç , Atiye Karakul , Duygu Sönmez Düzkaya","doi":"10.1016/j.yebeh.2025.110869","DOIUrl":"10.1016/j.yebeh.2025.110869","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy is one of the most common chronic neurological disorders in childhood and can negatively affect children’s academic performance, social relationships, and emotional well-being. This study aimed to examine the school experiences of children aged 10–18 years.</div></div><div><h3>Method</h3><div>The research was conducted between August 2024 and May 2025 at the Mersin University Hospital Pediatric Neurology Outpatient Clinic. Twenty children with epilepsy, aged 10–18 years, were included. After transcription, interview data were coded, themes were generated, and relationships among codes and subcodes were analyzed using MAXQDA 22. Eight themes and 51 codes emerged: perceptions of ıllness, emotional responses to epilepsy<strong>,</strong> challenges in daily life, seizure symptoms, postictal experiences at school, peer relationships, academic performance and engagement, and social support at school.</div></div><div><h3>Results</h3><div>Children frequently reported emotional challenges such as sadness, fear, and anxiety regarding their condition. Daily life was significantly impacted by ’functional impairments’ (e.g., motor control issues), activity limitations (e.g., physical fatigue during sports), and participation restrictions (e.g., exclusion from social events and school absenteeism). During seizures, the most common symptoms were loss of consciousness and dizziness, followed by postictal states of fear, fatigue, and confusion. Regarding peer relationships, while some friendships remained unaffected, “concealment of epilepsy” emerged as a key subtheme, with some children hiding their condition to avoid exclusion. Academic engagement was often hindered by concentration difficulties and absenteeism related to medical appointments. Guidance counselors and peers were identified as primary sources of social support.</div></div><div><h3>Conclusion</h3><div>Children with epilepsy face significant emotional, social, and academic challenges in the school environment. Awareness-raising activities within schools and broader community education efforts, including the use of social media, are recommended to reduce stigma and support the well-being of these children.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110869"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145787494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transfer of Finnish adolescents with epilepsy to adult care: a population-based study 芬兰青少年癫痫患者转至成人护理：一项基于人群的研究

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2026-02-01 Epub Date: 2025-12-11 DOI: 10.1016/j.yebeh.2025.110856

Matti L Sillanpää , Vivian Reinhold , Leevi Toivonen , Peter R Camfield

Background

Transferring adolescents with epilepsy (AWE) to adult care is a complex process, yet there is limited data on its overall epidemiology and clinical implications.

Objective

This population-based study analyzes the long-term clinical trajectories and predictors of transfer among AWE within a robust Finnish healthcare system.

Methods

A cohort of 439 AWE was followed for a mean of 10.28 years. Transfer outcomes, care settings, and long-term seizure control were evaluated for patients reaching transfer age, focusing on predictors of public adult specialty care.

Results

Of 222 AWE reaching transfer age, 189 (85.1 %) were transferred to adult services, with 64 % entering university hospital care. Remission was achieved in 23 % during extended follow-up, while 27 % remained drug-resistant. Multivariable analysis identified developmental and epileptic encephalopathy, specific developmental disorders, and comorbidities such as asthma, allergies, and obesity as significant predictors for public adult specialty care. Notably, changing the transfer age from 16 to 18 years had no significant effect on transfer rates.

Conclusion

Transfer to adult specialty care affects the vast majority of AWE, imposing considerable demands on public health systems. These findings underscore the need for early identification of high-risk patients to inform resource planning and individualized care strategies.

背景：将青少年癫痫患者（AWE）转移到成人护理是一个复杂的过程，但有关其总体流行病学和临床意义的数据有限。目的：本研究以人群为基础，分析芬兰健康医疗体系中AWE转移的长期临床轨迹和预测因素。方法对439例患者进行随访，平均随访10.28年。对达到转院年龄的患者的转院结果、护理环境和长期癫痫控制进行评估，重点关注公共成人专科护理的预测因素。结果222名达到转院年龄的学生中，189名（85.1%）转入成人服务，其中64%进入大学医院。在延长随访期间，23%的患者获得缓解，而27%的患者仍然耐药。多变量分析确定发育性和癫痫性脑病、特定发育障碍和合并症（如哮喘、过敏和肥胖）是公共成人专科护理的重要预测因素。值得注意的是，将转会年龄从16岁改为18岁对转会率没有显著影响。结论转入成人专科护理影响了绝大多数AWE患者，对公共卫生系统提出了相当大的需求。这些发现强调了早期识别高危患者的必要性，以便为资源规划和个性化护理策略提供信息。

