Epilepsy Research最新文献

{"title":"Clinical and hematologic predictors of early intensive care unit admission in seizure patients presenting to the emergency room","authors":"Eun Seok Park ,&nbsp;Hyo Min Shin ,&nbsp;Sung-Woo Kim ,&nbsp;Won-Joo Kim ,&nbsp;Heewon Hwang","doi":"10.1016/j.eplepsyres.2026.107752","DOIUrl":"10.1016/j.eplepsyres.2026.107752","url":null,"abstract":"<div><h3>Objective</h3><div>History of hypertension is a common comorbidity among patients with epilepsy, yet its role in acute seizure outcomes remains unclear. This study investigated whether history of hypertension and routine hematologic markers could predict intensive care unit (ICU) admission among patients with seizures presenting to the emergency room (ER).</div></div><div><h3>Methods</h3><div>Ninety patients with confirmed seizures were retrospectively analysed. Demographic characteristics, comorbidities, and laboratory findings were compared between patients admitted to the ICU and those who were not. Multivariate logistic regression analysis identified independent predictors of ICU admission. In addition, all 20 ICU-admitted cases during the study period were further examined to characterize their clinical patterns.</div></div><div><h3>Results</h3><div>Twenty patients (22.2 %) required direct ICU admission. History of hypertension was more frequent in the ICU group (45.0 % vs. 17.1 %, <em>p</em> = 0.009) and independently predicted ICU admission (OR 4.07, 95 % CI 1.05–15.80, <em>p</em> = 0.042). Elevated white blood cell counts (OR 1.27, 95 % CI 1.10–1.48, <em>p</em> = 0.002) and reduced red blood cell counts (OR 0.17, 95 % CI 0.05–0.59, <em>p</em> = 0.006) were also significant predictors.</div></div><div><h3>Conclusion</h3><div>History of hypertension, leukocytosis, and anemia may indicate a higher risk of clinical deterioration in patients with seizures. These routinely available measures could assist early triage and management decisions in the ER. Prospective studies are warranted to confirm their prognostic utility.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"221 ","pages":"Article 107752"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131558","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":"Seizure recurrences after temporal lobe epilepsy surgery in childhood and adolescence: predictive factors, patterns of recurrence, and long-term outcomes","authors":"Ming-Chen Tsai ,&nbsp;Keith Starnes ,&nbsp;Anthony L. Fine ,&nbsp;Katherine C. Nickels ,&nbsp;Elaine C. Wirrell ,&nbsp;Jamie J. Van Gompel ,&nbsp;Kai J. Miller ,&nbsp;Lily C. Wong-Kisiel","doi":"10.1016/j.eplepsyres.2026.107732","DOIUrl":"10.1016/j.eplepsyres.2026.107732","url":null,"abstract":"<div><h3>Background</h3><div>Temporal lobe epilepsy (TLE) is the leading cause of drug-resistant focal epilepsy. Surgery is effective, yet many patients experience postoperative seizure recurrence.</div></div><div><h3>Objective</h3><div>To identify predictors of recurrence and characterize recurrence patterns, treatment responses, and long-term outcomes using a 16-year surgical database.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed children and adolescents (0–19 years) with TLE who underwent resective or destructive temporal lobe surgery at Mayo Clinic, Rochester (2008–2024). All patients underwent scalp EEG phase I monitoring and 1.5 T or 3 T MRI, with invasive monitoring and advanced imaging studies utilized in selected patients when clinically indicated. Patients with prior epilepsy surgery, &lt;1-year follow-up, or without research authorization were excluded. Data were analyzed using descriptive statistics, survival analysis, and Cox proportional hazard models. Seizure recurrence was categorized as acute post-operative seizures (APOS, ≤1 week post-surgery), early recurrence (&gt;1 week–2 years), and late recurrence (&gt;2 years). Delayed seizure freedom was defined as ≥1 year seizure-free before last follow-up after recurrence.</div></div><div><h3>Results</h3><div>Among 61 patients, 34 (55.7 %) had recurrence over a median follow-up of 49 months. Median time to first recurrence was 48 months. Four patients (6.5 %) had APOS; all developed early recurrence. APOS predicted early recurrence (HR = 6.02, 95 % CI = 1.64–22.04, p = 0.006). Delayed seizure freedom was achieved with medication trials in 19 % (5/26) of early and 75 % (6/8) of late recurrences. At last follow-up, 68 % (42/61) were seizure free: 44 % (27/61) since the first surgery and 24 % (15/61) after recurrence.