Seizure-European Journal of Epilepsy最新文献

{"title":"The current clinical practice and experiences in buccal midazolam prescribing in community for status epilepticus termination in the United Kingdom: The Rescue Epilepsy Medication and Training (REMIT) study","authors":"Audrey McBride ,&nbsp;Lance Watkins ,&nbsp;Samuel Tromans ,&nbsp;Paraskevi Triantafyllopoulou ,&nbsp;Paul Basset ,&nbsp;Phil Tittensor ,&nbsp;Caryn Jory ,&nbsp;Rohit Shankar","doi":"10.1016/j.seizure.2024.12.022","DOIUrl":"10.1016/j.seizure.2024.12.022","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy is one of the commonest neurological conditions worldwide and confers a significant mortality risk, partly driven by status epilepticus (SE). Terminating SE is the goal of pharmaceutical rescue therapies. This survey evaluates UK-based healthcare professionals’ clinical practice and experience in community-based rescue therapy prescribing.</div></div><div><h3>Methods</h3><div>A cross-sectional, 21 item questionnaire composed of Likert-style and free-text based questions was administered online. It was distributed through a non-discriminative snow-balling methodology to members of the Epilepsy Specialist Nurses’ Association (ESNA) and the British International League Against Epilepsy (ILAE). Quantitative analysis used Chi-squared, Fishers’ exact and Mann-Whitney tests. Qualitative data were analysed through NVivo 14 software, following Braun and Clarke methodology.</div></div><div><h3>Results</h3><div>86 participants comprising of nurses (<em>n</em> = 64) and doctors (<em>n</em> = 21) responded. Participants’ responses reflected guideline-concordant use of emergency management plans and buccal midazolam (BM) as a first-choice therapy for terminating tonic-clonic seizures in SE. However, significant variation (<em>P &lt;</em> 0.05) was found between doctors and nurses in prescribing practices of BM including maximum dose prescribed/day, withdrawal plans and the use in multimorbid patients. Eight themes were identified with some suggestive of concerns of overuse, misuse and abuse of BM by patients/carers.</div></div><div><h3>Conclusion</h3><div>This is the first study to give insights to community management of SE using rescue therapies particularly BM. Further evidence-based guidelines are needed for BM use in multimorbid patients and for its deprescribing. Robust safeguarding protocols and vigilance is needed to regulate BM's misuse and abuse potential. Oncoming community-based technology could provide objective assurance for evidencing utility of rescue medications.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 62-72"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985246","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 between anti-seizure medications and cardiac arrhythmias in patients undergoing ambulatory electroencephalographic and electrocardiographic monitoring","authors":"Francis J. Ha ,&nbsp;Ewan S. Nurse ,&nbsp;Vanessa Di Tano ,&nbsp;Duron Prinsloo ,&nbsp;Hariharan Sugumar ,&nbsp;Elizabeth D. Paratz ,&nbsp;Mark J. Cook","doi":"10.1016/j.seizure.2025.01.009","DOIUrl":"10.1016/j.seizure.2025.01.009","url":null,"abstract":"<div><div><em>Background</em> Anti-seizure medications (ASMs) are commonly prescribed in epilepsy. However some have been associated with adverse cardiac outcomes including cardiac arrhythmias.</div><div><em>Methods</em> We conducted an observational study evaluating patients aged ≥16 years undergoing ambulatory video – electroencephalographic (EEG) – electrocardiographic (ECG) monitoring (AVEEM) between 2020 and 2023 in Australia. Data collected included baseline demographics, type, number and dose of ASMs and cardiac arrhythmias during monitoring. ASMs were not withdrawn while monitored. Average QT interval was calculated and corrected for heart rate (QTc). Logistic regression was used to evaluate association between demographic variables, ASMs and cardiac arrhythmias.</div><div><em>Results</em> 3695 patients underwent AVEEM (median age 40 years [interquartile range 26–57], female 64 %). Median AVEEM duration was 6.8 days. 51 % of patients were taking ≥1 ASMs. About 28 % (1029/3695) patients had a cardiac arrhythmia; the most frequent was non-sustained SVT (19 %; 695/3695). On multivariable analysis, carbamazepine (OR 0.72, 95 %CI 0.53–0.98, <em>p</em> = 0.03), lamotrigine (OR 0.57, 95 %CI 0.44–0.73, <em>p</em>&lt;0.001) and lacosamide (OR 0.63, 95 %CI 0.43–0.92, <em>p</em> = 0.02) were associated with fewer cardiac arrhythmias. Their association with cardiac arrhythmias was not dose-dependent. No commonly-prescribed ASMs were associated with increased risk of cardiac arrhythmias. There was no significant association between use of ASMs and dynamic QTc interval change.