{"title":"Transfer of Finnish adolescents with epilepsy to adult care: a population-based study","authors":"Matti L Sillanpää , Vivian Reinhold , Leevi Toivonen , Peter R Camfield","doi":"10.1016/j.yebeh.2025.110856","DOIUrl":"10.1016/j.yebeh.2025.110856","url":null,"abstract":"<div><h3>Background</h3><div>Transferring adolescents with epilepsy (AWE) to adult care is a complex process, yet there is limited data on its overall epidemiology and clinical implications.</div></div><div><h3>Objective</h3><div>This population-based study analyzes the long-term clinical trajectories and predictors of transfer among AWE within a robust Finnish healthcare system.</div></div><div><h3>Methods</h3><div>A cohort of 439 AWE was followed for a mean of 10.28 years. Transfer outcomes, care settings, and long-term seizure control were evaluated for patients reaching transfer age, focusing on predictors of public adult specialty care.</div></div><div><h3>Results</h3><div>Of 222 AWE reaching transfer age, 189 (85.1 %) were transferred to adult services, with 64 % entering university hospital care. Remission was achieved in 23 % during extended follow-up, while 27 % remained drug-resistant. Multivariable analysis identified developmental and epileptic encephalopathy, specific developmental disorders, and comorbidities such as asthma, allergies, and obesity as significant predictors for public adult specialty care. Notably, changing the transfer age from 16 to 18 years had no significant effect on transfer rates.</div></div><div><h3>Conclusion</h3><div>Transfer to adult specialty care affects the vast majority of AWE, imposing considerable demands on public health systems. These findings underscore the need for early identification of high-risk patients to inform resource planning and individualized care strategies.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110856"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145734946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quality of life and synergistic combinations of antiseizure medication in patients treated with cenobamate in early therapy lines for focal-onset seizures 在局灶性癫痫的早期治疗线中使用cenobamate治疗的患者的生活质量和抗癫痫药物的协同组合

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2026-02-01 Epub Date: 2025-12-10 DOI: 10.1016/j.yebeh.2025.110835

Yaroslav Winter , Raya Abou Dargham , Erik Ellwardt , Thilo Hammen , Christoph Massing , Sarah Gößling , Marina Flotats-Bastardas , Sergiu Groppa , Michael Zemlin , Christopher Meudt

Background

Quality of life is an important outcome measure for patients with epilepsy (PWE). However, data on health-related quality of life (HRQoL) in PWE treated with cenobamate (CNB), a new antiseizure medication (ASM) that achieves a high level of seizure freedom, is scarce. These data are especially important for evaluating the use of CNB in early therapy lines for focal-onset seizures.

Methods

The study population consisted of patients with focal-onset seizures that could not be controlled by fewer than three lifetime ASMs. They began treatment with CNB („CNB group“) or another ASM (controls). Both groups were matched at a ratio of 1:2 based on sex, age, and seizure frequency. HRQoL was evaluated using the Quality of Life in Epilepsy-10 (QOLIE-10), the EuroQol Visual Analogue Scale (EQVAS), and the EuroQol-5-Dimensions (EQ5D) questionnaire. The drug combinations were analyzed.

Results

Of the 231 study participants, 33.3 % were treated with CNB, 19.0 % with valproate, 17.3 % with lacosamide, 16.4 % with levetiracetam, and 13.9 % with topiramate. The percentage improvement in the EQ5D index score from baseline to the 12-month follow-up was higher for CNB (32.2 %) than for other ASMs (3.2 %–17.5 %, p < 0.05). Similar results were obtained for EQVAS (31 % vs. 3.2 %–17.5 %) and QOLIE-10 (46.9 % vs. 13.4 %–28.2 %), p < 0.05. CNB demonstrated superior seizure control and HrQoL when combined with low-dose clobazam and a trend for combination with SV2A modulators.

Conclusion

Our study provides evidence that CNB in early therapy lines for focal-onset seizures is associated with an increased HrQoL. Low-dose clobazam can wok synergistically with CNB. The combination with SV2A modulators showed a positive trend.

