Seizure-European Journal of Epilepsy最新文献

{"title":"Nationwide registry-linked retrospective cohort study of Ganglioglioma in children and adults: Long-term follow-up of anti-seizure medication and mortality","authors":"Irena Grubor ,&nbsp;Maria Compagno Strandberg ,&nbsp;Johan Bengzon","doi":"10.1016/j.seizure.2026.01.002","DOIUrl":"10.1016/j.seizure.2026.01.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Gangliogliomas are highly epileptogenic tumors that are common in epilepsy surgery. The main aim of this study was to investigate whether the outcome of Anti-seizure medication (ASM) withdrawal differed between patients undergoing ganglioglioma surgery in an epilepsy surgery program compared with those who underwent surgery in other surgical programs. We also investigated which factors influence ASM discontinuation after ganglioglioma surgery.</div></div><div><h3>Method</h3><div>We achieved a nationwide Swedish coverage by retrieving and linking data from five registries, including 144 patients of all ages with surgically confirmed ganglioglioma (ICD-O-95051/95053) treated between 2005 and 2019. Cases required concordance across registries and unmatched records were excluded. Key variables included age at surgery, waiting time for surgery, and tumor location, along with demographic, surgical, and ASM-related data. ASM discontinuation was defined as a 14-month dispensing-free interval. Associations with ASM discontinuation were examined using nonparametric tests, Kaplan-Meier estimates and Cox regression.</div></div><div><h3>Results</h3><div>Most patients, 76%, had been prescribed ASM during the study period. Increasing age was found to be negatively associated with ASM withdrawal. Five years after surgery, 36% of adults and 59% of children had discontinued ASMs. There was no difference in ASM withdrawal in patients who had undergone surgery in an epilepsy surgery program compared with those who had not. Mortality was 15% overall.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that long-term ASM discontinuation after ganglioglioma surgery is negatively associated with increasing age. ASM discontinuation is the same for those undergoing surgery in an epilepsy surgery program as for those who do not. Future studies are needed to explore why older patients are less likely to discontinue ASM treatment after ganglioglioma surgery.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"135 ","pages":"Pages 4-10"},"PeriodicalIF":2.8,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928434","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":"Association between electrographic seizures and better neurological functional outcomes in non-convulsive status epilepticus","authors":"Kazuma Koda ,&nbsp;Masaya Togo ,&nbsp;Kohei Morimoto ,&nbsp;Kento Matoba ,&nbsp;Mayumi Otani ,&nbsp;Yasufumi Kageyama ,&nbsp;Riki Matsumoto","doi":"10.1016/j.seizure.2025.12.014","DOIUrl":"10.1016/j.seizure.2025.12.014","url":null,"abstract":"<div><h3>Objective</h3><div>In non-convulsive status epilepticus (NCSE), predicting patient outcomes is crucial in deciding treatment intensity. However, electroencephalograms (EEGs) of NCSE show various patterns, and their relationship with functional outcomes remains unclear. We aimed to examine the relationship between NCSE EEG patterns and functional outcomes.</div></div><div><h3>Methods</h3><div>We retrospectively collected data from 105 NCSE patients without cardiopulmonary arrest at two centers and compared functional outcomes in NCSE patients with electrographic seizures (ESz) and those with rhythmic/periodic patterns (RPPs) at discharge. Functional outcomes were assessed using the dichotomized modified Rankin scale (≥4 or less), with univariate and multivariate analyses conducted on patient backgrounds and therapeutic interventions. We compared background activities and discharge waveforms in periodic discharges (PDs) using the Fourier transform.</div></div><div><h3>Results</h3><div>ESz independently predicted better outcomes after adjusting for severity (Glasgow Coma Scale and Epidemiology-based Mortality Score). In PDs, the group with better outcomes exhibited larger alpha-band background activity and larger post-discharge slow waves.</div></div><div><h3>Conclusions</h3><div>NCSE with ESz was associated with better functional outcomes than RPPs alone. Spared alpha-band background activity and larger amplitude of post-discharge slow shifts may indicate spared brain function in patients with PDs.</div></div><div><h3>Significance</h3><div>These results could assist in predicting outcomes and deciding treatment intensity in NCSE.