</div><div><em>Conclusions</em> Certain ASMs, namely carbamazepine, lamotrigine and lacosamide, were associated with fewer cardiac arrhythmias and this association was not dose-dependent. No other ASM was associated with cardiac arrhythmias. Further large clinical prospective studies are needed to confirm these findings and to clarify the mechanism for any potential antiarrhythmic properties of ASMs.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 113-117"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014970","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 value of saliva therapeutic drug monitoring of newer antiseizure medications","authors":"Eva Choong ,&nbsp;Paola Vassallo ,&nbsp;Irene Aícua-Rapún ,&nbsp;Camille Stampfli ,&nbsp;Pascal André ,&nbsp;Andrea O. Rossetti ,&nbsp;Thierry Buclin ,&nbsp;Jan Novy ,&nbsp;Laurent A. Decosterd","doi":"10.1016/j.seizure.2025.01.013","DOIUrl":"10.1016/j.seizure.2025.01.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Saliva is a promising option for therapeutic drug monitoring, with studies since the 1970s indicating a good correlation between plasma and saliva levels for early anti-seizure medications, although limited data exist for newer generation drugs.</div></div><div><h3>Objectives</h3><div>To evaluate the reliability and predictive power of saliva as a minimally invasive surrogate marker of plasma concentration for the routine therapeutic drug monitoring (TDM) of newer anti-seizure medications (ASM).</div></div><div><h3>Methods</h3><div>We collected blood samples at steady state in patients at least 6 h post-dose, paired with unstimulated saliva samples. We evaluated the correlation between plasma and saliva drug levels and the positive and negative predictive value for plasma values extrapolation from saliva levels. A very low saliva level was defined as below half the plasma lower reference limit.</div></div><div><h3>Results</h3><div>294 adult patients (53 % male) with a mean age of 40 (SD: 16) were enrolled and 589 paired saliva-plasma samples were quantified. The highest significant correlations between saliva and plasma were observed for zonisamide (R²: 0.92) perampanel (0.91), brivaracetam (0.87), followed by topiramate, lamotrigine, lacosamide (0.76–0.68), and rufinamide, levetiracetam, pregabalin (0.63–0.55). No significant correlation was found for the active mono-hydroxy derivative of oxcarbazepine. Despite a good correlation coefficient, the correlations between saliva and plasma levels were generally loose, resulting in a broad predicted range of plasma levels for a given saliva level. Nonetheless, very low saliva levels exhibited strong specificity in predicting low plasma levels, with 87 % to 100 % accuracy, and when saliva levels fell below the limit of quantification, all corresponding plasma levels were below reference ranges.</div></div><div><h3>Conclusions</h3><div>This large newer ASM paired plasma-saliva collection allows to precise the potential use of saliva in the management of epilepsy, especially for commonly used ASM such as lamotrigine and levetiracetam. Although they correlate well, extrapolating plasma levels from saliva samples is still an imprecise approximation, making it inadequate for fine dosage adjustments. Yet, a very low saliva level has an appreciable discriminative ability for low plasma level. Unstimulated saliva represents a convenient non-invasive alternative to plasma, to readily identify compliance issues or major drug-drug interactions.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 106-112"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015008","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":"Investigating the frequency of neural autoantibodies in refractory focal epilepsy","authors":"Lisa Gillinder ,&nbsp;Donald Craig ,&nbsp;Tamara Powell ,&nbsp;Stephen Walsh ,&nbsp;John Phamnguyen ,&nbsp;Ian Wilson ,&nbsp;Xiaohua Chen ,&nbsp;David Gillis ,&nbsp;Pamela McCombe","doi":"10.1016/j.seizure.2025.01.007","DOIUrl":"10.1016/j.seizure.2025.01.007","url":null,"abstract":"<div><h3>Objectives</h3><div>There have been conflicting reports about the frequency of neural autoantibodies in epilepsy cohorts, which is confounded by the lack of clear distinction of epilepsy from acute symptomatic seizures due to encephalitis. The aim of this study was to determine the frequency of neural autoantibodies in a well characterised population of refractory focal epilepsy of known and unknown cause.