Seizure-European Journal of Epilepsy最新文献

{"title":"The path to post-traumatic epilepsy: A review of emerging biomarkers and therapeutic targets","authors":"Soheil M. Yazdi ,&nbsp;Andres Jimenez- Gomez ,&nbsp;Alica Goldman ,&nbsp;Spyridoula Tsetsou","doi":"10.1016/j.seizure.2025.10.021","DOIUrl":"10.1016/j.seizure.2025.10.021","url":null,"abstract":"<div><h3>Background</h3><div>Post-traumatic epilepsy (PTE) is a common, disabling sequela of traumatic brain injury (TBI), contributing to long-term morbidity. Short-term antiseizure prophylaxis reduces early provoked seizures, but no interventions prevent late unprovoked seizures or PTE. This gap arises from limited understanding of underlying mechanisms.</div></div><div><h3>Objective</h3><div>This review synthesizes PTE pathophysiology and emerging mechanism-based prevention strategies, emphasizing a shift from reactive management to personalized prophylaxis.</div></div><div><h3>Evidence Synthesis</h3><div>PTE develops via epileptogenesis—a latent, multifactorial process distinct from acute seizure triggers—involving chronic neuroinflammation (e.g., IL-1β, NLRP3 pathways), blood-brain barrier dysfunction, maladaptive gliosis with glutamate dysregulation, and aberrant plasticity (e.g., mTOR signaling, interneuron loss). These insights identify targets for intervention. Promising repurposed agents include IL-1 receptor antagonists (anakinra), mTOR inhibitors (rapamycin), and glutamate modulators (ceftriaxone), with preclinical data showing reduced seizure burden. Predictive biomarkers (neuroimaging, EEG, cytokines, microRNAs) are essential for risk stratification in prophylactic trials.</div></div><div><h3>Conclusions</h3><div>The field is pivoting toward disease prevention through targeted therapies and precision medicine. Translating these advances could yield the first PTE-preventive treatment, altering TBI outcomes for survivors.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"133 ","pages":"Pages 195-201"},"PeriodicalIF":2.8,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446311","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":"Cardiac safety of low-dose ACTH therapy in infantile spasms: Evidence from electrocardiography and advanced echocardiography","authors":"Borakay Dilek ,&nbsp;Saylan Cevik Berna ,&nbsp;Unver Olcay ,&nbsp;Doganci Demet Deniz ,&nbsp;Gunes Sager Safiye ,&nbsp;Turkdogan Dilsad","doi":"10.1016/j.seizure.2025.10.020","DOIUrl":"10.1016/j.seizure.2025.10.020","url":null,"abstract":"<div><h3>Objective</h3><div>Infantile epileptic spasms syndrome (IESS) is a catastrophic epileptic encephalopathy of infancy. While adrenocorticotropic hormone (ACTH) remains the most effective first-line therapy, its cardiac safety profile, particularly at low doses, has not been systematically evaluated. This study aimed to investigate the effects of low-dose ACTH therapy on cardiac conduction and function using electrocardiography (ECG) and advanced echocardiography.</div></div><div><h3>Methods</h3><div>This prospective controlled study included 24 infants with IESS and 24 age- and sex-matched healthy controls. All patients received low-dose ACTH (Synacthen® Depot, intramuscular; 0.5 mg/kg if &lt; 10 kg, 1 mg/kg if ≥ 10 kg; 18 injections over 8 weeks). Serial 12-lead ECGs and echocardiographic assessments, including M-mode, Doppler, tissue Doppler imaging (TDI), and speckle-tracking strain, were performed at baseline and at 2, 4, and 6 months. Controls underwent single baseline assessments.</div></div><div><h3>Results</h3><div>No patient developed overt arrhythmia or hypertension during treatment. However, ECG analysis revealed progressive prolongation of PR, QRS, QT, QTc, Tp–Te, and Tp–Te-related ratios (p &lt; 0.001). Echocardiography demonstrated significant increases in LVEDD, LVESD, LV mass, and MPI, with impaired diastolic relaxation and progressive deterioration of longitudinal and circumferential strain (p &lt; 0.05). Subgroup analyses showed no significant differences among genetic, hypoxic-ischemic, and hypoxia-related etiologies.</div></div><div><h3>Conclusion</h3><div>Even short-term, low-dose ACTH therapy is associated with subclinical conduction abnormalities and myocardial dysfunction in IESS patients. Routine cardiac monitoring, including advanced imaging modalities, should be integrated into ACTH protocols. Multidisciplinary management and larger multicenter studies are warranted to clarify the long-term cardiovascular implications of ACTH therapy in IESS.