Seizure-European Journal of Epilepsy最新文献

{"title":"Biallelic ACSF3 variants with combined malonic and methylmalonic acidemia and associated developmental epileptic encephalopathy phenotype: A novel genotype-phenotype correlation","authors":"JuleLayne Curry ,&nbsp;Emily Bonkowski ,&nbsp;Heather Mefford ,&nbsp;James Wheless ,&nbsp;Nitish Chourasia","doi":"10.1016/j.seizure.2025.09.015","DOIUrl":"10.1016/j.seizure.2025.09.015","url":null,"abstract":"<div><h3>Purpose</h3><div>Combined malonic and methylmalonic acidemia (CMAMMA) is a rare genetic disorder caused by biallelic variants in the acyl-CoA synthetase family member 3 (<em>ACSF3</em>) gene (Witkowski et al., 2011) and is associated with elevated levels of malonic acid (MA) and methylmalonic acid (MMA) in urine (Sloan et al., 2011). CMAMMA is generally considered a benign disorder, with recent descriptions of potential neuropsychiatric symptoms in children (Levtova et al., 2019). We expand the phenotype by describing a case of severe developmental and epileptic encephalopathy with a CMAMMA-associated Lennox-Gastaut Syndrome (LGS) phenotype and comorbid neuropsychiatric abnormalities.</div></div><div><h3>Methods and Results</h3><div>An 8-year-old boy with CMAMMA, referred to our clinic’s neurogenetic center, presented with refractory epilepsy and severe neurobehavioral symptoms. His epilepsy consisted of tonic, atonic, and generalized tonic-clonic seizures with electroclinical features consistent with LGS. The patient had comorbid autism, aggression, and intellectual disability with a history of developmental regression. Genetic testing confirmed pathogenic biallelic <em>ACSF3</em> variants, and urine organic acid testing showed elevated levels of MA and MMA in urine.</div></div><div><h3>Conclusion</h3><div>This case suggests that CMAMMA can lead to severe epilepsy and a neuropsychiatric phenotype, expanding the clinical spectrum of the disorder.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"133 ","pages":"Pages 16-19"},"PeriodicalIF":2.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271022","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 haemorrhagic transformation in acute ischaemic strokes and incidence of post-stroke epilepsy: A systematic review and meta-analysis","authors":"Nicholas Goh ,&nbsp;Karthikeyan Saravanan ,&nbsp;Mya Thee Char Tin Oo ,&nbsp;Evan Michael NEO Ren Jie ,&nbsp;Rahul Rathakrishnan ,&nbsp;Mingxue Jing ,&nbsp;Jennifer Hung ,&nbsp;Ching-Hui Sia ,&nbsp;Benjamin YQ Tan ,&nbsp;Hui Shi Lim ,&nbsp;Megan BJ Ng ,&nbsp;Leonard LL Yeo ,&nbsp;Joshua YP Yeo","doi":"10.1016/j.seizure.2025.09.014","DOIUrl":"10.1016/j.seizure.2025.09.014","url":null,"abstract":"<div><h3>Background</h3><div>Post-stroke epilepsy (PSE) is a complication of stroke and accounts for a large proportion of seizures in the elderly population. Moreover, it is associated with heightened morbidity and mortality, poor functional outcomes and longer hospital stays. The effect of haemorrhagic transformation (HT) of ischaemic strokes on the incidence of PSE is not well-understood.</div></div><div><h3>Objectives</h3><div>Our aim is to investigate how the incidence of PSE is affected by the presence of HT in adult patients with ischaemic stroke.</div></div><div><h3>Methods</h3><div>PubMed, Embase and Scopus were searched from inception to 26th August 2025 for studies on PSE and HT. Inclusion criteria included primary observational studies (cohort studies, case-control studies), adults &gt; 18 years old, ischaemic stroke, and PSE. The odds ratio of PSE incidence in patients with and without HT was evaluated using a random effects model. Our study was registered with PROSPERO (CRD42024610806).</div></div><div><h3>Results</h3><div>A total of 8 studies were included in our analysis, including 7 cohort studies and 1 case control study, comprising a total of 4273 patients. The pooled prevalence of PSE in this cohort was 0.075 (95 % CI = 0.057, 0.095). HT significantly increased the incidence of PSE in ischaemic stroke patients (OR = 2.95, 95 % CI = 1.93, 4.50, <em>p</em> &lt; 0.005).</div></div><div><h3>Conclusion</h3><div>Understanding how HT affects PSE incidence can help objectively quantify the morbidity from this complication. Future studies may include this outcome to guide the judicious use of thrombolytic reperfusion therapy in ischaemic stroke.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"133 ","pages":"Pages 96-105"},"PeriodicalIF":2.