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"134 ","pages":"Pages 238-246"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879136","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":"Optimal cutoff score for diagnosing generalized anxiety disorder with the Generalized Anxiety Disorder 7-item scale in people living with epilepsy: A systematic review with diagnostic test accuracy meta-analysis","authors":"Minjung Kim ,&nbsp;Rock Bum Kim ,&nbsp;Tae-Won Yang ,&nbsp;Young-Soo Kim ,&nbsp;Do-Hyung Kim ,&nbsp;Oh-Young Kwon","doi":"10.1016/j.seizure.2025.12.008","DOIUrl":"10.1016/j.seizure.2025.12.008","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>The Generalized Anxiety Disorder 7-item (GAD-7) is a self-report questionnaire assessing anxiety-related symptoms experienced over the past two weeks. The GAD-7 is widely used to screen for generalized anxiety disorder (GAD), and reported optimal cutoff scores for detecting GAD in people living with epilepsy (PLWE) range between &gt;6 and &gt;9. This meta-analysis aims to determine the most appropriate GAD-7 cutoff score for PLWE.</div></div><div><h3>Methods</h3><div>We identified relevant studies through comprehensive searches in MEDLINE, Embase, Cochrane Library, Web of Science, and Scopus. Studies included original research examining GAD-7 accuracy for detecting GAD in adult PLWE, using structured diagnostic interviews including the Mini International Neuropsychiatric Interview as a reference standard. Only studies providing sufficient data for meta-analysis were included, including the number of PLWE with GAD, the total participant number, sensitivity, and specificity. We performed summary receiver operating characteristic curve analyses.</div></div><div><h3>Results</h3><div>Seven studies conducted in outpatient epilepsy clinics were included. The area under the curve (AUC) ranged between 0.91 and 0.96 across cutoff scores from &gt;5 to &gt;9. The cutoff score of &gt;6 provided the best balance of diagnostic accuracy, with an AUC of 0.96, sensitivity of 0.95, and specificity of 0.83.</div></div><div><h3>Conclusions</h3><div>The GAD-7 cutoff score of &gt;6 has optimal diagnostic performance for screening GAD in PLWE. These results offer valuable guidance for clinicians and researchers applying the GAD-7 questionnaire to detect GAD among PLWE, especially in geographic areas without previously validated language-specific versions.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"134 ","pages":"Pages 229-237"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866209","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":"Gut microbiota signatures associated with ketogenic diet response in pediatric drug-resistant epilepsy","authors":"Yao Wang ,&nbsp;Jing Guo ,&nbsp;Peiqi Zhang,&nbsp;Qing Zhou,&nbsp;Kai Peng,&nbsp;Zheng Xu,&nbsp;Xiaoli Dong,&nbsp;Jiaying Ye,&nbsp;Hua Li","doi":"10.1016/j.seizure.2025.12.012","DOIUrl":"10.1016/j.seizure.2025.12.012","url":null,"abstract":"<div><h3>Purpose</h3><div>Emerging evidence suggests that gut microbiota may mediate the antiseizure effects of the ketogenic diet (KD) in drug-resistant epilepsy (DRE), yet predictive microbial biomarkers remain poorly characterized. This study aimed to investigate gut microbiota signatures associated with therapeutic response to KD in pediatric DRE patients.</div></div><div><h3>Methods</h3><div>In this prospective study conducted at Guangdong Sanjiu Brain Hospital, 42 children with DRE (age range: 2–10 years, 22 males and 20 females) received KD therapy. The primary endpoint was assessed at 3 months, with an extended follow-up to 6 months in eligible patients. Fecal samples were collected at baseline and at 1, 2, 3, and 6 months after KD initiation. 16S rRNA gene sequencing was performed to analyze gut microbiota composition. Therapeutic response was defined as ≥50% seizure frequency reduction at 3-month follow-up.</div></div><div><h3>Results</h3><div>The median age at epilepsy onset was 18.50 (8.25–41.50) months, and the median age at KD initiation was 53.50 (41.00–80.75) months. Among 34 patients completing the 3-month follow-up, 16 were responders. Responders showed significantly higher baseline abundances of <em>Lachnoclostridium</em> and <em>Barnesiella</em>. Following three months of KD therapy, responders demonstrated increased levels of <em>Parabacteroides</em> and <em>Akkermansia</em> relative to baseline, whereas these genera remained stable in non-responders. Non-responders exhibited consistently higher abundance of <em>Catenibacterium</em> both at baseline and throughout the intervention period compared to responders. Notably, after one month of KD, responders exhibited significantly elevated levels of <em>Parabacteroides</em> compared to non-responders.