</div></div><div><h3>Conclusion</h3><div>Temporal lobe epilepsy surgery provides durable seizure control in two-thirds of pediatric and adolescent patients. APOS may predict early recurrence, which is often less medically responsive and may warrant repeat surgery.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"221 ","pages":"Article 107732"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146006812","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":"Antiseizure medication discontinuation in pediatric epilepsy: Real-world insights","authors":"Deniz Menderes ,&nbsp;Salih Akbaş ,&nbsp;Esra Serdaroğlu ,&nbsp;Tuğba Hırfanoğlu ,&nbsp;Ayşe Serdaroğlu ,&nbsp;Ebru Arhan","doi":"10.1016/j.eplepsyres.2026.107742","DOIUrl":"10.1016/j.eplepsyres.2026.107742","url":null,"abstract":"<div><h3>Objective</h3><div>This retrospective study aimed to precisely characterize the factors necessitating antiseizure medication (ASM) discontinuation in pediatric epilepsy patients and to delineate drug-specific adverse event patterns based on monotherapy and polytherapy regimens.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data from patients under 18 years of age, followed at a single Pediatric Neurology Clinic between January 2015 and September 2024. Discontinuation was defined as the cessation of a medication due to inadequate efficacy or intolerable adverse effects. Patient demographics, epilepsy classification, ASM regimen, treatment duration, and detailed reasons for discontinuation were collected for analysis.</div></div><div><h3>Results</h3><div>Out of 4578 pediatric epilepsy patients screened, ASM discontinuation was recorded in 169 cases (4 %). The discontinuation rate was higher in polytherapy (68/1373, 5 %) than in monotherapy (101/3205, 3 %). The most frequent compelling reasons for cessation were seizure persistence or worsening (48/169, 28 %) and psychiatric adverse effects (40/169, 24 %). Levetiracetam was overwhelmingly associated with psychiatric complaints (25/34, 74 %), while carbamazepine demonstrated a powerful correlation with the emergence of continuous spikes and waves during sleep (CSWS) like sleep-activated epileptiform EEG pattern (28/42, 67 %), leading to its withdrawal. The mean time to discontinuation was 8 ± 6 months.</div></div><div><h3>Conclusion</h3><div>Our real-world data confirms that persistent seizures and drug-induced psychiatric adverse effects are the dominant causes of ASM discontinuation in children. The particular correlations between levetiracetam and psychiatric issues, and carbamazepine and CSWS-like sleep-activated EEG pattern, highlight the critical necessity for highly individualized ASM selection and close clinical and electroencephalographic monitoring in pediatric practice.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"221 ","pages":"Article 107742"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146075798","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":"Examination of psychological resilience and self-esteem in adolescents having siblings with epilepsy","authors":"Buşra Kantarcı ,&nbsp;Fatma Kurudirek","doi":"10.1016/j.eplepsyres.2026.107741","DOIUrl":"10.1016/j.eplepsyres.2026.107741","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to examine the relationship between psychological resilience and self-esteem among healthy adolescents who have siblings diagnosed with epilepsy.</div></div><div><h3>Methods</h3><div>This descriptive and cross-sectional study was conducted between May and November 2024 at Muş State Hospital. The sample consisted of 126 healthy adolescents aged 12–18 years who had siblings diagnosed with epilepsy and were receiving follow-up care at the pediatric neurology outpatient clinic. Data were collected using a Personal Information Form, the Rosenberg Self-Esteem Scale (RSES), and the Child and Youth Resilience Measure (CYRM).