生活质量是衡量癫痫患者预后的重要指标。然而，关于使用cenobamate （CNB）治疗PWE的健康相关生活质量（HRQoL）的数据很少，CNB是一种新的抗癫痫药物（ASM），可实现高水平的癫痫发作自由。这些数据对于评估CNB在局灶性癫痫早期治疗中的应用尤其重要。方法研究人群包括局灶性癫痫发作患者，其终生asm不能控制在3次以下。他们开始用CNB（“CNB组”）或另一种ASM（对照组）治疗。两组根据性别、年龄和发作频率按1:2的比例配对。HRQoL采用癫痫生活质量-10 （QOLIE-10）、EuroQol视觉模拟量表（EQVAS）和EuroQol-5维量表（EQ5D）进行评估。并对其联合用药进行分析。在231名研究参与者中，33.3%的人接受CNB治疗，19.0%的人接受丙戊酸治疗，17.3%的人接受拉可沙胺治疗，16.4%的人接受左乙拉西坦治疗，13.9%的人接受托吡酯治疗。从基线到12个月的随访，CNB组EQ5D指数评分的改善百分比（32.2%）高于其他asm组（3.2% - 17.5%,p < 0.05）。EQVAS （31% vs. 3.2% - 17.5%）和QOLIE-10 （46.9% vs. 13.4% - 28.2%）的结果相似，p < 0.05。CNB与低剂量氯巴唑联用时表现出更好的癫痫发作控制和HrQoL，并有与SV2A调节剂联用的趋势。结论本研究为局灶性癫痫早期治疗线的CNB与HrQoL升高相关提供了证据。低剂量氯巴唑可与CNB协同作用。与SV2A调制器的组合表现出积极的趋势。

{"title":"Quality of life and synergistic combinations of antiseizure medication in patients treated with cenobamate in early therapy lines for focal-onset seizures","authors":"Yaroslav Winter , Raya Abou Dargham , Erik Ellwardt , Thilo Hammen , Christoph Massing , Sarah Gößling , Marina Flotats-Bastardas , Sergiu Groppa , Michael Zemlin , Christopher Meudt","doi":"10.1016/j.yebeh.2025.110835","DOIUrl":"10.1016/j.yebeh.2025.110835","url":null,"abstract":"<div><h3>Background</h3><div>Quality of life is an important outcome measure for patients with epilepsy (PWE). However, data on health-related quality of life (HRQoL) in PWE treated with cenobamate (CNB), a new antiseizure medication (ASM) that achieves a high level of seizure freedom, is scarce. These data are especially important for evaluating the use of CNB in early therapy lines for focal-onset seizures.</div></div><div><h3>Methods</h3><div>The study population consisted of patients with focal-onset seizures that could not be controlled by fewer than three lifetime ASMs. They began treatment with CNB („CNB group“) or another ASM (controls). Both groups were matched at a ratio of 1:2 based on sex, age, and seizure frequency. HRQoL was evaluated using the Quality of Life in Epilepsy-10 (QOLIE-10), the EuroQol Visual Analogue Scale (EQVAS), and the EuroQol-5-Dimensions (EQ5D) questionnaire. The drug combinations were analyzed.</div></div><div><h3>Results</h3><div>Of the 231 study participants, 33.3 % were treated with CNB, 19.0 % with valproate, 17.3 % with lacosamide, 16.4 % with levetiracetam, and 13.9 % with topiramate. The percentage improvement in the EQ5D index score from baseline to the 12-month follow-up was higher for CNB (32.2 %) than for other ASMs (3.2 %–17.5 %, p < 0.05). Similar results were obtained for EQVAS (31 % vs. 3.2 %–17.5 %) and QOLIE-10 (46.9 % vs. 13.4 %–28.2 %), p < 0.05. CNB demonstrated superior seizure control and HrQoL when combined with low-dose clobazam and a trend for combination with SV2A modulators.</div></div><div><h3>Conclusion</h3><div>Our study provides evidence that CNB in early therapy lines for focal-onset seizures is associated with an increased HrQoL. Low-dose clobazam can wok synergistically with CNB. The combination with SV2A modulators showed a positive trend.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110835"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Post-vagus nerve stimulation mood and cognitive burden in dual epileptic–functional seizure patients 迷走神经刺激后癫痫-功能双重发作患者的情绪和认知负担

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2026-02-01 Epub Date: 2025-12-02 DOI: 10.1016/j.yebeh.2025.110837

Vishva Natarajan , Ravi Sandhu , Charles Mazof , Nicole Odom , Jennifer Hong

Objective

To evaluate neuropsychiatric burden in the understudied population of patients with dual diagnoses of epileptic seizures (ES) and functional seizures (FS) who have received vagus nerve stimulation (VNS).

