Seizure-European Journal of Epilepsy最新文献

{"title":"A global survey of telemedicine use in epilepsy care – practices before, during and after the COVID-19 pandemic","authors":"Hsiang-Yu Yu ,&nbsp;Mamta Bhushan Singh ,&nbsp;Josephine Chan ,&nbsp;Pauline Samia ,&nbsp;Amza Ali ,&nbsp;Ji Yeoun Yoo ,&nbsp;Yanin Rivera ,&nbsp;Jitendra Kumar Sahu ,&nbsp;Patricia Osborne Shafer ,&nbsp;Bosanka Jocic-Jakubi ,&nbsp;Johan Zelano ,&nbsp;Ana Carolina Coan ,&nbsp;Roberto Horacio Caraballo ,&nbsp;Pablo Sebastián Fortini ,&nbsp;Najib Kissani ,&nbsp;J Helen Cross","doi":"10.1016/j.seizure.2024.10.012","DOIUrl":"10.1016/j.seizure.2024.10.012","url":null,"abstract":"<div><h3>Purpose</h3><div>Telemedicine was widely adopted for epilepsy care during the COVID-19 pandemic. Its role extends beyond preventing disease transmission, offering an efficient and high-quality care alternative. To understand the global scenario, an international group conducted a survey comparing telemedicine practices in epilepsy care before, during, and after the pandemic.</div></div><div><h3>Methods</h3><div>The survey included 26 questions on demographics, telemedicine use for epilepsy care, regulations, reimbursement mechanisms, and tools used. Responses were collected via an online survey platform from June to October 2023.</div></div><div><h3>Results</h3><div>Two hundred eighty-five respondents from 60 countries participated. The average telemedicine use in daily practice was 0 %, 0–10 % (median, IQR) before the pandemic, 65 %, 30–90 % during the pandemic, and 20 %,10–50 % after the COVID pandemic. Female respondents reported higher telemedicine use than males after the pandemic (25 %, 10–50 % vs 15 %, 5 %-30 %, <em>p</em> = 0.002). According to respondents' perceptions, post-pandemic telemedicine regulations flexibilities were reported as expanded by 36.8 %, restricted by 17.2 %, and unchanged by 46 %. Reimbursement for telemedicine increased during the pandemic but decreased afterward (Cochran's Q test, <em>p</em> &lt; 0.001). Voice calls were the most used telemedicine platform (46.6 %). Privacy issues were reported by 49 respondents (18.3 %).</div></div><div><h3>Conclusion</h3><div>Telemedicine use for epilepsy care increased during the pandemic and remained higher than pre-pandemic levels. However, improvements are needed in telemedicine applications, regulations, reimbursement, and patient privacy. International collaboration and experience sharing can enhance telemedicine's acceptance and practice globally.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 82-87"},"PeriodicalIF":2.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631270","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":"Lack of association of first and second-line medication dosing and progression to refractory status epilepticus in children","authors":"Cristina Barcia Aguilar ,&nbsp;Marta Amengual-Gual ,&nbsp;J. Nicholas Brenton ,&nbsp;Kevin E. Chapman ,&nbsp;Justice Clark ,&nbsp;William D. Gaillard ,&nbsp;Joshua L. Goldstein ,&nbsp;Howard P. Goodkin ,&nbsp;Robert Kahoud ,&nbsp;Yi-Chen Lai ,&nbsp;Mohamad A. Mikati ,&nbsp;Lindsey A. Morgan ,&nbsp;Eric T. Payne ,&nbsp;Craig A. Press ,&nbsp;Latania Reece ,&nbsp;Tristan T. Sands ,&nbsp;Kumar Sannagowdara ,&nbsp;Theodore Sheehan ,&nbsp;Renée A. Shellhaas ,&nbsp;Robert C. Tasker ,&nbsp;Tobias Loddenkemper","doi":"10.1016/j.seizure.2024.10.017","DOIUrl":"10.1016/j.seizure.2024.10.017","url":null,"abstract":"<div><h3>Purpose</h3><div>Evaluate the relationship between first and second-line medication dosing and progression to refractory status epilepticus (RSE) in children.</div></div><div><h3>Methods</h3><div>This is a retrospective analysis of prospectively collected data from September 2014 to February 2020 of children with status epilepticus (SE) who received at least two antiseizure medications (ASMs). We evaluated the risk of developing RSE after receiving a low total benzodiazepine dose (lower than 100 % of the minimum recommended dose for each benzodiazepine dose administered within 10 min) and a low first non-benzodiazepine ASM dose (lower than 100 % of the minimum recommended dose of non-benzodiazepine ASM given as the first single-dose) using a logistic regression model, adjusting for confounders such as time to ASMs. The proportion of patients receiving low first non-benzodiazepine ASM doses was calculated and a logistic regression model was used to evaluate risk factors for low dosing of the first non-benzodiazepine ASM.</div></div><div><h3>Results</h3><div>Among 320 children, 170 (53.1 %) developed RSE, and 150 (46.9 %) responded to the first non-benzodiazepine ASM dose (non-RSE). One hundred thirty-seven (42.8 %) received a low total benzodiazepine dose, and 128 (40 %) received a low first non-benzodiazepine ASM dose. The odds of developing RSE were not higher after a low total benzodiazepine dose (OR=0.76, 95 %CI 0.47–1.23, <em>p</em> = 0.27) or low first non-benzodiazepine ASM dose (OR=0.85, 95 %CI 0.42–1.71, <em>p</em> = 0.65). Receiving a low first non-benzodiazepine ASM dose was independently associated with having received a low total benzodiazepine dose (OR=1.65, 95 %CI 1.01–2.70, <em>p</em> = 0.04).