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"133 ","pages":"Pages 268-274"},"PeriodicalIF":2.8,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520657","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 intersection of epilepsy and assisted reproduction: A review of therapeutic approaches and considerations","authors":"Banafsheh Mohammadi ,&nbsp;Jafar Mehvari ,&nbsp;Navid Naghibi ,&nbsp;Nasim Tabrizi","doi":"10.1016/j.seizure.2025.10.019","DOIUrl":"10.1016/j.seizure.2025.10.019","url":null,"abstract":"<div><h3>Objective</h3><div>Women with epilepsy (WWE) have unique reproductive problems due to interactions among seizures, antiseizure medications (ASMs), and endocrine changes. These interactions can cause infertility, menstrual dysfunction, and an increased risk for reproductive endocrine disorders. Assisted reproductive technologies (ART), offer a hope for WWE seeking pregnancy but raise questions about seizure control, drug interactions, and pregnancy outcomes. This review aims to discuss the challenges associated with the use of ART in WWE.</div></div><div><h3>Methods</h3><div>A narrative review was conducted through PubMed, MEDLINE, and ISI Web of Science. Inclusion criteria were original research, cohort studies, case series, randomized trials, and systematic reviews incorporating ART outcomes, ASM interactions, and hormonal therapies in WWE. Animal studies and abstracts without full text available were excluded.</div></div><div><h3>Results</h3><div>The data about the use, most appropriate protocols and success rate of ART in WWE is scarce. Current findings suggest that ART is effective in WWE, with live birth rates comparable to those of women without epilepsy. Most WWE with well-controlled epilepsy have seizure stability during ART, but sporadic cases of seizure worsening, have been reported. ART hormonal treatments can interact with ASMs, necessitating therapeutic drug level monitoring and dose adjustment, especially for lamotrigine. Enzyme-inducing ASMs can reduce the efficacy of hormonal treatments, requiring augmented doses of progesterone for luteal support. WWE remain at higher risk of pregnancy complication, but ART does not yet appear to contribute to these risks when appropriately managed.</div></div><div><h3>Conclusion</h3><div>Based on the limited current studies, ART might be an acceptable and safe fertility treatment for WWE, provided that seizure control is optimized and ASM-hormone interactions are carefully managed. ASM choice, therapeutic drug monitoring, and multidisciplinary care need to be tailored to maximize reproductive and neurological outcomes. Frozen embryo transfer protocols and progestin-only contraception may also enhance safety. Continued research and clinical monitoring are needed to further develop management strategies and long-term outcomes in WWE undergoing ART.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"133 ","pages":"Pages 219-223"},"PeriodicalIF":2.8,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460483","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":"Fragile balance: Managing bone health in people with intellectual disability and epilepsy, an english multi-site study","authors":"Rachel Menon ,&nbsp;Charlotte Young ,&nbsp;Madeline Dale ,&nbsp;Matthew Allen ,&nbsp;Joanne McCabe ,&nbsp;Sarah Badger ,&nbsp;Myles Appleyard ,&nbsp;Georgios Mousailidis ,&nbsp;Rachel Newman ,&nbsp;Caryn Jory ,&nbsp;Joanne Hammett ,&nbsp;Abigail Swift ,&nbsp;Coryn Jones ,&nbsp;Indermeet Sawhney ,&nbsp;Robert Winterhalder ,&nbsp;Lance Watkins ,&nbsp;Rohit Shankar","doi":"10.1016/j.seizure.2025.10.018","DOIUrl":"10.1016/j.seizure.2025.10.018","url":null,"abstract":"<div><h3>Background</h3><div>People with intellectual disability (ID) experience poorer health outcomes than the general population, with epilepsy and polypharmacy contributing to further risks. Bone health is a neglected area, despite the established association between antiseizure medications (ASMs), (especially those cautioned by the UK Medicines and Healthcare products Regulatory Agency (MHRA)), and reduced bone mineral density. We aimed to evaluate prescribing practices, fracture risk, and bone health management in adults with ID and epilepsy attending specialist ID services.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted across three English specialist ID epilepsy services between August 2021–August 2022. Data were collected from case-note review, including ASM prescribing, falls and fracture history, bone health monitoring, and protective treatments. Descriptive statistics, Chi-squared and Mann-Whitney U tests were conducted. Logistic regression was used to examine associations between ASM use and fracture risk.</div></div><div><h3>Results</h3><div>Of 484 adults analysed almost all (97%) were prescribed ≥1 ASM, with 18% receiving four or more and 63% receiving at least one MHRA-cautioned ASM. Over 25% on MHRA-cautioned ASMs had a history of fractures, yet 38% received no bone-protective treatment. Patients with severe-profound ID were prescribed significantly more ASMs than those with mild-moderate ID. Each additional ASM increased fracture risk by 37%, and each additional MHRA-cautioned ASM by 43%.