</div></div><div><h3>Results</h3><div>The mean CYRM score was 41.32 ± 9.87, indicating moderate psychological resilience, and the mean RSES score was 2.11 ± 1.75, indicating moderate self-esteem. Psychological resilience scores were significantly higher among girls and adolescents from higher-income families, as well as those whose parents had higher educational levels and professional occupations. Self-esteem levels were higher among adolescents whose parents were university graduates or civil servants and lower among those from low-income families. Emotional responses during siblings’ seizures were also associated with both outcomes; adolescents reporting compassion or sadness demonstrated higher psychological resilience and self-esteem than those reporting pity. A moderate negative correlation was found between CYRM and RSES scores, reflecting the inverse scoring structure of the RSES, in which lower scores indicate higher self-esteem.</div></div><div><h3>Conclusion</h3><div>Adolescents who have siblings with epilepsy exhibit moderate levels of psychological resilience and self-esteem compared with normative adolescent samples. Sociodemographic characteristics and emotional responses to seizures play an important role in shaping these outcomes, highlighting the need for psychosocial support strategies to strengthen resilience and self-esteem.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"221 ","pages":"Article 107741"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124302","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":"Antiseizure medication effects on sleep architecture in epilepsy: Glymphatic insights and implications for cognitive decline","authors":"Justyna Swierz ,&nbsp;Michael Doherty ,&nbsp;Sung Ji ,&nbsp;Jeffrey Iliff ,&nbsp;Yeilim Cho","doi":"10.1016/j.eplepsyres.2025.107730","DOIUrl":"10.1016/j.eplepsyres.2025.107730","url":null,"abstract":"<div><div>Disruptions in sleep architecture may contribute to cognitive decline in people with epilepsy (PWE), potentially through impaired glymphatic clearance. In this narrative review, we explore how antiseizure medications (ASMs) influence key sleep stages, particularly slow-wave sleep (SWS) and rapid eye movement (REM) sleep, and consider how these changes may intersect with glymphatic function and cognitive outcomes. SWS supports glymphatic clearance of interstitial waste, including neurotoxic solutes such as amyloid-β and tau. Some ASMs appear to enhance SWS, while others suppress it, suggesting the possibility of differential long-term cognitive effects. We propose that sleep disruption may represent an important but underappreciated factor linking epilepsy and neurocognitive decline. While sleep impairment in epilepsy is often attributed to seizures or interictal activity, ASM-induced alterations in sleep architecture may also play a role. However, this relationship remains largely theoretical and requires further experimental study. We also review the use of diffusion tensor image analysis along the perivascular space (DTI-ALPS) as an emerging imaging method to approximate glymphatic activity. Although DTI-ALPS provides a non-invasive proxy for perivascular water diffusivity, it does not directly measure glymphatic clearance and may be affected by factors such as partial volume effects. Its role in epilepsy research remains exploratory and should be interpreted cautiously. To date, no study has directly examined the combined effects of ASMs, sleep structure, and glymphatic function in a single cohort. We outline opportunities for future research integrating neuroimaging, sleep assessment, and cognitive testing to better understand how sleep-targeted strategies might preserve brain health in epilepsy.