</div></div><div><h3>Conclusion</h3><div>For most patients, dosing variability in first and second-line medications for SE was not the sole clinical feature predicting progression to RSE in this cohort of benzodiazepine-resistant patients. Identification of additional modifiable clinical biomarkers that predict progression to RSE is needed. Though lower ASM doses did not predict RSE in this model, the administration of ASMs at doses likely to prevent RSE remains crucial in SE treatment.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 133-141"},"PeriodicalIF":2.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649498","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":"Epileptic seizure as the prominent symptom in Fahr syndrome, case report and literature review","authors":"Mengyao Zhang ,&nbsp;Yu Jia ,&nbsp;Huifang Wang ,&nbsp;Aihua Liu ,&nbsp;Lehong Gao ,&nbsp;Yuping Wang","doi":"10.1016/j.seizure.2024.09.023","DOIUrl":"10.1016/j.seizure.2024.09.023","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 88-91"},"PeriodicalIF":2.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631275","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":"Prehospital seizure management protocols need standardized guidelines. A descriptive study from Norway","authors":"Ingrid Anette Hustad ,&nbsp;Morten Horn ,&nbsp;Marius Rehn ,&nbsp;Erik Taubøll ,&nbsp;Maren Ranhoff Hov","doi":"10.1016/j.seizure.2024.10.002","DOIUrl":"10.1016/j.seizure.2024.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Patients with convulsive seizures constitute a significant group in acute neurology. No common European clinical practice guidelines on prehospital seizure management exist, and today most patients are brought to hospital for seizure treatment, with great variation in which prehospital treatment is provided. Only 33 % of status epilepticus patients receive a benzodiazepine as first anti-seizure medication (ASM). The aim of this study is to assess the prehospital seizure control protocols in the Emergency Medical Services (EMS) in Norway, and compare these with current evidence for acute management.</div></div><div><h3>Method</h3><div>We performed a descriptive analysis of the 18 regional EMS protocols in Norway and compared the findings with recent evidence on prehospital treatment. We analysed recommended drug and dosage, route of medication administration, number of additional rescue doses permitted, requirements for registration of type of seizures and seizure duration.</div></div><div><h3>Results</h3><div>The protocols vary in terms of preferred medication, administration method, dosage and recommendations regarding first- and second-line therapies. 33 % of protocols explicitly define status epilepticus according to contemporary guidelines, and 16.7 % have an operational definition of <em>when</em> to administer benzodiazepines. All protocols showed variations in dosing and administration instructions and only 28 % had a clearly stated first line treatment.</div></div><div><h3>Conclusion</h3><div>There are disparities in the prehospital seizure management protocols within the Norwegian healthcare system, a system comparable to other European countries. To improve seizure management there is a need for standardised guidelines for prehospital treatment.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 92-96"},"PeriodicalIF":2.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631283","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":"Acute effects of Mozart K.448 on interictal epileptiform discharges in adult patients with drug-resistant focal epilepsy: A crossover randomized controlled trial","authors":"Somjet Tosamran ,&nbsp;Thanaporn Pakotiprapha ,&nbsp;Thtiwat Asavalertpalakorn ,&nbsp;Thanakorn Kiatprungvech ,&nbsp;Totsapol Surawattanawong ,&nbsp;Chusak Limotai","doi":"10.1016/j.seizure.2024.10.016","DOIUrl":"10.1016/j.seizure.2024.10.016","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to validly assess the efficacy of Mozart K.448 on reducing interictal epileptiform discharges (IEDs) in adult patients with drug-resistant focal epilepsy (DRE).</div></div><div><h3>Methods</h3><div>This is a crossover RCT study. Adults with DRE were included. Stratified 1:1 randomization by epileptic foci i.e., temporal versus extratemporal foci, was performed. Intervention consisted of two study arms i.e., “Mozart arm” and “Control arm”. Study period encompassed 2 consecutive nights, each night consisted of baseline and intervention period. Outcomes were IED number and proportion of patients with significant IED reduction i.e., reduction ≥ 25 %. Within-group, within-subject and between-group analyses were used to test differences of IED number when listened to the Mozart piece as compared with baseline or with Control.