</div></div><div><h3>Conclusions</h3><div>Adults with ID and epilepsy are frequently exposed to polypharmacy, including bone health–compromising ASMs, yet bone health monitoring and treatment remain suboptimal. Targeted strategies and ID-specific guidance are urgently required to reduce fracture risk and improve outcomes in this vulnerable group.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"133 ","pages":"Pages 189-194"},"PeriodicalIF":2.8,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439945","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":"Predictive factors for early post-stroke seizures in a Hispanic population","authors":"Kleber Mosquera Rodríguez ,&nbsp;María Álvarez Falcon ,&nbsp;Andy Reinoso","doi":"10.1016/j.seizure.2025.10.016","DOIUrl":"10.1016/j.seizure.2025.10.016","url":null,"abstract":"<div><h3>Introduction</h3><div>Post-stroke seizures complicate diagnosis and treatment, worsen neurological outcomes, increase the risk of recurrence, and hinder recovery. Evidence in Hispanic populations is limited, so this study provides relevant data for clinical contexts in Latin America.</div></div><div><h3>Objective</h3><div>To identify predictive factors for early-onset seizures after a cerebrovascular event in a Hispanic population.</div></div><div><h3>Methods</h3><div>A retrospective, observational, cross-sectional study was conducted at a tertiary care health institution in Ecuador during the period 2024. Adult patients with a confirmed diagnosis of cerebrovascular event were included, selected by non-probabilistic sampling. Cases with a history of epilepsy, different structural causes, ambiguous events, or incomplete clinical records were excluded. The diagnosis of seizures was based on clinical evaluation and complementary studies such as an electroencephalogram (EEG). Binary logistic regression (95 % CI, margin of error 0.05) was used to identify predictive factors.</div></div><div><h3>Results</h3><div>A total of 218 stroke patients were included, of whom 55 % (<em>n</em> = 120) had ischemic stroke and 45 % (<em>n</em> = 98) had hemorrhagic stroke. The average age was 62.9 years, and 65.6 % (<em>n</em> = 143) of the participants were men. Early post-stroke seizures occurred in 47.2 % (<em>n</em> = 103) of patients. Male sex showed a non-significant trend toward reduced seizure risk (Exp(B) = 0.524; adjusted <em>p</em> = 0.075), while diabetes mellitus was independently associated with an increased risk of seizures (Exp(B) = 3.542; adjusted <em>p</em> = 0.043). No significant associations were found with age, type of stroke, hypertension, history of previous stroke, or cortical involvement. Finally, hypertension was associated with a statistically significant delay in the time to onset of seizures after the cerebrovascular event (<em>U</em> = 1620; <em>p</em> = 0.015), with a median of 2 days (IQR: 1–3) in hypertensive patients.</div></div><div><h3>Conclusion</h3><div>Early seizures are a common post-stroke complication, particularly in women and patients with diabetes mellitus. This study, conducted in a Hispanic population, provides relevant evidence to improve management and prognosis in Latin American contexts. Early identification and management are crucial in reducing adverse outcomes.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"133 ","pages":"Pages 202-207"},"PeriodicalIF":2.8,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460456","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":"Electroencephalographic manifestations of intracranial hypertension in a patient with ventriculoperitoneal shunt malfunction","authors":"E. Bernardi ,&nbsp;V. Ros-Castelló ,&nbsp;M. Coronel-Coronel ,&nbsp;R. Lazzari ,&nbsp;J.A. Aibar-Durán ,&nbsp;A. Sierra-Marcos","doi":"10.1016/j.seizure.2025.10.017","DOIUrl":"10.1016/j.seizure.2025.10.017","url":null,"abstract":"<div><h3>Background</h3><div>Differentiating epileptic seizures from manifestations of intracranial pressure (ICP) fluctuations can be challenging in patients with a ventriculoperitoneal shunt (VPS). We report a case of intermittent VPS malfunction presenting with focal motor events initially misdiagnosed as refractory status epilepticus.