</div></div><div><h3>Methods</h3><div>Cases were recruited from epilepsy outpatient clinics at the Princess Alexandra, Mater, Royal Brisbane and Women's and Cairns Base Hospitals from 2021 – 2023. Included cases were refractory to medical therapy, met the ILAE definition of focal epilepsy and were characterised using anatomo-electro-clinical correlation. Cases with prior encephalitis, inflammatory neurological disease or prior parenchymal brain insults were excluded.</div></div><div><h3>Results</h3><div>A total of 100 patients were recruited. No cases with clinically significant neural autoantibodies were discovered. One was positive for serum anti-NMDAR antibodies, however autoantibodies were absent from CSF. Cases were also screened using a predictive score (McGinty et al.). From this, 2 cases were identified as seronegative autoimmune associated epilepsy and demonstrated significant reduction in seizure frequency with administration of immunotherapy. These cases had common features including temporo-perisylvian semiology especially ictal piloerection and high seizure frequency.</div></div><div><h3>Conclusion</h3><div>Clinically relevant neural autoantibodies are uncommon in well characterised chronic focal epilepsy populations. Despite this there are isolated cases that still demonstrate improved seizure control with the use of immunotherapy. Such cases highlight the need for further studies to understand the role of immunity in novel pathophysiological mechanisms in epilepsy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 73-78"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015096","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":"Ventricular tachycardia induced by adrenocorticotropic hormone therapy in infantile epileptic spasms syndrome: A case report","authors":"Hirokazu Takeuchi ,&nbsp;Reiko Koichihara ,&nbsp;Akiharu Omori ,&nbsp;Rikako Takeda ,&nbsp;Yuko Hirata ,&nbsp;Ryuki Matsuura ,&nbsp;Kenjiro Kikuchi ,&nbsp;Kenji Hoshino ,&nbsp;Shin-ichiro Hamano","doi":"10.1016/j.seizure.2025.01.014","DOIUrl":"10.1016/j.seizure.2025.01.014","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 84-86"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015103","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":"Utilizing natural language processing to identify pediatric patients experiencing status epilepticus","authors":"Molly Ann Puckett ,&nbsp;Fatemeh Mohammad Alizadeh Chafjiri ,&nbsp;Jennifer V. Gettings ,&nbsp;Assaf Landschaft ,&nbsp;Tobias Loddenkemper","doi":"10.1016/j.seizure.2025.01.008","DOIUrl":"10.1016/j.seizure.2025.01.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Compare the identification of patients with established status epilepticus (ESE) and refractory status epilepticus (RSE) in electronic health records (EHR) using human review versus natural language processing (NLP) assisted review.</div></div><div><h3>Methods</h3><div>We reviewed EHRs of patients aged 1 month to 21 years from Boston Children's Hospital (BCH). We included all patients with convulsive ESE or RSE during admission. We employed and validated a pre-trained NLP tool, Document review Tool (DrT), to identify patients from 2013–2020, excluding training years (2017–2019). DrT notes a machine-learning score based on a support vector machine (SVM) and bag-of-n-grams. Higher scores indicated more likely ESE/RSE cases. To further evaluate the effectiveness of DrT-assisted review, we compared the results to human-reviewed notes from the pediatric Status Epilepticus Research Group (pSERG) consortium at BCH.</div></div><div><h3>Results</h3><div>The pre-trained algorithm identified 170 patients with RSE using DrT (Sensitivity: 98.8%), compared to 116 patients identified during human review (Sensitivity: 67.4%). Additionally, we identified 207 patients with ESE using DrT (Sensitivity: 99.5%), compared to 91 patients identified using human review (Sensitivity: 43.8%). Overall, DrT missed 3 cases (2 RSE and 1 ESE cases) that were identified during human review and identified 173 cases (56 RSE and 117 ESE cases) that were not found during the human review.</div></div><div><h3>Conclusion</h3><div>DrT-assisted manual review demonstrated higher sensitivity in identifying patients with ESE and RSE than the current standard of human review. This suggests that in contexts characterized by resource constraints NLP-related software like DrT can considerably enhance patient identification for research studies, treatment protocols, and preventative care interventions.