Epilepsy & Behavior最新文献

{"title":"Seizure Cycle app: A feasibility study","authors":"Alexandra Eid ,&nbsp;Christina Kallik ,&nbsp;Radwa Aly ,&nbsp;Ya-Huei Li ,&nbsp;Noor Taweh ,&nbsp;Anumeha Sheth","doi":"10.1016/j.yebeh.2025.110305","DOIUrl":"10.1016/j.yebeh.2025.110305","url":null,"abstract":"<div><h3>Background and objective</h3><div>Catamenial seizure exacerbation (CSE) is challenging to track given unreliable patient reports. This highlights the need for improved recognition of CSE. In this study, we discuss the feasibility of using the <em>Seizure Cycle</em> app for that purpose.</div></div><div><h3>Design/methods</h3><div>Eligible participants logged menstrual cycles and seizure data in the app for 6 months. CSE was defined based on criteria by Herzog et al <span><span>[1]</span></span>, as two-fold increase in average daily seizure frequency (ADSF) during menstrual (C1) and ovulatory (C2) phases during ovulatory cycles, and the entire luteal phase during anovulatory cycles (C3). Feasibility was assessed by the proportion of participants who completed 4-month and 6-month documentation.</div></div><div><h3>Results</h3><div>Among 8 participants, 5 (62.5 %) shared &gt; 4-month data and 4 (50 %) shared 6-month data. Among the 6 participants who shared at least one month of data, CSE type C3 was identified based on number of seizures in one participant who had variable cycle length and was presumed to have anovulatory cycles. This was not confirmed with calculation of ADSF.</div></div><div><h3>Conclusions</h3><div><em>Seizure Cycle</em> app can serve as a feasible tool to improve diagnosis of this underrecognized condition. Despite the small sample size, CSE was potentially identified in one participant, although use of ADSF did not confirm this classification. Clearer definition of the C3 pattern may be useful. Future work will prioritize app automation to streamline data collection, facilitating larger and more robust datasets. These advancements will ultimately support the systematic assessment of therapeutic interventions to improve the diagnosis and treatment of CSE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"Article 110305"},"PeriodicalIF":2.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386444","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}

{"title":"The non-invasive brain or nerve stimulation treatment did not increase seizure frequency in patients with epilepsy: A network meta-analysis","authors":"Ping-Tao Tseng ,&nbsp;Bing-Yan Zeng ,&nbsp;Chih-Wei Hsu ,&nbsp;Chih-Sung Liang ,&nbsp;Andre F. Carvalho ,&nbsp;Andre R. Brunoni ,&nbsp;Brendon Stubbs ,&nbsp;Kuan-Pin Su ,&nbsp;Yu-Kang Tu ,&nbsp;Yi-Cheng Wu ,&nbsp;Tien-Yu Chen ,&nbsp;Dian-Jeng Li ,&nbsp;Pao-Yen Lin ,&nbsp;Yen-Wen Chen ,&nbsp;Mein-Woei Suen ,&nbsp;Chun-Hung Chang ,&nbsp;Jiann-Jy Chen ,&nbsp;Yow-Ling Shiue ,&nbsp;Bing-Syuan Zeng ,&nbsp;Cheng-Ta Li","doi":"10.1016/j.yebeh.2025.110290","DOIUrl":"10.1016/j.yebeh.2025.110290","url":null,"abstract":"<div><div>The noninvasive brain and nerve stimulation (NIBNS) treatments had been widely applied in numerous psychiatric diseases. They exerted preferable efficacy and had been considered as an alternative or add-on treatment to the traditional pharmacotherapy. However, the risk of complication of seizure had seized the clinicians so that they feared about this potential complication. Actually, the NIBNS techniques have emerged as an alternative adjunctive treatment method for patients with epilepsy. However, the results of randomized controlled trials (RCTs) investigating the ability of NIBNS to reduce the frequency of seizures have been inconclusive. The aim of the current network <em>meta</em>-analysis (NMA) was to compare the efficacy and acceptability of various NIBNS techniques for reducing the frequency of seizures in patients with epilepsy. This frequentist model-based NMA included RCTs of NIBNS techniques for patients with epilepsy. The primary outcomes were seizure frequency change and acceptability (i.e., dropout rate). This NMA of 20 RCTs indicated that only 2-mA cathodal short-duration transcranial direct current stimulation (hc-sd-c-tDCS) was associated with significantly greater reduction in seizure frequency and significantly greater improvement in quality of life than the sham/control. Further, none of the investigated NIBNS techniques had significantly increased seizure frequency compared with the sham/control. In addition, all the investigated NIBNS techniques were associated with similar acceptability with the sham/control. Our results indicated that none of the investigated NIBNS techniques was associated with an increased risk of epileptic seizure.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"Article 110290"},"PeriodicalIF":2.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379223","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}