</div></div><div><h3>Results</h3><div>Twenty-six patients were randomized; 13 in Mozart and 13 in Control arm. Overall, 16 (61.54 %) out of 26 patients had significant IED reduction when listening to the Mozart piece, as compared with only 7 (26.92 %) when continuing sleep (silence). Between-group analysis showed that IED number during intervention period i.e., listening to the Mozart piece in Mozart arm and silence in Control arm was significantly different, with a lower number in Mozart arm, 39.5 (IQR 89) vs 56.5 (IQR 114); <em>p</em> = 0.007.</div></div><div><h3>Conclusions</h3><div>Our study demonstrates an acute effect of the Mozart K.448 on reducing IEDs in adult patients with DRE. Patients with temporal rather than extratemporal lobe epilepsy better responded to the Mozart piece. Mozart K.448 is safe and feasible in real practice. Further RCT study assessing its long-term effect is warranted.</div></div><div><h3>Trial registration</h3><div>Thai Clinical Trials Registry, TCTR20231019005, 19 October 2023, “retrospectively registered”</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 66-73"},"PeriodicalIF":2.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607253","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":"Unraveling the connection: Insights into SARS-CoV-2 vaccines and status epilepticus","authors":"Fedele Dono ,&nbsp;Michelangelo Dasara ,&nbsp;Giacomo Evangelista ,&nbsp;Stefano Sensi","doi":"10.1016/j.seizure.2024.10.015","DOIUrl":"10.1016/j.seizure.2024.10.015","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 49-50"},"PeriodicalIF":2.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142536084","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":"Intensive treatment course to identify pseudoresistant epilepsy and expedite surgery referrals - A prospective intervention study","authors":"Line Harboe ,&nbsp;Ole Abildgaard Hansen ,&nbsp;Maria Kjerside Døssing ,&nbsp;Marianne Juel Kjeldsen ,&nbsp;Christoph Patrick Beier","doi":"10.1016/j.seizure.2024.10.008","DOIUrl":"10.1016/j.seizure.2024.10.008","url":null,"abstract":"<div><h3>Introduction</h3><div>A significant proportion of patients do not achieve seizure freedom despite treatment attempts with two different anti-seizure medications (ASMs). A subset may not truly have drug-resistant epilepsy (“pseudoresistant”), while rapid referral of patients with genuine drug-resistant epilepsy to surgery is mandated. This study was designed to evaluate a structured and intensive treatment course with the objective of promptly identifying cases of pseudoresistance and accelerating the time to referral to epilepsy surgery.</div></div><div><h3>Methods</h3><div>From May 2017 to February 2021, this prospective interventional study recruited consecutive adult patients with epilepsy treated at Odense University Hospital, Denmark, who had at least one seizure per month despite attempts with two or more ASMs. The predefined endpoint was improvement in seizure activity. Secondary endpoints were referral to epilepsy surgery, patients with pseudoresistance, and achievement of seizure freedom.</div></div><div><h3>Results</h3><div>Of the 41 patients enrolled, 39 completed the study. The intervention comprised a initial seizure documentation, specialist evaluation, EEG monitoring as required, and an individualized plan for intensive treatment. The plans included e.g., optimization of medical treatment, seizure classification, and improvement of medication adherence. The subsequent intensive treatment (1–4 contacts/month; 1–13 contacts in total) was led by epilepsy nurses that executed the treatment plan. The intervention significantly improved seizure control, with 41.1 % of patients achieving seizure freedom and an additional 17.8 % of patients experiencing reduced seizure frequency. One-third of the patients turned out to be “pseudoresistant” due to various reasons, including wrong classification of seizures and inadequate adherence to ASMs. Ten patients were offered a referral for epilepsy surgery at the end of the study after an average of 34.8 weeks.</div></div><div><h3>Conclusion</h3><div>This study demonstrates the efficacy of a standardized, intensive treatment course involving epilepsy nurses in identifying and managing patients with persisting seizures despite treatment attempts with two ASMs. This approach led to favourable seizure outcomes and facilitated expedited referrals for epilepsy surgery where appropriate.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 51-56"},"PeriodicalIF":2.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565266","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":"Association of blood count–derived immunoinflammatory makers and risk of epilepsy: A prospective cohort of 497,291 participants","authors":"Qinlian Huang ,&nbsp;Zhihan Zhang ,&nbsp;Rui Fan ,&nbsp;Shiyi Liu ,&nbsp;Wei Zheng ,&nbsp;Fei Xiao","doi":"10.1016/j.seizure.2024.10.006","DOIUrl":"10.1016/j.seizure.2024.10.006","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the longitudinal association between blood count-derived immunoinflammatory markers and the risk of epilepsy in a large population cohort.