</div></div><div><h3>Conclusion</h3><div>Higher baseline abundances of <em>Lachnoclostridium</em> and <em>Barnesiella</em> were identified as potential predictive biomarkers for favorable KD response in pediatric DRE. The dynamic increases in <em>Parabacteroides</em> and <em>Akkermansia</em> during KD intervention further distinguished responders, whereas elevated <em>Catenibacterium</em> levels were associated with poor treatment outcomes, providing preliminary insights for treatment stratification.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"134 ","pages":"Pages 220-228"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866191","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":"Absence seizures with ictal yawning in Rubinstein-Taybi syndrome","authors":"Sara Bellido-Cuéllar,&nbsp;Rosa Ana Saiz-Díaz,&nbsp;Jesús González de la Aleja","doi":"10.1016/j.seizure.2025.12.011","DOIUrl":"10.1016/j.seizure.2025.12.011","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"135 ","pages":"Pages 1-3"},"PeriodicalIF":2.8,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145891210","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 correlation between tuber burden and epilepsy onset in children with tuberous sclerosis complex","authors":"Zhanqi Hu ,&nbsp;Xinyuan Chen ,&nbsp;Ping Song ,&nbsp;Xia Zhao ,&nbsp;Ling Lin ,&nbsp;Lingyu Kong ,&nbsp;Benqing Wu ,&nbsp;Tian Yu ,&nbsp;Ying Qi ,&nbsp;Isah Salim Ahmad ,&nbsp;Tong Mo ,&nbsp;Haifeng Wang ,&nbsp;Jianxiang Liao ,&nbsp;Cailei Zhao ,&nbsp;Rongbo Lin","doi":"10.1016/j.seizure.2025.12.010","DOIUrl":"10.1016/j.seizure.2025.12.010","url":null,"abstract":"<div><h3>Background &amp; Objective</h3><div><strong>:</strong> Early-onset epilepsy in Tuberous Sclerosis Complex (TSC) is a major risk factor for neurodevelopmental impairment and drug resistance. This study aims to identify key neuroimaging biomarkers, including tuber brain proportion (TBP) and tuber type, that predict early seizure onset and response to anti-seizure medications (ASMs).</div></div><div><h3>Methods</h3><div><strong>:</strong> In this retrospective study of 306 pediatric TSC patients, we analyzed clinical data and magnetic resonance imaging (MRI). Cortical tubers were classified into four imaging-based subtypes. We performed quantitative volumetric and TBP analyses and used univariate and multivariate regression to identify risk factors for early-onset epilepsy (&lt;12 months) and poor ASM outcome (defined as persistent seizures at one year).</div></div><div><h3>Results</h3><div>The cohort had a median seizure onset age of 10 months (IQR: 4–25), with 57.8% (<em>n</em> = 177) classified as early-onset. A majority (66.7%, <em>n</em> = 204) had a poor ASM response. Key imaging features, including higher total TBP, type II/III TBP, and frontal/temporal/parietal lobar TBP, were significantly associated with early onset (all <em>p</em> &lt; 0.05). Multivariate analysis confirmed type II lesion TBP (OR: 2.63, 95% CI: 1.15–6.01), cortical calcification burden (OR: 2.01, 95% CI: 1.24–3.24), and subependymal nodule (SEN) count (OR: 1.15, 95% CI: 1.06–1.25) as independent predictors of early-onset epilepsy. Furthermore, type II lesion volume (<em>p</em> &lt; 0.001) and TBP (<em>p</em> &lt; 0.001) were significant predictors of poor ASM response.</div></div><div><h3>Conclusion</h3><div><strong>:</strong> Type II tuber burden, cortical calcification, and SEN count are independent neuroimaging predictors of early-onset epilepsy in TSC. The volume and proportion of type II tubers are also critically associated with antiseizure medication resistance, highlighting their clinical utility for prognosis and guiding early intervention strategies.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"134 ","pages":"Pages 211-219"},"PeriodicalIF":2.8,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839216","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":"An updated overview on clinical and developmental trajectories of developmental and epileptic encephalopathies: From childhood to adulthood","authors":"Mario Mastrangelo ,&nbsp;Carlo Di Bonaventura ,&nbsp;Giuliana Lentini ,&nbsp;Francesco Pisani","doi":"10.1016/j.seizure.2025.12.009","DOIUrl":"10.1016/j.seizure.2025.12.009","url":null,"abstract":"<div><div>Developmental and epileptic encephalopathies (DEEs) are a group of diseases characterized by recurring drug-resistant seizures, frequent EEG epileptiform abnormalities and a developmental slowing/regression.</div><div>This narrative review aimed to analyse the progression of DEEs across the lifespan to characterize the clinical and developmental implications of these conditions in the different age-ranges. The lifespan evolution of DEEs includes age-dependent patterns ranging from severe epilepsy phenotypes during the infancy associated with the loss of previously acquired developmental milestones to a decreased seizure frequency in patients with a profound intellectual/motor disability, a possible neurodegenerative course or a hypokinetic movement disorder consistent with parkinsonian features during adulthood.