Status epilepticus (SE) is a neurological emergency that can be studied in animal models, particularly mice. However, these models are labour-intensive and require large numbers of animals, which raises ethical and logistical challenges. Additionally, rodent-based models could lack direct relevance to human physiology. While reduced models offer some insights, they fail to replicate the full complexity of brain connectivity and interactions with other organs. To address this, human forebrain assembloids, formed by both cortical excitatory and subpallial inhibitory neurons, could be an alternative SE model. Assembloids offer a middle ground, enabling high-throughput screening of potential treatments while maintaining relevant human cell biology. This approach could serve as an intermediate step before transitioning to animal models, ultimately reducing the time and number of animals required for SE research. This paper is based on a presentation made at the 9thLondon-Innsbruck Colloquium on Status Epilepticus and Acute Seizures in April 2024.

Mind-wandering is a pervasive human brain state and, when in excess, may promote negative affect and neuropsychiatric conditions. Mindfulness meditation may promote alternate brain states, improving affect and reducing stress. An understanding of the neural basis between these brain states could thus advance treatment of neuropsychiatric conditions, including those associated with epilepsy.

Drug resistance is defined as the failure of adequate trials of two tolerated and appropriately chosen antiseizure medications to achieve sustained seizure freedom. In case of uncontrolled seizures, pseudo-drug-resistance (poor compliance, a worsening effect of an antiseizure medication, a diagnosis of psychogenic non-epileptic seizure) should be first ruled out in case of pediatric epilepsies. This paper discusses the process of choosing antiseizure medication and the concepts of rationale polytherapy and precision medicine. In drug-resistant epilepsy, when curative surgery is not feasible, the aim of the treatment is focused on the improvement of quality of life rather than on seizure count. In recent years, despite an increase in available antiseizure medications, the incidence of drug-resistant epilepsy has not changed. Precision medicine may offer in rare epilepsies a mechanism-driven treatment, but it is still unclear if this will end up in an improvement of efficacy in drug-resistant epilepsies. Gene therapy with antisense oligonucleotides or Adeno-associated Virus (AAV) is transitioning from the experimental side to the first human trial. It may modify the natural history of selected epileptic syndromes.

To investigate the effects of vagus nerve stimulation (VNS) on the seizure frequency in patients with drug-resistant epilepsy (DRE) and bilateral temporal lobe epilepsy (bi-TLE). Additionally, we aimed to determine the safety of VNS and its side effects.

The objective of this study was to evaluate the diagnostic yield and clinical utility of an automated AI video-based seizure detection device, Nelli®, (SDD) in pharmacoresistant epilepsy patients. The SDD captures and automatically classifies nocturnal motor behavior suggestive of epileptic seizures or non-epileptic motor behavior of potential clinical value.

Epilepsy is a chronic disorder characterized by a predisposition to epileptic seizures, affecting more than 50 million people worldwide.

Social media platforms have significant potential to enhance public knowledge on how to respond to generalised seizures. Among the platforms, TikTok emerges as a standout performer, demonstrating exceptional user engagement.

Understanding parental attitudes and health literacy is crucial for promoting safe and effective medication use, which is pivotal in managing epilepsy, a condition requiring consistent and informed treatment decisions. So, this study aimed to determine the impact of health literacy among parents of children with epilepsy on their attitudes towards rational drug use.

Treatment trials for functional seizure (FS) help improve functioning and reduce disability in affected individuals. Clinical trials have prioritized clinician-defined outcomes, but no studies have directly asked adults with FS what they hope to accomplish. This study examined patient-defined goals for treatment in a consecutive cohort of 826 adults with FS referred for outpatient treatment. Goals were reviewed and sorted into 6 categories with 32.5% of goals related to seizure management, 21.8% to abstract functional improvement, 20.3% to concrete functional improvement, 14.8% to seizure education, 10.1% to psychiatry tools, and 0.5% to Other. Although treatment trials have prioritized reduced event frequency as a primary outcome, people with FS most frequently prioritize goals for functional improvement. Data suggests that rehabilitation metrics of FS treatment outcome may be just as, or more important to adults with FS than what medical providers prioritize for outcome success. Study findings have implications for how to define FS treatment success and suggest equal prioritization of patient-centered goals to medically-defined goals in trial design.

Observational studies suggest that hypertension and epilepsy have a high co-occurrence, and antihypertensive medications may have impacts on the prevention and treatment of epilepsy. However, the directionality of causation between them is elusive.