Methods

In this retrospective study, adults with dual diagnoses of ES and FS who underwent VNS at a tertiary care center between 2015 and 2024 were identified via ICD-10 codes and confirmed by video-electroencephalography (VEEG). Propensity score matching generated two control groups: (1) patients with ES only with VNS, and (2) patients with dual ES and FS without VNS. Longitudinal patient-reported outcomes, including seizure frequency, NDDI-E, and the QOLIE-31 Cognitive subscale, were analyzed using time-weighted averaging and nonparametric statistics.

Results

Eight patients with dual ES and FS who received VNS were matched to eight in each control group. The dual-diagnosis patients with VNS implants had significantly higher seizure frequency than those without VNS implants (median seizure frequency = 14.1 vs. 2.2, p = 0.001). Among patients with VNS implants, those with dual diagnoses had significantly greater depressive symptoms (median NDDI-E = 16.4 vs. 8.8, p = 0.015) compared to those with ES alone. Significant differences in cognitive quality of life were not observed.

Significance

Dual-diagnosis patients exhibited higher seizure reporting after VNS therapy compared to those without VNS and higher depressive burden compared to patients with ES alone, patterns that may reflect the underlying severity of FS-related comorbidity. These exploratory results support careful pre-implant counselling and highlight the need for prospective studies with baseline assessments to clarify outcomes in this complex population.

目的评估接受迷走神经刺激（VNS）治疗的癫痫性发作（ES）和功能性发作（FS）双重诊断患者的神经精神负担。方法回顾性研究2015年至2024年间在三级保健中心接受VNS治疗的ES和FS双重诊断的成人，通过ICD-10代码进行识别，并通过视频脑电图（VEEG）进行确认。倾向评分匹配产生两个对照组：(1)仅伴VNS的ES患者和(2)伴VNS的双ES和FS患者。纵向患者报告的结果，包括癫痫发作频率、NDDI-E和QOLIE-31认知量表，采用时间加权平均和非参数统计进行分析。结果8例接受VNS治疗的双ES和FS患者与对照组8例相匹配。双重诊断的VNS植入患者的癫痫发作频率明显高于未植入VNS的患者（中位癫痫发作频率= 14.1比2.2,p = 0.001）。在植入VNS的患者中，与单独植入ES的患者相比，双重诊断的患者抑郁症状明显加重（中位NDDI-E = 16.4 vs. 8.8, p = 0.015）。在认知生活质量方面未观察到显著差异。双重诊断的患者在接受VNS治疗后癫痫发作报告高于未接受VNS治疗的患者，抑郁负担高于单独接受ES治疗的患者，这些模式可能反映了fs相关合并症的潜在严重程度。这些探索性结果支持仔细的植入前咨询，并强调需要进行基线评估的前瞻性研究，以明确这一复杂人群的结果。