</div><div>Seizure semeiology may be variable with earlier forms mainly presenting with tonic and myoclonic seizures and motor manifestations being more concentrated during the sleep in adults. EEG patterns may vary between abundant interictal epileptiform abnormalities in most cases with a worse developmental outcome associated with an earlier age at their detection.</div><div>The developmental impact of DEEs depends on the underlying aetiologies, the evolution of epilepsy phenotypes and the effects of antiseizure treatments. Predictors of negative outcome influencing neurocognitive, emotional and behavioural functioning include earlier age at seizure-onset, earlier age at the introduction of antiseizure treatments, altered EEG maturation/organization, longer history of epilepsy and occurrence of status epilepticus.</div><div>The optimization of transition of care to adult epilepsy centres might include a model of global reassessment based on the evaluation of seizure freedom and cognitive patterns, self-independence and social relationships and of the burden of the disease on caregivers.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"134 ","pages":"Pages 190-197"},"PeriodicalIF":2.8,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145796922","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":"Sex differences in the clinical characteristics of South African patients with functional seizures in a public and a private hospital","authors":"Gabriele Vilyte ,&nbsp;James Butler ,&nbsp;Victoria Ives-Deliperi ,&nbsp;Chrisma Pretorius","doi":"10.1016/j.seizure.2025.12.007","DOIUrl":"10.1016/j.seizure.2025.12.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Functional seizures (FS) are approximately three times more common in females than in males. However, the factors associated with this gender imbalance are not well understood.</div></div><div><h3>Methods</h3><div>This retrospective chart review study included 372 patients with FS (305 from a private and 67 from a public hospital) confirmed through video-electroencephalography (video-EEG) and without comorbid epilepsy. We collected data on psychological trauma, stressors, comorbidities, medical procedure history, medication use, and seizure semiology to identify clinical factors associated with female sex in this patient cohort. The study was conducted in a private and a public hospital epilepsy monitoring units (EMUs) based in Cape Town, South Africa.</div></div><div><h3>Results</h3><div>In the private hospital, female patients with FS had higher odds of reporting a history of sexual abuse (aOR = 9.58, 95 % CI [1.28, 72.02]) and lower odds of loss of consciousness during a seizure (aOR = 0.46, 95 % CI [0.23, 0.91]) compared to male patients. Female public hospital patients had higher odds of reporting a history of any psychological trauma/stressor (aOR = 3.64, 95 % CI [1.11, 11.88]), side-to-side head movements during seizures (aOR = 6.37, 95 % CI [1.16, 34.98]) and lower odds of reporting a history of at least one failed ASM trial (aOR = 0.27, 95 % CI [0.08, 0.88]).</div></div><div><h3>Conclusion</h3><div>This study, the first of its kind in South Africa, found that while male and female patients with FS shared broadly similar clinical profiles, differences in trauma exposure, antiseizure medication history, and semiology varied by sex and socioeconomic context. These findings underscore the importance of heightened clinical awareness regarding the influence of sex and social determinants on symptom presentation and diagnostic interpretation, thereby reducing diagnostic delays and ensuring more equitable FS management.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"134 ","pages":"Pages 204-210"},"PeriodicalIF":2.8,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821721","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 phenotype and genotype of KCNMA1 - related disorders in China","authors":"Qiuhong Wang ,&nbsp;Xiaojuan Tian ,&nbsp;Jie Deng,&nbsp;Xiaohui Wang,&nbsp;Lifang Dai,&nbsp;Changhong Ding","doi":"10.1016/j.seizure.2025.12.006","DOIUrl":"10.1016/j.seizure.2025.12.006","url":null,"abstract":"<div><h3>Objective</h3><div>The <em>KCNMA1</em> gene encodes the BK K⁺ channel, which modulates neuronal and muscular excitability. Variants in this gene are associated with heterogeneous or overlapping clinical features, including movement disorders, epilepsy, and developmental delays. This study aimed to analyze the genotype-phenotype correlations of <em>KCNMA1</em>-related disorders in China.