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"220 ","pages":"Article 107730"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938883","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":"Elevated thalamic blood flow in self-limited epilepsy with centrotemporal spikes","authors":"Niki Iasinovschi ,&nbsp;Elizabeth Tong ,&nbsp;Lucia Bicknell ,&nbsp;Fiona Mitchell Baumer","doi":"10.1016/j.eplepsyres.2025.107716","DOIUrl":"10.1016/j.eplepsyres.2025.107716","url":null,"abstract":"<div><div>Children with self-limited epilepsy syndrome with centrotemporal spikes (SeLECTS) exhibit altered thalamocortical connectivity, but whether thalamic function itself is abnormal remains unclear. We investigated whether thalamic blood flow, a marker of metabolism, differs between children with SeLECTS and controls, and examined the effects of spike distribution and antiseizure medications (ASMs) on thalamic perfusion. In this retrospective cohort study, we identified consecutive children with SeLECTS who underwent magnetic resonance imaging (MRI) for epilepsy evaluation (n = 44) and age- and sex-matched children who underwent MRI for non-epilepsy indications (n = 35). We quantified thalamic blood flow via manual segmentation of cerebral blood flow (CBF) sequences obtained from arterial spin labeling MRI. Clinical variables including sedation use during MRI, daily ASM use, and spike distribution (unilateral or bilateral) were extracted from medical records. Children with SeLECTS demonstrated elevated thalamic blood flow compared to controls, with the most pronounced differences in specific subgroups. Children with unilateral spikes showed the highest CBF, particularly in the thalamus contralateral to spike activity. ASM use significantly modulated thalamic blood flow: children taking oxcarbazepine showed the highest CBF, while those on levetiracetam had CBF similar to controls. Unmedicated children showed intermediate elevations. These findings demonstrate that elevated thalamic blood flow may be intrinsic to SeLECTS pathophysiology, with different ASMs producing distinct neurobiological effects. The differential medication effects may relate to their clinical efficacy and provide neurobiological rationale for treatment selection in this common childhood epilepsy syndrome.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"220 ","pages":"Article 107716"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693019","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 systematic review of highly purified cannabidiol in developmental and epileptic encephalopathies and complex treatment-resistant epilepsies: Changes in seizure frequency and adverse events","authors":"Antonietta Coppola ,&nbsp;Lisa Moore-Ramdin ,&nbsp;Marco Navetta ,&nbsp;Debopam Samanta","doi":"10.1016/j.eplepsyres.2026.107731","DOIUrl":"10.1016/j.eplepsyres.2026.107731","url":null,"abstract":"<div><h3>Objective</h3><div>The efficacy and safety of a highly purified plant-derived cannabidiol (CBD) oral solution (Epidiolex® [US]/Epidyolex® [EU], EPX) have been established for the treatment of seizures in patients with Lennox-Gastaut syndrome, Dravet syndrome, or tuberous sclerosis complex. These conditions involve diverse etiologies, suggesting EPX may have broad utility across different seizure types. This systematic literature review (SLR) evaluated studies reporting CBD effectiveness and tolerability in patients with other developmental and epileptic encephalopathies (DEEs) and complex treatment-resistant epilepsies (TREs).</div></div><div><h3>Methods</h3><div>In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, an SLR was conducted in March 2024 using Embase, PubMed, and Cochrane libraries for publications on complex TREs, CBD, seizure outcomes, and adverse events (AEs). Results were narratively summarized according to epilepsy type.</div></div><div><h3>Results</h3><div>Seizure frequency-related changes were reported in 57 studies including 37 DEEs/TREs comprising 971 patients; most (n=33)(n = 33) were case reports/small case series. Most common diagnoses were focal/multifocal-onset epilepsy (n=401)(n = 401) and Angelman syndrome (n=188).(n = 188). Overall, 47 studies reported seizure frequency reduction in ≥1≥ 1 patient; definitions/thresholds included seizure reduction (n = 18 studies; 20–100 % of patients) and mean/median percent seizure reduction (n = 8 studies; 12–99 % reduction). Twenty-two studies reported ≥ 1 patient was seizure-free for ≥ 48 days.</div><div>AEs experienced while taking CBD were generally mild or moderate and most commonly gastrointestinal, including diarrhea (17–50 %), decreased appetite (7–45 %), and vomiting (5–86 %).</div></div><div><h3>Conclusion</h3><div>CBD may reduce seizure frequency in patients with a range of DEEs and complex TREs. These findings support future studies in these populations.