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349554","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":"Financial distress among individuals with epilepsy: Insights from a nationwide survey analysis","authors":"Jaan K Nandwani ,&nbsp;Soonmyung A Hwang ,&nbsp;Leah Blank ,&nbsp;Benjamin R Kummer ,&nbsp;Parul Agarwal","doi":"10.1016/j.seizure.2025.09.012","DOIUrl":"10.1016/j.seizure.2025.09.012","url":null,"abstract":"<div><h3>Purpose</h3><div>We aimed to assess the prevalence of financial distress, defined as the negative effects of the economic burden of medical care on patients’ quality of life, in persons with epilepsy compared to those without epilepsy in a nationally representative sample of U.S. adults. We also aimed to identify associated factors of financial distress in persons with active epilepsy.</div></div><div><h3>Methods</h3><div>We pooled cross-sectional data from the 2021 and 2022 National Health Interview Survey. We divided individuals with epilepsy into active (medication use or seizure in the past year) and inactive cohorts. We analyzed measures of financial distress using survey responses from individuals who had self-reported epilepsy. Multivariable logistic regression was conducted to investigate the association between epilepsy status and financial distress, and to identify factors associated with financial distress measures among persons with epilepsy.</div></div><div><h3>Results</h3><div>In a multivariable logistic regression analysis, epilepsy status was not significantly associated with financial distress (OR=1.03, 95% CI: 0.87–1.22, <em>p</em> = 0.76). However, several factors were significantly associated with higher odds of financial distress among those with active epilepsy, including female sex (OR=1.38, 95% CI: 1.32–1.44), Hispanic ethnicity (OR=1.72, 95% CI 1.61–1.85), having a high school degree or less (OR=1.34, 95% CI: 1.26–1.41), one or more annual hospitalizations (OR=1.33, 95% CI: 1.27–1.40), and multiple comorbidities (OR=1.76, 95% CI: 1.60–1.93).</div></div><div><h3>Conclusion</h3><div>A substantial proportion of individuals with active epilepsy experience financial distress, underscoring the need for system-level policies to expand access and patient-level strategies to improve financial navigation and promote affordable therapies.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"133 ","pages":"Pages 29-36"},"PeriodicalIF":2.8,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287513","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":"Clinical and radiological evaluation of children with hemimegalencephaly and epilepsy: A single-center study","authors":"Ceren Günbey ,&nbsp;Kader Karlı Oğuz ,&nbsp;Burçak Bilginer ,&nbsp;Ülkühan Öztoprak ,&nbsp;Fatma Ilgaz ,&nbsp;Nejat Akalan ,&nbsp;Meral Topçu ,&nbsp;Güzide Turanlı ,&nbsp;Dilek Yalnızoğlu","doi":"10.1016/j.seizure.2025.09.011","DOIUrl":"10.1016/j.seizure.2025.09.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Hemimegalencephaly (HME) is characterized by severe seizures, cognitive impairment, and unilateral motor deficits. This study aimed to evaluate the clinical features, electroencephalogram (EEG) and neuroimaging findings along with treatment outcomes in pediatric epilepsy patients diagnosed with HME.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on 14 pediatric epilepsy patients with HME, encompassing clinical data, video-EEG findings, neuroradiological assessments and treatment outcome.</div></div><div><h3>Results</h3><div>The study revealed a predominance of left-sided HME (11/14) and syndromic presentations in three patients. The median age of seizure onset was within the first day of life (range: 0–225 days). The median follow-up duration was 30 months (3–72 months). All patients experienced daily seizures. At the time of evaluation, 11 patients were on three or more antiseizure medications. Adjunctive therapies included ketogenic diet in four patients, <em>mTOR</em> inhibitors in two patients, and a combination of both in one patient. Ictal recordings were obtained in 13 patients, with two patients exhibiting bilateral independent ictal onset. All but one patient demonstrated refractory seizures on follow-up. Six patients (42.8 %) underwent epilepsy surgery, resulting in seizure freedom in three cases (50 %) and a mild reduction in seizure frequency in one. Two patients experienced intraoperative hemorrhage, resulting in monthly seizures and postoperative mortality, each in one patient.</div></div><div><h3>Conclusion</h3><div>Hemimegalencephaly represents a challenging etiology in refractory epilepsy of early childhood. Given the limited efficacy of pharmacological modalities, epilepsy surgery seems to be the only effective treatment option for seizure control in these young patients, however, carries significant risks for mortality and morbidity.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"132 ","pages":"Pages 186-191"},"PeriodicalIF":2.