</div></div><div><h3>Methods</h3><div>Clinical and genetic datas were collected from patients diagnosed with <em>KCNMA1</em>-related disoreders at Beijing Children’s Hospital between January 2017 and December 2024. Literature reviews were conducted using the China National Knowledge Infrastructure (CNKI) and Wanfang databases with \"KCNMA1″ as the keyword (from database establishment to December 2024) to summarize reported Chinese cases. Data on clinical phenotypes, genetic variant types, imaging findings, and prognosis were analyzed.</div></div><div><h3>Results</h3><div>Twenty-seven patients (20 males, 7 females) with <em>KCNMA1</em> variants were included. Six presented with epilepsy and paroxysmal movement disorders, 6 with movement disorders alone, and 12 with epilepsy alone. Movement disorder types included paroxysmal nonkinesigenic dyskinesia (PNKD), ataxia, and episodic limb weakness. Seizure types encompassed generalized tonic-clonic, tonic, epileptic spasms, absence, focal, myoclonic, and atonic seizures. Twenty-six patients exhibited developmental delays, including 3 with delays alone (no seizures or movement disorders). A total of 25 distinct variants were identified, including 19 missense, 2 frameshift, 2 splice-site, 1 nonsense, and 1 deletion variant, of which 16 were novel. About genotype-phenotype correlations, among the 12 epilepsy-only cases, 8 (66.7%, 8/12) had variants located in transmembrane domains (S0–S6). Of the 12 cases with movement disorders (with or without epilepsy; 10 variants), 8 (80%, 8/10) had variants in intracellular domains, predominantly the RCK-2 region.</div></div><div><h3>Conclusions</h3><div>This study summarized the primary clinical features of <em>KCNMA1</em> variants, including movement disorders, epilepsy, and developmental delays. Additionally, 16 novel variants were reported. Genotype-phenotype correlations analysis suggested that variants in transmembrane domains are more likely to cause epilepsy, while those in intracellular domains, especially RCK-2, are primarily associated with movement disorders, with or without epilepsy. However, further studies with larger sample sizes are needed for validation.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"134 ","pages":"Pages 173-179"},"PeriodicalIF":2.8,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758185","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":"Nutritional status and functional gastrointestinal disorders in pediatric patients with drug-resistant epilepsy: Impact of vagus nerve stimulation","authors":"Ayse Akcay ,&nbsp;Zeynep Ozturk ,&nbsp;Alev Elci Karaduman ,&nbsp;Esra Serdaroglu ,&nbsp;Ebru Arhan ,&nbsp;Ercan Demir ,&nbsp;Tugba Hirfanoglu","doi":"10.1016/j.seizure.2025.12.005","DOIUrl":"10.1016/j.seizure.2025.12.005","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the nutritional status and functional gastrointestinal disorders (FGIDs) in children with drug-resistant epilepsy (DRE) and determine whether vagus nerve stimulation (VNS) influences gastrointestinal outcomes.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 98 pediatric patients with DRE (30 with VNS and 68 without). Anthropometric status was assessed using LMS-derived Z-scores, and FGIDs were diagnosed according to the Rome IV criteria. Logistic regression and ROC analyses were used to investigate the relationship between antiseizure medication (ASM) burden and constipation.</div></div><div><h3>Results</h3><div>Each additional ASM increased the odds of constipation by 1.63 (95 % CI: 1.08–2.47; <em>p</em> = 0.021). A cutoff of ≥3 ASMs demonstrated a moderate predictive value for constipation (AUC 0.63). Earlier epilepsy onset was significantly associated with lower weight, height, and BMI Z-scores (all <em>p</em> &lt; 0.05). Despite the higher ASM burden, children treated with VNS did not exhibit an increased frequency of gastrointestinal adverse effects.</div></div><div><h3>Conclusion</h3><div>ASM polytherapy is a measurable risk factor for constipation in pediatric DRE, and early epilepsy onset is associated with impaired growth. The absence of increased gastrointestinal symptoms among VNS recipients, despite a higher medication load, suggests a potential modulatory role of vagal neuromodulation. These findings highlight the need for routine nutritional surveillance and structured gastrointestinal assessments and support future longitudinal studies incorporating objective GI measures and biomarker-based evaluations.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"134 ","pages":"Pages 198-203"},"PeriodicalIF":2.8,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145796921","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}