{"title":"Early career in epilepsy in Greece","authors":"Panagiota-Eleni Tsalouchidou ,&nbsp;Zafeirenia Vlakou ,&nbsp;Maria Angeli ,&nbsp;Lampros Kousoulos ,&nbsp;Marianna Bregianni ,&nbsp;Anna Keramida ,&nbsp;Vasiliki Kotsali-Peteinelli ,&nbsp;Klearchos Ntemiris ,&nbsp;Maria Gogou","doi":"10.1016/j.yebeh.2025.110288","DOIUrl":"10.1016/j.yebeh.2025.110288","url":null,"abstract":"<div><h3>Background</h3><div>Early-career professionals in epilepsy face unique challenges that can impact their professional growth and capacity to provide high-quality care. This study explores the demographic and professional characteristics, access to resources, barriers, and training needs of young professionals in epilepsy in Greece, to identify key areas for support and improvement.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among early-career professionals in epilepsy in Greece, including neurologists, pediatricians, residents, nurses, and allied health professionals. Participants completed a structured questionnaire addressing demographics, professional experiences, training needs, and perceived challenges. Data were analyzed using descriptive statistics, and results were visualized through graphs and tables.</div></div><div><h3>Results</h3><div>The survey included 58 participants, the majority being female (74.1 %) and aged 30–35 years (56.9 %). Most participants were employed in public or university hospitals (81.04 %), with 49.12 % reporting no specialized training in epilepsy but expressing a strong intention to pursue it. Financial constraints (41.4 %) and work-related challenges (31.0 %) were the primary barriers to attending educational activities. Key training priorities included clinical neurophysiology (71.9 %), neuroimaging (68.4 %), and genetics (66.7 %). Preferences for conference topics focused on hands-on EEG (81 %) and neuroimaging (77.6 %) courses, followed by pharmacological management (67.2 %), diagnostic approaches (63.8 %), epilepsy surgery (63.8 %), and precision medicine (55.2 %).</div></div><div><h3>Conclusion</h3><div>The findings highlight the barriers and training needs among early-career epilepsy professionals in Greece. Addressing these challenges through targeted educational initiatives, mentorship programs, and financial support mechanisms could foster professional development and enhance the quality of epilepsy care. These results also provide a foundation for the establishment of initiatives such as the Young Epilepsy Section in Greece to support the next generation of epilepsy specialists.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"Article 110288"},"PeriodicalIF":2.3,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive function at the time of focal epilepsy diagnosis is not associated with treatment resistance","authors":"Jacob Pellinen ,&nbsp;Stefan Sillau ,&nbsp;Chris Morrison ,&nbsp;Paul Maruff ,&nbsp;Terence J. O’Brien ,&nbsp;Patricia Penovich ,&nbsp;Jacqueline French ,&nbsp;Kelly G. Knupp ,&nbsp;Sarah Barnard ,&nbsp;Manisha Holmes ,&nbsp;Manu Hegde ,&nbsp;Andres M. Kanner ,&nbsp;Kimford J. Meador ,&nbsp;the Human Epilepsy Project Investigators","doi":"10.1016/j.yebeh.2025.110293","DOIUrl":"10.1016/j.yebeh.2025.110293","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Seizures can impact cognition both acutely and chronically. However, among those without significant comorbidities and broadly average cognition at epilepsy onset, the relationship between cognitive function at the time of diagnosis and long-term seizure control has been relatively unexplored. This analysis investigated associations between participant characteristics including specific aspects of cognitive performance at the time of focal epilepsy diagnosis and antiseizure medication (ASM) treatment resistance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This was a secondary analysis of Human Epilepsy Project (HEP) data, which enrolled people with newly diagnosed focal epilepsy and broadly average cognition (estimated IQ ≥ 70) from June 29, 2012, to September 1, 2019. Participants analyzed in this study were between 18 and 60 years old, and scored within an acceptable range (i.e., Standard Score of ≥80) on measures estimating premorbid cognitive ability were offered the Cogstate Brief Battery (CBB). Participant characteristics were analyzed, including the presence of any anxiety disorders or depression, and summary CBB scores. HEP participants who were classified by the study as treatment resistant if they had experienced failure to achieve seizure freedom after two adequate trials of ASMs. Treatment resistance was modeled using multiple logistic regression to assess for independent associations between attention and working memory after correcting for the presence of the other potentially explanatory variables.