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207770","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":"Delivery of care, anti-seizure medication adherence and factors affecting seizure outcomes in women with epilepsy during pregnancy: a retrospective cohort study","authors":"AD Marshall ,&nbsp;A Askariah ,&nbsp;S Yule ,&nbsp;D Fyfe ,&nbsp;R Hassett ,&nbsp;J Todd ,&nbsp;S MacBride-Stewart ,&nbsp;SEF Nichol ,&nbsp;L Stephen ,&nbsp;D Mackay ,&nbsp;CA Heath","doi":"10.1016/j.seizure.2025.09.009","DOIUrl":"10.1016/j.seizure.2025.09.009","url":null,"abstract":"<div><h3>Objective</h3><div>The rate of maternal mortality and obstetric complications amongst women with epilepsy during pregnancy is higher than that of the general population. The reason for this remains unclear but poor access to epilepsy specialist in a timely manner, poor medication adherence and falling levels of ASM are often stated within the published literature. We aim to explore whether this assumption is correct and consider the influence that clinical and epidemiological factors have on outcomes.</div></div><div><h3>Methods</h3><div>Pregnant women with epilepsy were identified between January 2015 and June 2022 from the local obstetric register. Key clinical features were identified following a manual review of patient records. Demographic information, scheduled and unscheduled secondary care contact, maternity care and medication dispensing history were obtained from routinely collected health datasets. An adverse outcome was defined as a reported seizure or epilepsy-related hospital contact during pregnancy or within 12-weeks postpartum.</div></div><div><h3>Results</h3><div>We identified 458 pregnancies from 336 WWE. An adverse epilepsy related outcome was observed in 212/458 (46%) pregnancies. Review during the pre-booking period was noted in 189/458 (41.2%) cases and during pregnancy in 302/458 (65.9%). The most common ASM monotherapy was levetiracetam (LVT)(152/285 pregnancies, 53.3%) followed by lamotrigine (LTG) (110/285 pregnancies, 38.6%). Overall, exposure to polytherapy, LTG exposure, a seizure during the preconception period and low socioeconomic status were associated with an adverse outcome.</div></div><div><h3>Conclusion</h3><div>An epilepsy related admission or reported seizure was commonly experienced in WWE during pregnancy and in a small proportion of women this came after a period of seizure freedom. There is much work to be done to improve outcomes in women with epilepsy during pregnancy and the low rates of pre-conception care remain a concern. Routine preconception care would potentially allow complex issues such as ASM adherence, potential falling levels of ASM in pregnancy, driving and teratogenicity to be considered. Although seizure freedom is not possible for a significant proportion of women (both during the preconception period and pregnancy) early review in the preconception period and throughout pregnancy is likely to ensure epilepsy control is optimum and all potentially modifiable factors are considered.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"132 ","pages":"Pages 163-170"},"PeriodicalIF":2.8,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158014","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 spectrum of cognitive outcomes following admission to hospital for refractory status epilepticus (RSE): A scoping review","authors":"Aiman Al Wahaibi ,&nbsp;Karnig Kazazian ,&nbsp;Margaret Gopaul ,&nbsp;Alla Iansavitchene ,&nbsp;Teneille E. Gofton","doi":"10.1016/j.seizure.2025.09.010","DOIUrl":"10.1016/j.seizure.2025.09.010","url":null,"abstract":"<div><h3>Background</h3><div>Refractory status epilepticus (RSE) may have many different causes. Preventing neurological complications and controlling acute seizures are early priorities, but long-term cognitive consequences must also be considered.</div></div><div><h3>Objective</h3><div>The objective of this scoping review is to report the spectrum of outcomes following admission to hospital for RSE from all etiologies and to determine whether there is evidence to suggest that survivors of new-onset RSE (NORSE) have different cognitive outcomes compared to survivors of RSE of identified etiology.</div></div><div><h3>Methods</h3><div>Scoping review methodology was used for this study. A clinical librarian prepared the search strategy. Studies were eligible if they were original research reporting cognitive outcomes after RSE.</div></div><div><h3>Results</h3><div>2202 articles were identified, of which 2121 were excluded. After full text review, we included 14 studies. Studies were from 2005–2023 and included retrospective, prospective and case studies with a total of 323 patients from ages 1–80 years. Outcomes were similar across studies, but there was heterogeneity with respect to tests used and timing of outcome measurement. Most pediatric reports were in survivors of NORSE and a minority of pediatric survivors return to baseline, with a large proportion of survivors having intellectual disability ranging from mild to severe. Outcomes were less consistent across adult survivors, with some having minimal cognitive impairment and others reporting that no previously employed patients returning to employment.