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"220 ","pages":"Article 107731"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009412","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":"Factors influencing pediatric epilepsy outcomes: Predictive variables and adherence to clinical practice guidelines","authors":"Vaibhav R. Suryawanshi ,&nbsp;Kavita Srivastava ,&nbsp;Anshu Priya ,&nbsp;Bhakti Sarangi ,&nbsp;Asavari Raut","doi":"10.1016/j.eplepsyres.2026.107738","DOIUrl":"10.1016/j.eplepsyres.2026.107738","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric epilepsy constitutes significant challenges for long-term management in resource-limited settings. This study determined factors influencing epilepsy outcomes in children (predictive variables) and assessed adherence to clinical practice guidelines (CPG) and its effect on clinical outcomes, addressing the evidence gap in Indian settings.</div></div><div><h3>Methods</h3><div>We enrolled prospectively followed 170 children (&lt;18 years) diagnosed with epilepsy, treated and monitored at a tertiary-care university hospital from ‘January 2021 to December 2024’. Adherence to clinical practice guidelines (CPG) was assessed using ‘Indian Academy of Pediatrics’ and ‘American Epilepsy Society’ standards. Clinical outcomes were studied and classified as ‘favorable (seizure freedom)’ and ‘unfavorable (seizure recurrence at 6 months of ASM initiation AND/OR active epilepsy ≥1 year of ASM initiation AND/OR time to seizure freedom exceeding 15 months after ASM initiation)’. Factors predictive of unfavorable epilepsy outcomes were analyzed using multivariate regression, and the event probabilities were estimated using Kaplan–Meier analysis.</div></div><div><h3>Results</h3><div>Of 170 children, 117 (68.8 %) diagnosed with new‑onset epilepsy (NOE) and 53 (31.2 %) with drug‑resistant epilepsy (DRE). The median (IQR) age was 4.6 (3.1 – 11.5) years. Male preponderance was observed [93 (54.7 %)]. Overall adherence to CPG was 70 %, with deviations noted in 28.2 % of NOE cases and in 34 % of DRE cases. Seizure recurrence at 6 months of ASM initiation [82.4 % versus 64.7 %, P = 0.034] and active epilepsy for ≥ 1 year of ASM initiation [60.8 % versus 32.8 %, P = 0.001] was higher in CPG non-adherent group. Seizure freedom was observed in a total of 100 (58.8 %) children. Patients from CPG non-adherent group took longer (&gt;15 months) to gain seizure freedom (P &lt; 0.042). Of 11 studied factors predictive of unfavorable epilepsy outcomes, 2 factors in NOE and 5 factors in DRE achieved statistical significance. Kaplan-Meier analysis demonstrated increased hazards of unfavorable epilepsy outcomes in patients with DRE compared to NOE, (HR 2.3, 95 % CI 1.2–4.7, P = 0.0147).</div></div><div><h3>Conclusion</h3><div>Adherence to CPG was associated with favorable epilepsy outcomes, while non‑adherence predicted higher risk of seizure recurrence and prolonged active epilepsy. DRE cases demonstrated significantly greater risk of unfavorable epilepsy outcomes compared to NOE, underscoring the importance of guideline‑based management in optimizing pediatric epilepsy care.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"220 ","pages":"Article 107738"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972764","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":"Hospitalisation burden among persons with epilepsy attending an outpatient neuroscience specialist clinic in Singapore","authors":"Anushika Raheja ,&nbsp;Zhibin Tan ,&nbsp;Kaavya Narasimhalu","doi":"10.1016/j.eplepsyres.2026.107736","DOIUrl":"10.1016/j.eplepsyres.2026.107736","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy carries significant clinical and socioeconomic burden, largely driven by hospitalisations. Although hospitalisation rates are well described internationally, data from Asia remain limited. We aimed to quantify hospitalisation rates among persons with epilepsy (PwE) attending an outpatient neuroscience specialist clinic in Singapore and assess whether anti-seizure medication (ASM) polytherapy is associated with hospitalisation.