{"title":"Post-vagus nerve stimulation mood and cognitive burden in dual epileptic–functional seizure patients","authors":"Vishva Natarajan , Ravi Sandhu , Charles Mazof , Nicole Odom , Jennifer Hong","doi":"10.1016/j.yebeh.2025.110837","DOIUrl":"10.1016/j.yebeh.2025.110837","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate neuropsychiatric burden in the understudied population of patients with dual diagnoses of epileptic seizures (ES) and functional seizures (FS) who have received vagus nerve stimulation (VNS).</div></div><div><h3>Methods</h3><div>In this retrospective study, adults with dual diagnoses of ES and FS who underwent VNS at a tertiary care center between 2015 and 2024 were identified via ICD-10 codes and confirmed by video-electroencephalography (VEEG). Propensity score matching generated two control groups: (1) patients with ES only with VNS, and (2) patients with dual ES and FS without VNS. Longitudinal patient-reported outcomes, including seizure frequency, NDDI-E, and the QOLIE-31 Cognitive subscale, were analyzed using time-weighted averaging and nonparametric statistics.</div></div><div><h3>Results</h3><div>Eight patients with dual ES and FS who received VNS were matched to eight in each control group. The dual-diagnosis patients with VNS implants had significantly higher seizure frequency than those without VNS implants (median seizure frequency = 14.1 vs. 2.2, p = 0.001). Among patients with VNS implants, those with dual diagnoses had significantly greater depressive symptoms (median NDDI-E = 16.4 vs. 8.8, p = 0.015) compared to those with ES alone. Significant differences in cognitive quality of life were not observed.</div></div><div><h3>Significance</h3><div>Dual-diagnosis patients exhibited higher seizure reporting after VNS therapy compared to those without VNS and higher depressive burden compared to patients with ES alone, patterns that may reflect the underlying severity of FS-related comorbidity. These exploratory results support careful pre-implant counselling and highlight the need for prospective studies with baseline assessments to clarify outcomes in this complex population.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110837"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neurocognitive outcomes of ADHD as a comorbidity in pediatric epilepsy: a systematic review ADHD作为儿童癫痫共病的神经认知结果：一项系统综述

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2026-02-01 Epub Date: 2025-12-11 DOI: 10.1016/j.yebeh.2025.110852

Laura Zaffari Leal , Inácio Kehl , Natália Donati Polesello , Yolanda Aquino de Souza , Catarina Hauser Schmitz , Thiago Wendt Viola , Magda Lahorgue Nunes

Attention-deficit/hyperactivity disorder (ADHD) is a common neuropsychiatric comorbidity in pediatric epilepsy. Although the cognitive effects of epilepsy are well documented, the impact of ADHD as a comorbidity on neurocognitive outcomes remains unclear. This systematic review evaluates cognitive performance in pediatric patients with both epilepsy and ADHD. Following PRISMA 2020 guidelines, searches were conducted in MEDLINE, EMBASE, Cochrane Library and LILACS. Studies were included if they involved patients aged less than or equal to 18 years diagnosed with both epilepsy and ADHD. Fourteen studies met the inclusion criteria. Methodological quality was assessed using the Newcastle–Ottawa Scale (NOS), ROBINS-I and NIH/NHLBI tools. Results indicated that children with both epilepsy and ADHD exhibited more severe cognitive impairments than those with epilepsy only, ADHD only or healthy controls. These included lower Full-Scale and Verbal IQ scores and more frequent omission and commission errors, as well as increased reaction-time variability in attention tasks. Across studies, domains most affected included perceptual-motor function and executive function, as illustrated in a heat map summarizing the distribution and severity of cognitive impairments. These findings underscore that ADHD comorbidity in pediatric epilepsy is associated with exacerbated neurocognitive deficits, highlighting the need for early identification and tailored interventions to support cognitive development.

注意缺陷/多动障碍（ADHD）是小儿癫痫中常见的神经精神合并症。虽然癫痫对认知的影响有充分的文献记载，但ADHD作为一种共病对神经认知结果的影响尚不清楚。本系统综述评估儿童癫痫和ADHD患者的认知表现。按照PRISMA 2020指南，在MEDLINE、EMBASE、Cochrane Library和LILACS中进行检索。研究包括年龄小于或等于18岁的被诊断为癫痫和多动症的患者。14项研究符合纳入标准。采用纽卡斯尔-渥太华量表（NOS）、ROBINS-I和NIH/NHLBI工具评估方法学质量。结果表明，癫痫和ADHD患儿比单纯癫痫患儿、单纯ADHD患儿和健康对照患儿表现出更严重的认知障碍。这些包括较低的全面和口头智商分数，更频繁的遗漏和委托错误，以及注意力任务中反应时间的变异性增加。在所有研究中，最受影响的领域包括感知运动功能和执行功能，如总结认知障碍的分布和严重程度的热图所示。这些发现强调小儿癫痫的ADHD合并症与加重的神经认知缺陷有关，强调了早期识别和定制干预以支持认知发展的必要性。