Despite the introduction of several first-in-class antiseizure medications in the last 15 years and the recent generation of new hypotheses to explain the drug-resistant phenotype in epilepsy, the proportion of patients with refractory epilepsy remains apparently unchanged. Therefore, it is essential to provide new perspectives (or, perhaps, revive old perspectives) to develop more effective therapeutic interventions. Some of the complex comorbid disorders associated with epilepsy, which present similar rates of unresponsive patients and whose refractoriness is possibly mediated by similar causes, could provide keys to implement novel therapeutic interventions. In this article, based on Swanson's ABC model to develop scientific hypotheses, we establish (or rescue) some interesting connections between depression and epilepsy, focusing on the relationship between drug-resistant epilepsy and depression.

Previous research has linked epilepsy of the temporal lobe (TLE) with comorbidities of psychiatric nature, yet few studies have investigated personality psychopathology in patients with TLE. This is the first study on the topic in the Arab world and the first study using the Personality Inventory for DSM-5-Brief From (PID-5-BF). Thus, this study, which is cross-sectional by nature, aims to explore the potential relationship between TLE and personality psychopathology.

Whilst the dominant temporal lobe has a well-established role in memory, the functions of its nondominant counterpart remain enigmatic. We compared the lateralizing ability of a promising spatial memory task (Brown Location Test, BLT) to other commonly used verbal and visual memory tasks in a sample of patients with unilateral temporal lobe epilepsy (TLE).

Children with focal epilepsy often present with executive functions (EFs) deficits. EFs deficits can contribute to adaptive challenges and have a negative impact on academic achievement. The purpose of this study was to investigate the EFs profiles of children diagnosed with frontal lobe epilepsy or temporal lobe epilepsy. Also, we aimed to examine the impact of medical and sociodemographic features on executive functioning and to compare the results of performance-based tests and ratings measures.

This study aimed to clarify perceptions of the transition from pediatric to adult care for patients with childhood-onset epilepsy in Japan.

To attempt an analysis of the future of treatment for status epilepticus, the author divided the goals of status treatment into several categories: clinical, research, economic, and equity. This paper is based on a lecture presented at the 9th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures, in London 8-10 April 2024.

As the adequacy of determining hemispheric language lateralization (HLL) is of special importance for the planning of epilepsy surgery, this study aimed to identify predictive factors for receiving inconclusive HLL results using functional transcranial Doppler sonography (fTCD). Data from 495 epilepsy patients who received fTCD in a standardized fashion was analyzed retrospectively. HLL was left-sided in 324 patients (65.5 %), right-sided in 76 (15.4 %), and inconclusive in 95 (19.2 %). Univariate logistic regression analyses revealed significant positive associations between inconclusive HLL results and a multiregional localization of epilepsy. Significant negative associations with higher educational qualification, more years of education, and better letter verbal fluency were found. In multiple logistic regression analyses, a multiregional localization of epilepsy (OR = 2.74, p < 0.001) and years of education (OR = 0.86, p < 0.001) remained independent predictors. A cut-off value of 10.77 years of education determined by discriminant function analyses is provided. Our findings indicate that the adequacy of determining HLL using fTCD is highly dependent on the extension of the epileptogenic lesion and the patients' years of education. We therefore recommend not to use the same paradigm for all patients, but to adapt the selection of adequate test materials to their cognitive abilities.

Stress is one of the most common trigger factors for epileptic seizures and is strongly related to clinical and emotional variables. Despite its influence in the course of the disease, there is an absence of instruments for measuring perceived stress in people with drug-resistant epilepsy. Therefore, this study develops and validates the Epilepsy Perceived Stress Inventory for Adults (EPSI-A), a self-report inventory in Spanish designed to quantify perceived chronic stress in this population.

To examine the relationship between clinical, psychological, and cognitive characteristics of adults with functional seizures.

Children with childhood absence epilepsy (CAE) are deemed to be at higher risk of attention deficit hyperactivity disorder (ADHD), however the magnitude of that risk has not been assessed in a population-based study.

Observational studies have consistently indicated a significant correlation between abnormal cardiac conditions and epilepsy. However, the association and direction of this relationship remain a subject of debate. This study employs a two-sample bidirectional Mendelian randomization (MR) approach to investigate the association between abnormal cardiac conditions and epilepsy.

Evaluate relationships between PSG-confirmed OSA and SUDEP risk using the revised SUDEP Risk Inventory (rSUDEP-7).