</div></div><div><h3>Methods</h3><div>This exploratory secondary analysis included PwE enrolled in a prospective cohort at a tertiary adult neurology clinic in Singapore from August 2020 to December 2022, and followed up to mid-July 2025. Polytherapy was defined as concurrent use of ≥ 2 ASMs. Incidence rate ratios (IRRs) were calculated and multivariate logistic regression identified factors associated with hospitalisation.</div></div><div><h3>Results</h3><div>A total of 54 PwE were followed up at the outpatient neuroscience specialist clinic for a median of 3.5 years (range 2.6–4.6). The incidence rates of all-cause hospitalisations and seizure-related hospitalisations was 0.679 hospitalisations per person-year (95 % CI: 0.401 – 1.150) and 0.189 hospitalisations per person-year (95 % CI: 0.071 – 0.501), respectively. PwE on polytherapy had significantly higher incidence rates of all-cause (incidence rate ratio, IRR 3.45, 95 % CI 1.24 – 9.90, <em>p</em> = 0.021) and epilepsy-related hospitalisation (IRR 7.59, 95 % CI 1.76 – 32.7, <em>p</em> = 0.007). On multivariate analysis, PwE on polytherapy had a higher risk of at least one all-cause hospitalisation (OR = 5.952, 95 % CI 1.504 – 23.553, <em>p</em> = 0.011) during the study period.</div></div><div><h3>Conclusion</h3><div>We report hospitalisation incidence in PwE in Singapore for the first time and describe our finding that ASM polytherapy is associated with all-cause hospitalisations. These findings may help plan further studies on the morbidity of epilepsy and how it may be better addressed.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"220 ","pages":"Article 107736"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972841","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":"Sexual and developmental variability of spike-wave discharges in the taiep rat: A model of H-ABC leukodystrophy","authors":"Carmen Cortes ,&nbsp;Juan M. Ibarra-Hernández ,&nbsp;Gilles van Luijtelaar ,&nbsp;Jose R. Eguibar","doi":"10.1016/j.eplepsyres.2026.107733","DOIUrl":"10.1016/j.eplepsyres.2026.107733","url":null,"abstract":"<div><div><em>Taiep</em> rat has a leukodystrophy caused by a tubulinopathy affecting the β-tubulin 4 A (TUBB4A) gene characterized by hypomyelination and progressive demyelination of the central nervous system. In magnetic resonance imaging <em>taiep</em> rats showed hypomyelination and atrophy of the putamen and cerebellum that resemble human leukodystrophy named hypomyelination with atrophy of the basal ganglia and cerebellum (H-ABC). In addition, <em>taiep</em> rat has spike-wave discharges (SWDs) in the electroencephalogram (EEG) associated with behavioral interruption of the ongoing activity. This study aims to analyze the characteristics and circadian distribution of SWDs in both sexes throughout the first year of life. We chronically implanted male and female <em>taiep</em> rats aged 3, 6, 9, and 12 months with electrodes in the cerebral cortex, neck muscles, and right eye orbit for 24-hour video-EEG recordings. Offline, we analyzed the number, mean and total duration of SWDs, the latency of the first SWD, and the spectral content using Fast Fourier Transform. A cosinor analysis was applied to 24-hour data to describe circadian distributions of SWD number and mean duration. In both sexes, the number, mean, and total duration of SWDs increased with age; onset occurred earlier in males at 3 months with respect to females that have SWDs at 6 months. The acrophase of the mean duration rhythm was delayed in females. These findings indicate a sexual dimorphism in the SWDs expression and timing during the circadian cycle. In both sexes, the interspike frequency of SWDs was 6.31 showing no change with age, suggesting similar thalamo-cortical circuit properties across all groups. In conclusion, these results clearly demonstrate that hypomyelination and demyelination affect the expression and circadian dynamics of SWDs in both sexes throughout development in <em>taiep</em> rats. In conclusion, <em>taiep</em> rats had a leukodystrophy associated to spike-wave discharges and behavioral arrest that are absence-like epilepsy.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"220 ","pages":"Article 107733"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972842","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}