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;200 HEP participants had comprehensive enrollment records including CBB results and complete seizure outcome data for analysis in this study. After correcting for potentially confounding variables, there were no independent associations between cognitive measures on the CBB at the time of enrollment and subsequent development of ASM treatment resistance. Specifically, z-scores for reaction time on the CBB (an average of the CBB Identification and Detection tests) were not associated with treatment resistance (p = 0.51) and z-scores for memory performance (an average of the CBB One Card Learning test and One Back tests) were not associated with treatment resistance (p = 0.24). There were no significant independent associations between age or the presence of depression or anxiety disorders at the time of CBB testing and treatment resistance. However, there was an independent association between employment status and treatment resistance, with those who were employed or students (&gt;18 years old) at the time of enrollment and CBB testing having 0.35 times lower odds of treatment resistance (95 %CI 0.15–0.81, p = 0.01).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Significance&lt;/h3&gt;&lt;div&gt;The findings from this study suggest that in otherwise healthy people with new onset focal epilepsy who have broadly average intelligence, attention and working memory as measured by the CBB at the time of diagnosis is not ass","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"Article 110293"},"PeriodicalIF":2.3,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350469","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}

{"title":"Corrigendum to “The impact of a walking program on self-management, anxiety, stress, depression, quality of life, and seizure frequency in patients with epilepsy: A mixed methods approach using the COM-B behaviour change model” [Epilepsy Behav. 162 (2025) 110149]","authors":"Esin Kavuran ,&nbsp;Cemal Özalp ,&nbsp;Emrah Ay","doi":"10.1016/j.yebeh.2025.110303","DOIUrl":"10.1016/j.yebeh.2025.110303","url":null,"abstract":"","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"Article 110303"},"PeriodicalIF":2.3,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350472","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}

{"title":"(2R, 6R)-hydroxynorketamine alleviates postictal depression induced by pilocarpine through modulating LRP4 expression in hippocampal astrocytes","authors":"Meiying Zhang ,&nbsp;Liting Zheng ,&nbsp;Jixing Chen ,&nbsp;Zheng Yu","doi":"10.1016/j.yebeh.2025.110294","DOIUrl":"10.1016/j.yebeh.2025.110294","url":null,"abstract":"<div><div>Postictal depression is a common comorbidity in epilepsy, yet effective treatments remain limited. While ketamine is well-known for its antidepressant properties, its role in postictal depression has not been thoroughly investigated. In this study, we utilized a pilocarpine-induced status epilepticus (SE) mouse model and found that depression-like behavior does not appear within a day after SE but develops within one week and persists for over two weeks. We also observed a significant reduction in hippocampal LRP4 expression one day after SE. However, despite partial recovery over the next seven days, LRP4 levels remained markedly lower through day 14, correlating with the onset and persistence of postictal depression. These findings suggest that SE-induced modulation of LRP4 expression plays distinct roles at different stages of postictal depression. Furthermore, treatment with (2R, 6R)-hydroxynorketamine ((2R, 6R)-HNK), a ketamine metabolite that lacks dissociative and addictive properties while retaining strong antidepressant-like effects, significantly alleviated depressive-like behaviors and reduced LRP4 expression in hippocampal astrocytes within one day of administration. This treatment continued to alleviate depressive-like behaviors for up to seven days, while notably increasing Lrp4 levels within one week. To further investigate the role of LRP4, we generated astrocyte-specific LRP4 overexpression mice by stereotactically injecting an <em>Lrp4</em> OE adenovirus with the gfaABC1D promoter, driving astrocyte-specific expression, into the molecular layer (ML) of the hippocampus. LRP4 overexpression in hippocampal astrocytes accelerated the onset of depressive-like behaviors and abolished the antidepressant effects of (2R, 6R)-HNK. These findings indicate that (2R, 6R)-HNK alleviates postictal depression induced by pilocarpine through stage-specific modulation of LRP4 expression in hippocampal astrocytes. This research provides novel insights into potential therapeutic targets for managing postictal depression.