</div></div><div><h3>Conclusion</h3><div>Current approaches to cognitive assessment in survivors of RSE are highly variable. A large proportion of survivors had impairment in greater than one cognitive domain. Future research should focus on using age-appropriate, domain-specific tools administered at defined timepoints post-RSE.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"132 ","pages":"Pages 154-160"},"PeriodicalIF":2.8,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092891","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":"New onset of comorbidities in people with epilepsy in a national healthcare claims database","authors":"Edward Faught ,&nbsp;Emily Klatte ,&nbsp;Clarence T. Wade ,&nbsp;Sean Stern ,&nbsp;Wesley T. Kerr","doi":"10.1016/j.seizure.2025.09.008","DOIUrl":"10.1016/j.seizure.2025.09.008","url":null,"abstract":"<div><h3>Purpose</h3><div>This study evaluated the rate of new occurrence of select comorbidities in adults after events of uncontrolled epilepsy versus controlled epilepsy.</div></div><div><h3>Methods</h3><div>The HealthVerity Marketplace Inovalon healthcare claims database was used. Adults (≥18 years) with an epilepsy diagnosis (ICD-10-CM G40*) prescribed at least one antiseizure medication (ASM) between January 1, 2015, and December 31, 2021, were included. Patients were categorized as having either a first-filled or third-filled ASM. The first ASM filled was defined as no ASMs filled for at least 1 year of enrollment. Uncontrolled epilepsy events within 1 year of new ASM initiation were: seizure-related inpatient or emergency room visit or initiation of subsequent ASM. Patients with uncontrolled and controlled epilepsy were propensity score matched. Time to first new comorbidity was measured for cardiac/metabolic, neuropsychiatric, and neurologic disorders.</div></div><div><h3>Results</h3><div>First-filled ASM start date was identified for 78,714 patients with epilepsy, 64,031 of whom received a third ASM. Most patients had an uncontrolled epilepsy event within the first year after first-filled (57%) ASM initiation and after third-filled (56%) ASM initiation. The rate of most neuropsychiatric and neurologic comorbidities was higher among patients with uncontrolled epilepsy during first-filled and third-filled ASM. The rate of most cardiac/metabolic comorbidities was higher among patients with uncontrolled epilepsy after third-filled ASM initiation; however, these comorbidities were more common in controlled epilepsy during first-filled ASM.</div></div><div><h3>Conclusion</h3><div>Patients with uncontrolled epilepsy had a higher rate of new-onset comorbidities. These results indicated that seizure control may influence the non-seizure impacts of epilepsy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"132 ","pages":"Pages 178-185"},"PeriodicalIF":2.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186768","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":"Prediction of evolution to epilepsy or genetic epilepsy with febrile seizures plus (GEFS+) in children presenting with febrile seizures: a retrospective multicenter longitudinal study","authors":"Pietro Baso ,&nbsp;Silvia Masnada ,&nbsp;Monica Maria Lodi ,&nbsp;Federica Teutonico ,&nbsp;Aglaia Vignoli ,&nbsp;Emilia Ricci ,&nbsp;Maria Paola Canevini ,&nbsp;Francesca Brustia ,&nbsp;Maurizio Viri ,&nbsp;Cristina Cereda ,&nbsp;Luca Lalli ,&nbsp;Simona Ferraro ,&nbsp;Pierangelo Veggiotti","doi":"10.1016/j.seizure.2025.09.006","DOIUrl":"10.1016/j.seizure.2025.09.006","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify possible predictors of progression from febrile seizures to epilepsy or genetic epilepsy with febrile seizures plus (GEFS+), and to evaluate the management of febrile seizures in Italian clinical settings.</div></div><div><h3>Methods</h3><div>231 children with complex febrile seizures, febrile status epilepticus, or recurrent episodes of simple febrile seizures requiring therapy or follow-up, were recruited from four different hospitals. At the baseline evaluation and during follow-up, data were collected regarding each child’s febrile seizures (number, duration, triggers, clinical characteristics), psychomotor development, possible neuropsychiatric comorbidities, any family history of neuropsychiatric disorders, as well as findings of electroencephalographic evaluation (EEG), diagnostic tests, and prescribed treatments. The data were analyzed using Mann-Whitney and Fisher tests, and univariate and multivariate logistic models.