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 54-61"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972904","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":"Higher plasma total tau concentrations among patients reporting CNS-related side effects from antiseizure medication","authors":"Klara Andersson ,&nbsp;Sarah Akel ,&nbsp;Fredrik Asztély ,&nbsp;David Larsson ,&nbsp;Henrik Zetterberg ,&nbsp;Johan Zelano","doi":"10.1016/j.seizure.2025.01.015","DOIUrl":"10.1016/j.seizure.2025.01.015","url":null,"abstract":"<div><h3>Background</h3><div>Side effects from antiseizure medication (ASM) are common in epilepsy but biomarkers for detection and monitoring are missing. This study investigated associations between CNS-related side effects from ASM and blood concentrations of the brain injury markers neurofilament-light (NFL), total tau, glial acidic fibrillary protein (GFAP), S100 calcium-binding protein B (S100B) and neuron-specific enolase (NSE).</div></div><div><h3>Methods</h3><div>This is a population-based cohort study of adults with epilepsy recruited from five Swedish outpatient neurology clinics from December 2020 to April 2023. Side effects classified as CNS-related: tiredness, dizziness, headache, concentration, memory, mood, motor/tremor, or sleep. Marker concentrations in the groups CNS side effects/no side effects were analyzed with Mann-Whitney U-test and significant differences were included in multivariable logistic regression models adjusting for age, epilepsy duration, seizure status, acquired structural lesion, and mono-/polytherapy.</div></div><div><h3>Results</h3><div>The cohort consisted of 367 patients, 187 (51 %) were females, the median age was 43 years (IQR 30–61), and 123 (34 %) reported CNS side effects. Total tau was higher among participants reporting CNS side effects (median 4.44 (95 %CI 4.12–4.88) pg/ml) compared with participants without side effects (3.84 (95 %CI 3.52–4.07) pg/ml, <em>p</em> &lt; 0.01). The difference remained significant in multivariable regression models. NSE was higher among participants without side effects but did not remain significant in the multivariable regression model. No differences were observed for NFL, GFAP or S100B.</div></div><div><h3>Conclusions</h3><div>Higher total tau plasma concentration could be associated with increased risk of CNS side effects from ASM. Longitudinal studies could determine if this reflects vulnerability or detrimental effects of ASM. Trial registration: PREDICT, clinicaltrials.gov identifier NCT04559919.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 99-105"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015093","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":"Validation of the Chinese version of the Epilepsy Anxiety Survey Instrument (EASI) and its brief version (brEASI) in Western China","authors":"Chenshi Liu ,&nbsp;Lan Mou ,&nbsp;Yuwen Zhang ,&nbsp;Mingming Zhang ,&nbsp;Ping Yang ,&nbsp;Shuai Ma ,&nbsp;Min Zhang ,&nbsp;Jie Huang ,&nbsp;Xiaoqiang Xiao ,&nbsp;Jie Liu","doi":"10.1016/j.seizure.2025.01.004","DOIUrl":"10.1016/j.seizure.2025.01.004","url":null,"abstract":"<div><h3>Objective</h3><div>To translate and validate the Chinese version of the Epilepsy Anxiety Survey Instrument (EASI) and its brief version (brEASI) among Chinese people with epilepsy.</div></div><div><h3>Methods</h3><div>Adult outpatients from Sichuan Provincial People's Hospital were recruited. The type of anxiety disorder was determined via the Mini International Neuropsychiatric Interview (MINI). All patients completed the Chinese version of the Generalized Anxiety Disorders-7 (GAD-7), the Chinese version of the Neurological Disorders Depression Inventory for Epilepsy (C-NDDIE), and the EASI/brEASI. Cronbach's α coefficient was calculated, and receiver operating characteristic (ROC) curves were analyzed.</div></div><div><h3>Results</h3><div>A total of 110 patients with epilepsy were included. Twenty-six (23.6 %) patients were found to have anxiety disorder according to the MINI criteria. The Cronbach's α coefficient for the Chinese brEASI was 0.873. In the study, the AUC of the brEASI for detecting all anxiety disorders was 0.883, and the optimal cutoff score was &gt; 7, with a sensitivity of 92.3 % and a specificity of 72.6 %. For the diagnosis of non-GAD disorders, the brEASI had a greater AUC (0. 886) and performed better than the GAD-7 (AUC = 0. 824).</div></div><div><h3>Conclusion</h3><div>The Chinese version of the EASI and brEASI may be reliable and superior to the GAD-7 for anxiety screening in patients with epilepsy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 87-93"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015101","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":"A non-inferiority randomized controlled study of Perampanel versus Oxcarbazepine monotherapy for post-stroke epilepsy","authors":"Cuihua Yan ,&nbsp;Jing Liu ,&nbsp;Jing Jiang ,&nbsp;Yanping Sun ,&nbsp;Juan Chen ,&nbsp;Kunkun Wei ,&nbsp;Xiaoyun Liu ,&nbsp;Qi Xiang ,&nbsp;Anru Liu ,&nbsp;Yuxiang Han ,&nbsp;Liling Yang ,&nbsp;Tao Han ,&nbsp;Xuewu Liu","doi":"10.1016/j.seizure.2025.01.016","DOIUrl":"10.1016/j.seizure.2025.01.016","url":null,"abstract":"<div><h3>Background</h3><div>Post-stroke epilepsy (PSE) poses a significant challenge despite advances in stroke treatment. This study compares the efficacy of the novel anti-seizure medication (ASM) Perampanel with the classical ASM Oxcarbazepine in treating PSE.