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"Article 110294"},"PeriodicalIF":2.3,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in anxiety after temporal lobe epilepsy surgery: A systematic review and meta-analysis","authors":"Farhang Rashidi ,&nbsp;Samin Maleki ,&nbsp;Mohammadmahdi Sabahi ,&nbsp;Mohammad Amin Habibi ,&nbsp;Seyed Ahmad Naseri Alavi ,&nbsp;Saman Arfaie ,&nbsp;Oliver Flouty ,&nbsp;Peter Warnke ,&nbsp;Oren Sagher ,&nbsp;Badih Adada","doi":"10.1016/j.yebeh.2025.110296","DOIUrl":"10.1016/j.yebeh.2025.110296","url":null,"abstract":"<div><h3>Background</h3><div>Temporal lobe epilepsy (TLE) is often accompanied by psychiatric manifestations, of which, anxiety is among the most common. While the effects of surgery or ablation on TLE and seizure outcomes, as well as neuropsychological outcomes, have been well studied, anxiety is an exception and has not been systematically examined. Our study aims to systematically review the changes in anxiety before and after TLE surgery.</div></div><div><h3>Methods</h3><div>We systematically reviewed the existing literature on anxiety in the setting of TLE. Different electronic databases were queried for studies published until 3rd June 2024.</div></div><div><h3>Results</h3><div>Eighteen studies with 1403 patients who had refractory TLE and underwent surgical treatment were included. Eight different anxiety scales were used in the included studies, with baseline anxiety rates of 5.3 % to 35.1 %. A significant reduction in anxiety was observed in studies using the Hamilton Anxiety Rating Scale, with a pooled change of −0.87 (95 % CI: −1.26, −0.48, P &lt; 0.001) after surgery. Conversely, the State-Trait Anxiety Inventory (STAI) scores did not show significant changes, with pooled changes of −0.30 (95 % CI: −1.72, 1.12, P = 0.68) for the State (STAI-S) and 0.10 (95 % CI: −1.56, 1.77, P = 0.90) for Trait (STAI-T) anxiety types. Similarly, significant improvements in anxiety were observed on the Hospital Anxiety and Depression Scale, with a pooled change of −0.87 (95 % CI: −1.62, −0.12, P = 0.02) at the last follow-up.</div></div><div><h3>Conclusion</h3><div>Our findings indicate that TLE surgery leads to a significant reduction in anxiety levels, though evidence regarding subgroup differences, such as seizure-free versus non-seizure-free patients, remains limited due to the small number of studies. Additional research is necessary to clarify these findings and further assess the broader effects of surgery on anxiety.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"Article 110296"},"PeriodicalIF":2.3,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350468","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}

{"title":"Women’s issues in epilepsy: Knowledge, awareness, and attitudes among a sample of the Bahraini population","authors":"Alaa Elmazny ,&nbsp;Shaikha Saud Albinali ,&nbsp;Manar Matar Alhajooj ,&nbsp;Noor Ahmed Almousa ,&nbsp;Amr Mohamed Fouad ,&nbsp;Noor Mohammed Alzayer ,&nbsp;Fajer Saeed M Faraj ,&nbsp;Salsabil Abo Al-Azayem ,&nbsp;Marah Abdulhadi Alhamoud ,&nbsp;Layan Abdulmunem Al Abbas ,&nbsp;Hind Mohammed Abdulla ,&nbsp;Haneen Ammar Buallay ,&nbsp;Rehab Magdy","doi":"10.1016/j.yebeh.2025.110299","DOIUrl":"10.1016/j.yebeh.2025.110299","url":null,"abstract":"<div><h3>Background &amp; Objectives</h3><div>A previous study conducted in Bahrain found a clear gender gap in men’s willingness to marry women with epilepsy (WWE). Therefore, this study aimed to explore knowledge gaps in a sample of men living in Bahrain regarding issues related to females that might have influenced their attitudes toward WWE. <strong>Methods:</strong> An online self-reported questionnaire was used to collect data from males in the general population of Bahrain. The questions covered demographics, acceptance of marrying a WWE, the impact of epilepsy on sexual life, the risk of infertility, miscarriages, pregnancy outcomes, the risk of inheritance and birth defects in babies born to WWE, and parenting responsibilities. <strong>Results:</strong> A total of 1,054 males participated in the survey, with the sample predominantly young and highly educated. While most (82.4%) knew that epilepsy is caused by brain electrical dysfunction, only 21% would marry a WWE. About 56% thought that WWE would conceal her condition from her future spouse, and 33.4% believed that epilepsy itself could be a reason for divorce. About half of the participants believed that most children born to WWE would not have intellectual disabilities, birth defects, or inherit the disease. Regarding parenting responsibilities, most of them believed that a WWE could care for her children and perform household tasks. <strong>Conclusion:</strong> Bahrani male members of the general public displayed specific knowledge gaps in WWE-related issues, which induced their negative attitude toward marrying a WWE. Targeted educational programs to improve such knowledge gaps must be intensified and implemented.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"Article 110299"},"PeriodicalIF":2.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143223751","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}