{"title":"Neurocognitive outcomes of ADHD as a comorbidity in pediatric epilepsy: a systematic review","authors":"Laura Zaffari Leal , Inácio Kehl , Natália Donati Polesello , Yolanda Aquino de Souza , Catarina Hauser Schmitz , Thiago Wendt Viola , Magda Lahorgue Nunes","doi":"10.1016/j.yebeh.2025.110852","DOIUrl":"10.1016/j.yebeh.2025.110852","url":null,"abstract":"<div><div>Attention-deficit/hyperactivity disorder (ADHD) is a common neuropsychiatric comorbidity in pediatric epilepsy. Although the cognitive effects of epilepsy are well documented, the impact of ADHD as a comorbidity on neurocognitive outcomes remains unclear. This systematic review evaluates cognitive performance in pediatric patients with both epilepsy and ADHD. Following PRISMA 2020 guidelines, searches were conducted in MEDLINE, EMBASE, Cochrane Library and LILACS. Studies were included if they involved patients aged less than or equal to 18 years diagnosed with both epilepsy and ADHD. Fourteen studies met the inclusion criteria. Methodological quality was assessed using the Newcastle–Ottawa Scale (NOS), ROBINS-I and NIH/NHLBI tools. Results indicated that children with both epilepsy and ADHD exhibited more severe cognitive impairments than those with epilepsy only, ADHD only or healthy controls. These included lower Full-Scale and Verbal IQ scores and more frequent omission and commission errors, as well as increased reaction-time variability in attention tasks. Across studies, domains most affected included perceptual-motor function and executive function, as illustrated in a heat map summarizing the distribution and severity of cognitive impairments. These findings underscore that ADHD comorbidity in pediatric epilepsy is associated with exacerbated neurocognitive deficits, highlighting the need for early identification and tailored interventions to support cognitive development.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110852"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145734945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Plasma p-Tau217 and p-Tau181 levels in Well-Controlled versus Drug-Resistant focal epilepsy 控制良好与耐药局灶性癫痫患者血浆p-Tau217和p-Tau181水平

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2026-02-01 Epub Date: 2025-12-11 DOI: 10.1016/j.yebeh.2025.110855

Sabina Iqbal, Lei Liu, Gad A. Marshall, Rani A. Sarkis

Background

Compared to patients with well-controlled epilepsy, those with drug-resistant epilepsy often experience greater morbidity, mortality, and accelerated aging. Plasma biomarkers pTau217 and pTau181 align with cerebrospinal fluid tau values and amyloid PET imaging, correlating with Alzheimer’s disease (AD) pathology. These minimally invasive markers may help explore links between neurodegeneration and epilepsy. This study assessed plasma pTau217 and pTau181 levels in patients with drug-resistant (DR) and well-controlled (C) epilepsy to determine whether poor seizure control correlates with elevated biomarkers.

Methods

Adults aged 18–65 with focal epilepsy were prospectively recruited from the Brigham and Women’s Hospital Epilepsy Clinic. Clinical data, including time since last seizure, were obtained from electronic health records. Plasma pTau181 and pTau217 levels were measured and analyzed in relation to seizure control, MRI lesion presence, antiseizure medication use, and time since last seizure.

Results

Plasma was collected from 103 patients: 48 well-controlled (C, 31.3 % female) and 55 drug-resistant (DR, 50.9 % female). Mean ages were 38.7 ± 12.3 years (C) and 37.0 ± 11.6 years (DR). Log-transformed mean plasma levels were not significantly different: pTau181 (DR: 2.17 ± 0.99 vs. C: 2.33 ± 0.87, p = 0.35) and pTau217 (DR: 3.87 ± 0.97 vs. C: 4.10 ± 0.95, p = 0.23). No correlation was observed between plasma tau and time since last seizure: pTau181 (ρ = +0.001, p = 0.99), pTau217 (ρ = +0.13, p = 0.18). Tau levels did not differ based on use of synaptic vesicle protein 2A inhibitors or sodium channel blockers.

Discussion

Interictal plasma biomarkers of neurodegeneration are not elevated in adults with poorly controlled epilepsy and do not correlate with time since last seizure or specific antiseizure medications. Future studies should explore whether subpopulations exist with increased risk or early markers of accelerated aging.