</div><div>A 27-year-old man with childhood-onset hydrocephalus treated with a right VPS and a previous history of focal epilepsy—managed with levetiracetam, perampanel, and lacosamide—presented with increased seizure frequency and intermittent headaches. Initial treatment included continuous infusions of valproate, lacosamide, and levetiracetam under the presumption of status epilepticus. However, prolonged (15-hour) video-EEG monitoring during the clinical events showed diffuse delta activity with suppression of the background rhythm rather than ictal discharges. These EEG changes coincided with episodes of arterial hypertension, profound bradycardia (as low as 20 bpm), and papilledema on funduscopic examination. Revision of the shunt system resulted in complete resolution of symptoms and withdrawal of antiseizure medications.</div></div><div><h3>Conclusion</h3><div>Extended video-EEG monitoring can be a useful tool to distinguish epileptic seizures from paroxysmal manifestations of paroxysmal intracranial hypertension due to VPS malfunction.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"133 ","pages":"Pages 175-176"},"PeriodicalIF":2.8,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145418304","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":"Conventional clinical characteristics do not predict the result of genetic testing in adults with epilepsy","authors":"Wei Zhao ,&nbsp;Yi-Lee Ting ,&nbsp;Kaley J. Marcinski Nascimento ,&nbsp;Sarah R. Poll ,&nbsp;Daniel E. Pineda Alvarez ,&nbsp;M. Brandon Westover ,&nbsp;Fábio A. Nascimento","doi":"10.1016/j.seizure.2025.10.015","DOIUrl":"10.1016/j.seizure.2025.10.015","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Genetic testing in epilepsy has become increasingly available, and recommendations for its use have been set forth by professional society guidelines. The development of a user-friendly risk prediction model may aid providers in selecting adult patients with a high likelihood of receiving a positive genetic test result.</div></div><div><h3>Methods</h3><div>Adults who underwent multigene panel testing for epilepsy from March 2016 to June 2024 were divided into a training (<em>n</em> = 1449) and a testing set (<em>n</em> = 1450). We developed prediction models based on clinical characteristics using logistic regression and FasterRisk scores for positive genetic tests and evaluated their performance.</div></div><div><h3>Results</h3><div>The prediction models had poor discriminative power and failed to predict positive results, suggesting that conventional clinical characteristics (sex, intellectual disability, developmental delay, autism, medically refractory epilepsy, family history of epilepsy, and age at seizure onset) are insufficient for selecting patients for genetic testing.</div></div><div><h3>Discussion</h3><div>Our findings suggest that routine genetic testing may be broadly warranted for adults with unexplained epilepsy, as clinical characteristics alone appear unable to reliably identify which patients are likely to have positive results on multigene panels. Future models may benefit from incorporating physical exam findings, neuroimaging, and electroencephalogram data, as well as larger training sets.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"133 ","pages":"Pages 157-160"},"PeriodicalIF":2.8,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145364420","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":"Relationship between cortical tuber subtypes and interictal epileptiform discharges in tuberous sclerosis complex: MRI and scalp-EEG study","authors":"Masamune Kimura ,&nbsp;Masaya Togo ,&nbsp;Kento Matoba ,&nbsp;Mayumi Otani ,&nbsp;Kenji Sekiguchi ,&nbsp;Yosuke Fujimoto ,&nbsp;Koji Chiba ,&nbsp;Hiroaki Nagase ,&nbsp;Riki Matsumoto","doi":"10.1016/j.seizure.2025.10.014","DOIUrl":"10.1016/j.seizure.2025.10.014","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate association between magnetic resonance imaging (MRI)-defined cortical tuber subtypes and interictal epileptiform discharges (IEDs) in Tuberous sclerosis complex (TSC).</div></div><div><h3>Methods</h3><div>Twenty-three patients with TSC underwent brain MRI and scalp electroencephalogram (EEG). We analyzed total of 184 cerebral lobes (bilateral frontal, temporal, parietal, occipital). Tubers were classified into Types A, B, and C based on their signal intensity on MRI with T1-weighted (T1W), T2-weighted (T2W), and fluid-attenuated inversion recovery (FLAIR) images. Type A was isointense on T1W and subtly hyperintense on T2W/FLAIR, while Type B was hypointense on T1W and homogeneously hyperintense on T2W/FLAIR. Meanwhile, Type C was hypointense on T1W, hyperintense on T2W, and heterogeneous on FLAIR, characterized by a hypointense central region surrounded by a hyperintense rim. IEDs were detected using automated software and confirmed by expert visual inspection. The association between tuber subtypes and IED presence was assessed using multivariable generalized estimating equations (GEE). A negative binomial generalized linear mixed model (GLMM) was used to assess the association between tuber counts and IED frequency.