</div></div><div><h3>Results</h3><div>A family history of epilepsy, a higher absolute number of episodes, an older age at onset of febrile seizures, and the presence of afebrile seizures were found to be factors associated with an increased risk of developing epilepsy or GEFS+. Conversely, a normal EEG at onset and an increase in the number of simple febrile seizures or of complex febrile seizures occurring within the first 24 h were associated with a lower risk.</div></div><div><h3>Conclusions</h3><div>This study provides previously unreported evidence relevant to the prediction of epilepsy or GEFS+ in patients with febrile seizures, which may facilitate the identification of new prognostic factors. It also highlights concerns regarding the current national and international guidelines on febrile seizures.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"132 ","pages":"Pages 147-153"},"PeriodicalIF":2.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092906","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":"Adjunctive brexpiprazole for treatment-resistant functional/dissociative seizures","authors":"Ryo Mitoma,&nbsp;Shogo Hirano,&nbsp;Tomohiro Nakao","doi":"10.1016/j.seizure.2025.09.007","DOIUrl":"10.1016/j.seizure.2025.09.007","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"132 ","pages":"Pages 161-162"},"PeriodicalIF":2.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103159","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":"Long-term seizure outcomes and the likelihood of antiseizure medication withdrawal in patients with juvenile absence epilepsy: A 10-year follow-up study","authors":"Xiaoli Wang ,&nbsp;Xinbo Zhang ,&nbsp;Jingya Wei ,&nbsp;Chenwei Li ,&nbsp;Yuanhang Pan,&nbsp;Gengyao Hu,&nbsp;Min Li,&nbsp;Wenjuan Zhang,&nbsp;Yong-Hong Liu","doi":"10.1016/j.seizure.2025.09.005","DOIUrl":"10.1016/j.seizure.2025.09.005","url":null,"abstract":"<div><h3>Background and Objective</h3><div>Juvenile absence epilepsy is a common idiopathic generalized epilepsy syndrome that often requires long-term antiseizure medications (ASMs). However, it remains unclear whether and when such long-term medication is necessary. In this study, we aimed to explore the long-term seizure outcomes and the feasibility of ASMs withdrawal in patients with JAE. Additionally, we aimed to investigate the evolution of EEG patterns over time.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study on patients diagnosed with JAE according to the 2022 ILAE at Xijing Hospital between March 2014 and Dec 2024. We performed a retrospective review of their 24-h video-EEG recordings for seizure semiology and EEG pattern. Patient demographics, baseline clinical characteristics, and treatment details were extracted from clinical charts and electronic health records. All further follow-up visits were either through telemedicine or in-person visits.</div></div><div><h3>Results</h3><div>This retrospective study included 58 patients diagnosed with JAE, with a mean age at epilepsy onset of 11.86 ± 3.87 years. The median follow-up duration was 9.57 years (range, 3–27 years). Among these patients, 38 (65.5 %) achieved seizure freedom for at least 2 years. Treatment with valproate was identified as an independent predictor of a favorable outcome in terms of seizure freedom. Conversely, the total number of generalized tonic-clonic seizures experienced, presence of absence seizures on follow-up EEG and the persistence of hyperventilation positivity on EEG were associated with an unfavorable outcome regarding seizure freedom. Among the 38 patients, 25 (65.8 %) did not experience seizure recurrence. ASMs withdrawal was attempted in 28 patients (48.3 %) and 18 of them did not experience seizure recurrence during the tapering process. Among these 18 patients, ASMs were discontinued in 9 patients at the last follow-up.</div><div>The age of onset (<em>p</em> = 0.040) and age at last follow up (<em>p</em> = 0.044) were associated with seizure recurrence. After a median EEG follow-up period of 6 years, abnormal EEG improved in 34 of the 58 patients (58.6 %). Additionally, 14 of the 58 patients (24.1 %) had normal EEG in subsequent recordings.</div></div><div><h3>Conclusion</h3><div>Seizures were effectively controlled with ASMs in most patients with JAE, and a significant proportion of patients were able to attempt ASMs withdrawal without experiencing seizure recurrence. Additionally, EEG patterns of GSWD improved on follow-up EEGs for the majority of patients.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"132 ","pages":"Pages 117-124"},"PeriodicalIF":2.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049576","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}