背景：与控制良好的癫痫患者相比，耐药癫痫患者往往有更高的发病率、死亡率和加速衰老。血浆生物标志物pTau217和pTau181与脑脊液tau值和淀粉样蛋白PET成像一致，与阿尔茨海默病（AD）病理相关。这些微创标记可能有助于探索神经变性和癫痫之间的联系。本研究评估了耐药（DR）和控制良好(C)癫痫患者的血浆pTau217和pTau181水平，以确定癫痫发作控制不佳是否与生物标志物升高相关。方法前瞻性地从布莱根妇女医院癫痫诊所招募18-65岁局灶性癫痫患者。临床数据，包括上次癫痫发作的时间，都是从电子健康记录中获得的。测量和分析血浆pTau181和pTau217水平与癫痫发作控制、MRI病变存在、抗癫痫药物使用和上次癫痫发作时间的关系。结果103例患者采集血浆：对照组48例，女性31.3%；耐药组55例，女性50.9%。平均年龄38.7±12.3岁(C), 37.0±11.6岁（DR）。经对数变换后的平均血浆水平pTau181 （DR: 2.17±0.99 vs. C: 2.33±0.87,p = 0.35）和pTau217 （DR: 3.87±0.97 vs. C: 4.10±0.95,p = 0.23）无显著差异。血浆tau与上一次癫痫发作时间无相关性：pTau181 (ρ = +0.001, p = 0.99), pTau217 （ρ = +0.13, p = 0.18）。Tau水平没有因使用突触囊泡蛋白2A抑制剂或钠通道阻滞剂而不同。神经变性的血浆间期生物标志物在控制不良的成人癫痫患者中没有升高，并且与上次癫痫发作的时间或特定抗癫痫药物无关。未来的研究应该探索是否存在风险增加或加速衰老的早期标记的亚群。

{"title":"Plasma p-Tau217 and p-Tau181 levels in Well-Controlled versus Drug-Resistant focal epilepsy","authors":"Sabina Iqbal, Lei Liu, Gad A. Marshall, Rani A. Sarkis","doi":"10.1016/j.yebeh.2025.110855","DOIUrl":"10.1016/j.yebeh.2025.110855","url":null,"abstract":"<div><h3>Background</h3><div>Compared to patients with well-controlled epilepsy, those with drug-resistant epilepsy often experience greater morbidity, mortality, and accelerated aging. Plasma biomarkers pTau217 and pTau181 align with cerebrospinal fluid tau values and amyloid PET imaging, correlating with Alzheimer’s disease (AD) pathology. These minimally invasive markers may help explore links between neurodegeneration and epilepsy. This study assessed plasma pTau217 and pTau181 levels in patients with drug-resistant (DR) and well-controlled (C) epilepsy to determine whether poor seizure control correlates with elevated biomarkers.</div></div><div><h3>Methods</h3><div>Adults aged 18–65 with focal epilepsy were prospectively recruited from the Brigham and Women’s Hospital Epilepsy Clinic. Clinical data, including time since last seizure, were obtained from electronic health records. Plasma pTau181 and pTau217 levels were measured and analyzed in relation to seizure control, MRI lesion presence, antiseizure medication use, and time since last seizure.</div></div><div><h3>Results</h3><div>Plasma was collected from 103 patients: 48 well-controlled (C, 31.3 % female) and 55 drug-resistant (DR, 50.9 % female). Mean ages were 38.7 ± 12.3 years (C) and 37.0 ± 11.6 years (DR). Log-transformed mean plasma levels were not significantly different: pTau181 (DR: 2.17 ± 0.99 vs. C: 2.33 ± 0.87, p = 0.35) and pTau217 (DR: 3.87 ± 0.97 vs. C: 4.10 ± 0.95, p = 0.23). No correlation was observed between plasma tau and time since last seizure: pTau181 (ρ = +0.001, p = 0.99), pTau217 (ρ = +0.13, p = 0.18). Tau levels did not differ based on use of synaptic vesicle protein 2A inhibitors or sodium channel blockers.</div></div><div><h3>Discussion</h3><div>Interictal plasma biomarkers of neurodegeneration are not elevated in adults with poorly controlled epilepsy and do not correlate with time since last seizure or specific antiseizure medications. Future studies should explore whether subpopulations exist with increased risk or early markers of accelerated aging.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110855"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145734947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0