{"title":"Role of specific interictal and ictal EEG onset patterns","authors":"Christoph Baumgartner ,&nbsp;Jakob Baumgartner ,&nbsp;Christina Duarte ,&nbsp;Clemens Lang ,&nbsp;Tamara Lisy ,&nbsp;Johannes P. Koren","doi":"10.1016/j.yebeh.2025.110298","DOIUrl":"10.1016/j.yebeh.2025.110298","url":null,"abstract":"<div><div>The objective of this review is to present the role of specific interictal and ictal EEG onset patterns during scalp video-EEG monitoring. Specific non-epileptiform abnormalities include temporal intermittent rhythmic delta activity (TIRDA) and temporal intermittent rhythmic theta activity (TIRTA) indicating a temporal lobe seizure onset, while interictal rhythmical midline theta activity occurs more frequently in frontal epilepsy. Specific interictal epileptiform abnormalities comprise Type 1 spikes pointing towards a mesial and Type 2<!--> <!-->spikes indicating a lateral temporal irritative zone. Unilateral temporal interictal epileptiform discharges (IEDs) are predictive for a good surgical seizure outcome in temporal lobe epilepsy. Small sharp spikes (SSS) named Benign Epileptiform Transients of Sleep (BETS) in the past represent scalp EEG markers of hippocampal epileptic activity. While the localizing value of IEDs in extratemporal epilepsies is often limited, a consistently localized spike focus predicts a good surgical seizure outcome in non-lesional extratemporal patients. A specific ictal EEG pattern for mesial temporal lobe epilepsy consists of a 5–9 Hz rhythmic temporal activity which also predicts a good surgical outcome. In extratemporal epilepsies, ictal scalp EEG frequently is non-localized. Concerning the correspondence of ictal scalp-EEG and intracranial EEG (iEEG) patterns there is no simple one-to-one relationship. Scalp-EEG and iEEG patterns correspond closer to each other when there is no delay between clinical and scalp-EEG onset. Paroxysmal fast activity on scalp-EEG matches with low-voltage fast activity on iEEG. Repetitive epileptiform discharges on scalp EEG indicate an underlying focal cortical dysplasia.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"Article 110298"},"PeriodicalIF":2.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143290578","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}

{"title":"What contributes to recovery in the long term? Young people’s experiences with psychogenic non-epileptic seizures (PNES)","authors":"Hilde Nordahl Karterud,&nbsp;Merete Tschamper,&nbsp;Siv Bækkelund,&nbsp;Oliver Henning,&nbsp;Morten I. Lossius","doi":"10.1016/j.yebeh.2025.110281","DOIUrl":"10.1016/j.yebeh.2025.110281","url":null,"abstract":"<div><h3>Objective</h3><div>The aim was to explore young people’s experiences with PNES 2–9 years post-discharge from a multidisciplinary epilepsy center. We were particularly interested in their understanding of the underlying causes of their seizures, and the factors that may have contributed to their recovery.</div></div><div><h3>Methods</h3><div>A total of 52 patients with PNES participated in a telephone interview. The mean age was 20.9 years (range: 16–28 years), and 45 (87 %) were women. The patients had received psychoeducation from a multidisciplinary team during a 2–4 week inpatient stay at our hospital between 2012 and 2020. We qualitatively analyzed the data using thematic analysis.</div></div><div><h3>Results</h3><div>After a mean of 4.7 years (ranging from 2–9 years) post-hospital discharge, 90.4 % (47/52) of the participants were able to identify underlying stressors for the seizures. The cumulative burden of physical, social, and psychological stressors was considered overwhelming and was attributed to causing seizures, especially among those under 18. Elder participants were more likely to believe the seizures were related to one or more past traumas. Overall, a lower level of anxiety and stress was perceived essential for achieving seizure control. Four key factors were identified as crucial to the recovery process: 1) psychoeducation; 2) reduction in psychosocial stressors; 3) establishing good everyday routines; and 4) professional treatment, such as trauma therapy.</div></div><div><h3>Conclusions</h3><div>A low level of anxiety and stress was found to be crucial for the recovery process. The study suggests that psychoeducation, stress management assistance, and practical facilitation in everyday life should all be components of the standard therapy for young individuals with PNES.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"Article 110281"},"PeriodicalIF":2.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143291669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}