Seizure-European Journal of Epilepsy最新文献

{"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}

{"title":"Comparative analysis of clinical phenotypes and genetic characteristics in MEF2C-associated neurodevelopmental disorders","authors":"Xin Li ,&nbsp;Jia-Jun Ma ,&nbsp;Lin-Xue Meng ,&nbsp;Zi-Yao Han ,&nbsp;Qin-Lan Li ,&nbsp;Xiao-Yue Yang ,&nbsp;Ling-Ling Xie ,&nbsp;Li Jiang","doi":"10.1016/j.seizure.2025.12.003","DOIUrl":"10.1016/j.seizure.2025.12.003","url":null,"abstract":"<div><h3>Background</h3><div>Myocyte enhancer factor 2C (<em>MEF2C</em>) is among the important genes associated with neurodevelopmental disorders (NDDs). The phenotypic distinctions between <em>MEF2C</em> pathogenic variants and 5q14.3 microdeletions remain unclear.</div></div><div><h3>Methods</h3><div>We retrospectively collected the information of patients from our centre between May 2019 and October 2024 and identified them as having <em>MEF2C</em> mutations by whole-exome sequencing (WES). We searched the literature related to <em>MEF2C</em> mutations and 5q14.3 microdeletions and summarized the clinical features and genetic characteristics of the patients.</div></div><div><h3>Results</h3><div>Five patients with <em>MEF2C</em> mutations were identified from our hospital, and 34 articles were selected for analysis. Data from 62 <em>MEF2C</em>-associated copy number variations (CNVs) and 42 <em>MEF2C</em> mutations were analysed. We found that regression was more common in the mutation group (21.6 %, 8/37) than in the CNV group (2.0 %, 1/51; <em>P</em> = 0.008). Patients with mutations in <em>MEF2C</em> were more likely to present with a history of febrile seizures (45.2 % vs. 25.8 %, <em>P</em> = 0.040) and autistic traits (91.9 % vs. 74.5 %, <em>P</em> = 0.037). Myoclonic seizures (29.4 % vs. 70.6 %, <em>P</em> = 0.025), infantile epileptic spasm syndrome (3.3 % vs. 31.8 %, <em>P</em> = 0.018), refractory epilepsy (11.1 % vs. 47.8 %, <em>P</em> = 0.012), diffuse epileptiform discharges from electroencephalograms (15.0 % vs. 42.9 %, <em>P</em> = 0.2) and abnormal corpus callosum (23.1 % vs. 55.9, <em>P</em> = 0.06) may occur more often in the CNV group.</div></div><div><h3>Conclusion</h3><div>Patients with CNVs presented a higher prevalence of refractory epilepsy and vascular malformations, whereas those with point mutations more frequently presented with developmental regression, febrile seizure history and autistic traits. These genotype–phenotype correlations could inform genetic testing strategies.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"134 ","pages":"Pages 152-164"},"PeriodicalIF":2.8,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145748756","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":"History of lennox-gastaut syndrome: Sixty years of advancements in therapeutic practices","authors":"Philippe Gélisse ,&nbsp;Arielle Crespel ,&nbsp;Pierre Genton ,&nbsp;Charlotte Dravet","doi":"10.1016/j.seizure.2025.12.004","DOIUrl":"10.1016/j.seizure.2025.12.004","url":null,"abstract":"<div><div>Lennox-Gastaut Syndrome (LGS) is a severe, lifelong form of epileptic encephalopathy that presents significant treatment challenges. The management of LGS remains primarily symptomatic. Historically, the effectiveness of traditional antiseizure medications (ASMs) has been limited, prompting practitioners to explore off-label treatments and anecdotal drugs, including medications not originally intended for epilepsy. Although some controlled clinical trials have been conducted, LGS management often remains empirical and largely dependent on clinical experience. Recent advances in ASMs and adjunctive therapies have enhanced patient outcomes, yet LGS remains one of the most treatment-resistant forms of epilepsy, with complete seizure control rarely being achieved. Beyond ASMs, interventions such as a ketogenic diet, vagus nerve stimulation, and callosotomy may be considered based on individual patient needs. Recent developments in deep brain stimulation have also presented promising new therapeutic options. This article aims to provide a comprehensive overview of both pharmacological and non-pharmacological treatment strategies for LGS, tracing progress from the syndrome's first description in 1966 to the current management approaches.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"134 ","pages":"Pages 165-172"},"PeriodicalIF":2.8,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145748755","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":"Characterizing vascular tone in nocturnal major motor seizures using wearable photoplethysmography","authors":"Mohammad Shahbakhti ,&nbsp;Anemoon T. Bosch ,&nbsp;Xi Long ,&nbsp;Johannes P. van Dijk ,&nbsp;Roland D. Thijs","doi":"10.1016/j.seizure.2025.12.001","DOIUrl":"10.1016/j.seizure.2025.12.001","url":null,"abstract":"<div><h3>Objective:</h3><div>The impact of seizures on the peripheral vascular system has not been well studied. Here, we used wearable photoplethysmography (PPG) to characterize peripheral vascular tone dynamics in children with refractory epilepsy.</div></div><div><h3>Methods:</h3><div>We used data from the PROMISE trial, which included children aged 4–16 years with nocturnal major motor seizures. We selected continuous 10-minute PPG segments, each spanning the seizure-free baseline, pre-ictal, ictal, and post-ictal phases. The amplitude modulation (AM) of the PPG signal, representing the slow variation in pulse amplitude and serving as a proxy for relative blood volume, was analyzed to characterize peripheral vascular tone. We applied a linear mixed-effects model to compare the AM across pre-ictal, ictal, and post-ictal phases relative to the baseline.</div></div><div><h3>Results:</h3><div>We studied 135 seizure events from 13 children (42% female; mean age: 9.7 <span><math><mo>±</mo></math></span> 3.6 years). Our analysis revealed a significant AM decrease during the pre-ictal phase (<span><math><mrow><mi>p</mi><mo>&lt;</mo><mn>0</mn><mo>.</mo><mn>05</mn></mrow></math></span>), with a more pronounced decrease during the ictal and post-ictal phases (<span><math><mrow><mi>p</mi><mo>&lt;</mo><mn>0</mn><mo>.</mo><mn>001</mn></mrow></math></span>) relative to the baseline.</div></div><div><h3>Significance:</h3><div>Seizures impact peripheral vascular tone with signs of vasoconstriction that persists into the post-ictal phase.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"134 ","pages":"Pages 186-189"},"PeriodicalIF":2.8,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145796920","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}