</div></div><div><h3>Methods</h3><div>This prospective randomized controlled trial recruited PSE patients from September 2022 to January 2024 across multiple hospitals. Patients were randomly assigned to receive either Perampanel or Oxcarbazepine monotherapy. Baseline seizure frequency was measured over three months prior to treatment. Efficacy was assessed at six months, with <em>a</em> ≥ 50 % reduction in seizure frequency deemed effective. Perampanel was considered non-inferior to Oxcarbazepine if its lower 95 % confidence limit for efficacy was above 80 % of Oxcarbazepine's six-month seizure freedom rate. Intention-to-treat analysis and Kaplan-Meier methods evaluated retention rates and side effects.</div></div><div><h3>Results</h3><div>A total of 67 patients were included in this study: 33 patients in the Perampanel group (26 males, 78.8 %; 7 females, 21.2 %) and 34 patients in the Oxcarbazepine group (26 males, 76.5 %; 8 females, 23.5 %). There were no statistically significant differences in the baseline data between the two groups. This indicates that the groups are comparable. Treatment efficacy was 75.0 % and 78.8 % in the Perampanel and Oxcarbazepine groups at three months, and 80.6 % and 75.0 % at six months, respectively. At six months, the lower limit of the 95 % confidence interval for efficacy in the Perampanel group was higher than the prespecified non-inferiority threshold, indicating that Perampanel was noninferior than Oxcarbazepine. The rates of drug retention and adverse effects were similar in the two groups, with no statistically significant difference (<em>P</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Perampanel is noninferior to Oxcarbazepine and is considered a good option for the management of post-stroke epilepsy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 172-178"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029956","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 relationship between attitudes toward epilepsy and health literacy in Turkey: The mediating role of epilepsy knowledge","authors":"Emre Erkal","doi":"10.1016/j.seizure.2025.01.017","DOIUrl":"10.1016/j.seizure.2025.01.017","url":null,"abstract":"<div><h3>Objective</h3><div>This study determined the mediating role of knowledge about epilepsy in the relationship between attitudes toward epilepsy and health literacy in Turkey.</div></div><div><h3>Methods</h3><div>This descriptive and cross-sectional study was conducted in Turkey with 4,393 participants. The sociodemographic form, Epilepsy Attitude Scale, Epilepsy Knowledge Scale, and Health Literacy Scale were used for data collection.</div></div><div><h3>Results</h3><div>The participants’ mean attitude score was 57.05 ± 10.15, mean knowledge score was 7.70 ± 4.22, and mean health literacy score was 51.95 ± 9.61. Health literacy scores significantly predicted attitude (β = 0.498) and knowledge (β = 0.382) scores (<em>p</em> &lt; 0.05). Knowledge scores significantly predicted attitude scores (β = 0.529; <em>p</em> &lt; 0.05). However, health literacy (β = 0.346) and knowledge scores (β = 0.397) together significantly predicted attitude scores (<em>p</em> &lt; 0.05). The knowledge score has a mediating role between health literacy and attitude score (β = 0.152; <em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Individuals had relatively positive attitudes toward epilepsy and moderate levels of knowledge and health literacy. Health literacy positively affected knowledge and attitude towards epilepsy. However, knowledge about epilepsy also positively affected attitude. Additionally, health literacy and knowledge of epilepsy together positively affected attitudes toward epilepsy. Knowledge about epilepsy mediated the relationship between health literacy and attitude toward epilepsy. In this context, it is recommended that programs to raise awareness and improve health literacy be organized, social sensitivity should be increased, and additional epilepsy research should be conducted.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 186-191"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043075","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}