Articles

The research discusses the importance of achieving seizure freedom in epilepsy treatment and highlights the efficacy of newer antiseizure medications (ASMs) like cenobamate, which has shown significant rates of seizure freedom in patients with drug-resistant epilepsy. It also addresses common barriers to the adoption and optimization of these new treatments, emphasizing the need for clinicians to reassess and tailor medication management to improve patient outcomes.

This systematic review synthesizes existing integrated mental health care models for people with epilepsy, highlighting the prevalence of mental health comorbidities and the challenges in accessing care. The review identifies diverse approaches to integration, with promising uptake and acceptability, and proposes a framework for future initiatives that includes essential components like mental health screening and psychoeducation, along with key facilitators for effective delivery.

The study investigates the effectiveness of magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) for treating medically refractory epilepsy associated with periventricular nodular heterotopia (PVNH). Results show high rates of seizure freedom, particularly in unilateral cases, and highlight the importance of accurately targeting the seizure onset zone for improved surgical outcomes.

This study reports on the genetic analysis of a large cohort of patients with pediatric-onset epilepsies, identifying that 24% had likely pathogenic variants. The findings suggest that next-generation sequencing can effectively diagnose these conditions and help determine which patients may benefit from precision medicine treatments, particularly those with specific clinical features or types of epilepsy.

This study compares the efficiency and safety of high-dose undiluted intravenous push (IVP) levetiracetam loading doses to intravenous infusion (IVPB) in acutely seizing patients. The findings indicate that IVP significantly reduces the time to administration without increasing adverse events, and it may lower ICU admissions in patients with status epilepticus.

The study compares the views of epilepsy professionals in the UK and Norway regarding counselling on sudden unexpected death in epilepsy (SUDEP). It finds that UK clinicians are more likely to discuss SUDEP with patients, emphasize its importance, and have access to bereavement support, while highlighting the need for improved training and education to enhance communication about SUDEP in both countries.

This research investigates how depressive symptoms affect the perception of adverse effects in people with epilepsy undergoing antiseizure medication therapy. The study finds that specific depressive symptoms correlate with particular adverse effects, highlighting the importance of screening for depression in this population to improve medication tolerability and adherence.

The study investigates factors influencing the age at seizure onset in patients with bottom-of-sulcus dysplasia (BOSD), a specific type of focal cortical dysplasia. It finds that larger lesion size, the presence of germline pathogenic mTOR pathway variants, and increased connectivity with the default mode network are associated with younger ages at seizure onset. These results highlight the importance of both lesion characteristics and genetic factors in the timing of seizures in focal epilepsy.

Cognitive and psychological dysfunction is evident in individuals after their first seizure, prior to an epilepsy diagnosis and treatment. The study found that newly diagnosed epilepsy patients exhibited significantly worse cognitive performance and higher rates of depression and anxiety compared to healthy controls, indicating that these issues arise early in the disease process. Telehealth screening for cognitive and mental health issues is recommended for early management in new epilepsy cases.

This study evaluates the use of corpus callosotomy (CC) in pediatric patients with drug-resistant epilepsy (DRE) across multiple centers, highlighting its effectiveness and acceptable complication rates. The research found that while various surgical techniques were employed, including open craniotomy and laser interstitial thermal therapy, outcomes were generally favorable regardless of the method used. The findings suggest that less invasive approaches may enhance the adoption of CC as a treatment option for pediatric DRE.

The research emphasizes that comorbidities significantly impact the quality of life in people with epilepsy, yet they are often overlooked in treatment. A panel of experts provides consensus advice on diagnosing and managing various comorbidities, including sleep-wake disorders, cardiovascular diseases, cognitive dysfunction, and depression, to enhance overall health and seizure control in patients. Early identification and intervention for these comorbidities are crucial to prevent complications such as drug-resistant epilepsy.

The paper discusses the importance of counseling about Sudden Unexpected Death in Epilepsy (SUDEP), which is a leading cause of death in individuals with epilepsy. Despite guidelines recommending that all patients and caregivers be informed about SUDEP, many neurologists do not routinely provide this information, often citing concerns about causing stress. The review highlights the need for improved communication and understanding of SUDEP counseling among healthcare providers and patients.

This retrospective study evaluates the pharmacokinetic interactions between cenobamate and clobazam, revealing that the addition of cenobamate significantly increases serum concentrations of N-desmethylclobazam (NCLB) in patients. While this interaction may enhance therapeutic effects, it also leads to unwanted fatigue, necessitating dose adjustments of clobazam.

This study investigates patients' preferences for antiseizure medication (ASM) monotherapy, focusing on the trade-offs between treatment efficacy and side effect risks. It finds that patients prioritize seizure freedom and avoiding cognitive issues, while physicians emphasize similar but slightly different aspects, highlighting a divergence in treatment attribute importance between the two groups.

The paper discusses the differing perceptions of overtreatment in patients with temporal lobe epilepsy and their clinicians, highlighting that some patients may prefer to maintain their current condition rather than eliminate seizures. It argues that these patients' beliefs about treatment can be justified, and that a lack of acknowledgment from practitioners may result in overtreatment.

The study evaluated the impact of adverse effects from antiepileptic drugs on the quality of life (QOL) of patients with refractory epilepsy at a tertiary referral center in Brazil. It found that a significant number of patients experienced a high burden of adverse effects, which negatively affected their QOL, and concluded that addressing overtreatment requires a comprehensive management strategy beyond just structured assessments.