</div></div><div><h3>Methods</h3><div>We used data from the UK Biobank (UKB) to investigate the association between pre-diagnostic peripheral immunoinflammatory cells and their derived ratios, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), and the risk of epilepsy. This was a longitudinal cohort study in which multivariate Cox proportional hazards models and a series of sensitivity and subgroup analyses were performed to explore the nature of these associations.</div></div><div><h3>Results</h3><div>We examined these associations in a prospective UKB cohort of 497,291 participants. During a median follow-up of 12.43 years, 2,715 participants developed epilepsy. After adjusting for all covariates, the results showed that higher monocyte counts and some blood count-derived immunoinflammatory metrics (monocyte counts, hazard ratio [HR]=1.093, 95 % confidence interval [CI] 1.052–1.136, <em>P</em> <em>&lt;</em> <em>0.001</em>; NLR, HR=1.062, 95 % CI 1.022–1.103, <em>P</em> <em>=</em> <em>0.002</em>; PLR, HR=1.096, 95 % CI 1.055–1.139, <em>P</em> <em>&lt;</em> <em>0.001</em>; SII, HR=1.041, 95 % CI 1.003–1.082, <em>P</em> <em>=</em> <em>0.036</em>) were associated with an increased risk of epilepsy. Conversely, we found that higher lymphocyte counts and LMR were negatively associated with the risk of epilepsy (lymphocyte count, HR=0.889, 95 % CI 0.856–0.923, <em>P</em> &lt; <em>0.001</em>; LMR, HR=0.85, 95 % CI 0.82–0.881, <em>P</em> &lt; <em>0.001</em>).</div></div><div><h3>Conclusions</h3><div>Monocyte count, NLR, PLR, and SII increased the risk of epilepsy, whereas lymphocyte count and LMR decreased it. Further studies will help translate these findings into clinical practice or targeted treatments.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 9-16"},"PeriodicalIF":2.7,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479027","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":"Facial infiltrating lipomatosis with contralateral hemimegalencephaly","authors":"Hongrui Chen ,&nbsp;Bin Sun ,&nbsp;Chen Hua ,&nbsp;Xiaoxi Lin","doi":"10.1016/j.seizure.2024.10.010","DOIUrl":"10.1016/j.seizure.2024.10.010","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 34-36"},"PeriodicalIF":2.7,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511659","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":"Neurological care and outcomes in a cohort of Canadian pregnant patients with epilepsy","authors":"Julien Hébert ,&nbsp;Sharon Ng ,&nbsp;Yajur Iyengar ,&nbsp;Sabrina S.-W. Chan ,&nbsp;John W. Snelgrove ,&nbsp;Esther Bui","doi":"10.1016/j.seizure.2024.10.001","DOIUrl":"10.1016/j.seizure.2024.10.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize anti-seizure medication (ASM) use over time, therapeutic drug monitoring, ASM dose adjustments and gestational seizure frequency among Canadian people with epilepsy of childbearing potential seen in an urban tertiary care center.</div></div><div><h3>Methods</h3><div>Participants were retrospectively identified from the medical records of pregnant patients with epilepsy seen at the University Health Network Comprehensive Epilepsy Program between 2014 and 2021. A descriptive analysis of outcomes, a logistic regression analysis of the odds of patients being on three ASMs associated with higher rates of teratogenicity (i.e., valproate, carbamazepine, and topiramate) over time, and a second logistic regression for predictors of seizure freedom during pregnancy were performed.</div></div><div><h3>Results</h3><div>195 pregnancies were included: 52 % had a maternal diagnosis of generalized epilepsy and 92 % were prescribed at least one ASM, with 75 % on monotherapy. The majority underwent therapeutic drug monitoring (77 %) with approximately two-thirds requiring dose adjustments (69 %), typically dosage increases (82 %). The proportion of patients on either valproate, topiramate, or carbamazepine decreased over time (OR=0.80; <em>p</em> <em>&lt;</em> <em>0.01</em>). Fifty-seven percent of pregnancies maintained seizure freedom, with seizure-freedom for ≥1 year prior to conception being the strongest predictor of this outcome (OR of gestational seizure recurrence=0.04; <em>p</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>The proportion of patients on three ASMs associated with higher rates of teratogenicity has decreased over the duration of this study. Seizure-freedom prior to conception was associated with a decreased risk of gestational seizure recurrence.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 60-65"},"PeriodicalIF":2.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593545","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}