</div></div><div><h3>Results</h3><div>Multivariable analyses revealed that Type C tubers were the only subtype independently associated with both the presence of IEDs (Adjusted odds ratio = 1.417, <em>p</em> = 0.011) and a higher frequency of IEDs (<em>p</em> &lt; 0.001). The presence or number of Type A and B tubers were not significantly associated with either outcome.</div></div><div><h3>Conclusions</h3><div>Type C tubers demonstrate significantly higher cortical irritability than other subtypes, providing insights into varying irritability potential of different tuber types in TSC.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"133 ","pages":"Pages 149-156"},"PeriodicalIF":2.8,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145364423","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":"Enhancing diagnostic yield in functional seizures: A narrative review, design and implementation of a novel ictal testing battery for video telemetry","authors":"Elisaveta Sokolov ,&nbsp;Rohan Kandasamy ,&nbsp;Michael Kinney ,&nbsp;Nigel Lyttle ,&nbsp;Mahinda Yogarajah ,&nbsp;Beate Diehl","doi":"10.1016/j.seizure.2025.10.012","DOIUrl":"10.1016/j.seizure.2025.10.012","url":null,"abstract":"<div><div>Evaluation of behavioural impairment during functional seizures (FS) is critical for medical decision making, including accurate diagnosis, and future management recommendations. To date this type of behavioural evaluation in the setting of FS in an inpatient telemetry unit has not been closely reviewed. Here we perform a narrative review of the literature examining ictal testing and how best to improve diagnostic yield in the context of FS. We propose a novel ictal testing battery to obtain the most pertinent clinical information in people with functional seizures (PWFS). We then applied this novel ictal testing battery to patients as part of a service improvement project and compared it with the standard procedures in the video telemetry (VT) unit. This demonstrated significant improvement (Student’s T-Statistic of 2.284 and a p-value of 0.014) in the amount of FS-specific information extracted as identified in the review, suggesting that such a battery is useful and can be utilised in the VT setting.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"133 ","pages":"Pages 242-250"},"PeriodicalIF":2.8,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477347","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":"Ketogenic diet therapy enables antiseizure medication reduction and withdrawal in children with epilepsy","authors":"Julia W. Zinger ,&nbsp;Wim J.R. Rietdijk ,&nbsp;Sarita van den Berg ,&nbsp;Rinze F. Neuteboom ,&nbsp;Elisabeth J. Ruijgrok ,&nbsp;Elles J.T.M. van der Louw ,&nbsp;A. Laura Nijstad","doi":"10.1016/j.seizure.2025.10.013","DOIUrl":"10.1016/j.seizure.2025.10.013","url":null,"abstract":"<div><h3>Aim</h3><div>This study investigated the effectiveness of ketogenic diet therapy (KDT) in facilitating antiseizure medication (ASM) dose reduction and withdrawal in children with epilepsy. We aimed to determine the proportion of KDT responders able to reduce or withdraw ASMs within six months of starting KDT and to identify clinical factors associated with successful ASM withdrawal.</div></div><div><h3>Methods</h3><div>A retrospective evaluation for pediatric epilepsy patients treated with KDT at Erasmus MC-Sophia Children’s Hospital between 2008 and 2023 was conducted. Patients aged 0–18 years who successfully responded to, and remained on KDT for at least six months were included. Statistical analyses evaluated the association between clinical characteristics and ASM withdrawal.</div></div><div><h3>Results</h3><div>Of the 151 patients deemed as KDT responders, 27 % achieved successful withdrawal of at least one ASM after six months of KDT. The number of ASMs decreased from a mean of 2.6 at baseline to 2.4 at six months. Younger age at KDT initiation (OR 0.86, <em>p</em> = 0.018) and a lower baseline number of ASMs (OR 1.57, <em>p</em> = 0.016) were associated with higher odds of ASM withdrawal.</div></div><div><h3>Interpretation</h3><div>KDT is effective in enabling ASM withdrawal in one-fourth of the responding pediatric patients. Younger age and fewer initial ASMs predicted better withdrawal outcomes, supporting early ASM withdrawal within 3–6 months of KDT for appropriate candidates.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"133 ","pages":"Pages 144-148"},"PeriodicalIF":2.8,"publicationDate":"2025-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145364422","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}