In Ethiopia, the epilepsy knowledge gap among healthcare workers remains high. In this study, we conducted a survey among health care workers in Addis Ababa, Ethiopia, exploring their knowledge, attitudes, beliefs, and perceptions about social inclusion and exclusion regarding epilepsy. Furthermore, we analysed if and how these factors influence the management and quality of care provided. During a training workshop, 50 participants completed the survey. Nurses made up 22% of the participants, midwives comprised 11%, health officers constituted 16%, and medical officers represented 4%. Of the respondents, 69% were male, and 59% had experience in treating patients with epilepsy. This study showed that while 51% of respondents correctly identified epilepsy as being diagnosed after two seizures, many were uncertain about the criteria. Although 90% believed epilepsy is treatable, some were unsure or held misconceptions. Regarding its contagiousness, 82% correctly stated it is not contagious, but some held incorrect beliefs. Treatment options varied, with most recognizing clinical medicines, but some still believed in alternative methods like spiritual or herbal healing. Additionally, understanding of person-centered care was lacking, with several respondents admitting they were unfamiliar with the concept. The factors contributing to the epilepsy treatment gap in Ethiopia were a lack of comprehensive knowledge among healthcare workers about epilepsy, misconceptions such as the belief that epilepsy is contagious, inadequate management practices, challenges in accessing and securing medications due to shortages, and limited community awareness about the condition. Additionally, the study exposed a concerning gap in understanding of person-centered care among some healthcare workers. This study underscores the urgent need for targeted training programs, healthcare policies, and community awareness initiatives to enhance the quality of care for individuals with epilepsy in Ethiopia and similar settings.

Status epilepticus (SE) is a severe neurological condition that might lead to long-term consequences such as neuronal death. This study investigated whether SE leads to brain volume loss by characterizing the dynamic of peri-ictal MRI abnormalities (PMA) through follow-up MRIs and assessing whether SE duration and specific outcome characteristics are associated with brain atrophy.

Burst suppression (BS) on EEG induced by intravenous anesthesia (IVAT) is standard therapy for refractory status epilepticus (RSE). If BS has any independent therapeutic effect on RSE is disputed. We aimed to define EEG characteristics of BS predicting termination or recurrence of status after weaning. All RSE patients treated with IVAT while undergoing continuous EEG monitoring on the neurological intensive care unit between 2014 and 2019 were screened for inclusion. A one hour-period of visually preselected BS-EEG was analyzed. Bursts were segmented by a special thresholding technique and underwent power spectral analysis. Out of 48 enrolled patients, 25 (52.1 %) did not develop seizure recurrence (group Non SE) after weaning from IVAT; in 23 patients (47.9 %), SE reestablished (group SE). In group Non SE, bursts contained higher amounts of EEG delta power (91.59 % vs 80.53 %, p < 0.0001), while faster frequencies were more pronounced in bursts in group SE (theta: 11.38 % vs 5.41 %, p = 0.0008; alpha: 4.89 % vs 1.82 %, p < 0.0001; beta: 3.23 % vs 1.21 %, p = 0.0002). Spectral profiles of individual bursts closely resembled preceding seizure patterns in group SE but not in group Non SE. Accordingly, persistence of spectral composition of initial ictal patterns in bursts, suggests ongoing SE, merely interrupted but not altered by BS. Fast oscillations in bursts indicate a high risk of status recurrence after weaning from IVAT. EEG guided individualized sedation regimes might therefore be superior to standardized anesthesia protocols.

Persons with epilepsy have a higher risk of suicide compared to the general population, but limited data makes it unclear how extensive this risk is and who is most vulnerable. Our study aimed to explore the incidence of suicide among persons with epilepsy in Sweden, and compare to the general population. To facilitate prevention, we also wanted to examine methods and circumstances of suicide.

To characterize the time to return to full baseline functionality (RTFBF) in seizure cluster episodes (SCEs) treated with one or two midazolam nasal spray (MDZ-NS/Nayzilam®) doses over the course of repeated intermittent use in patients with seizure clusters (SCs).

Seizures may be one of the neurological consequences of COVID-19. The present study aims to review the prevalence of seizures in COVID-19 patients considering sex and geographical origin. A review protocol was submitted to the PROSPERO database (CRD42021281467). PRISMA statement was used to report the meta-analysis. The authors selected studies for the meta-analysis by searching the principal databases. Studies were eligible if they reported seizures in COVID-19 patients, regardless of study design. Data were analyzed by proportion meta-analysis with a 95 % confidence interval (95 % CI). Cochran's Q and Higgins' I were used to measure heterogeneity. R software was used for meta-analysis. Subgroup analyses were carried out for sex, geographical origin of the subjects, and illness severity. A checklist for prevalence studies was used to assess the risk of bias in the included studies. A total of 32 studies (n = 251,997 analyzed patients) were included in this meta-analysis. A prevalence of 1.03 % (95 % CI 0.73 to 1.37, I = 93 %, p < 0.001) was found. No statistically significant differences were found in the analysis by geographical subgroups. Men were found to be less likely to had COVID-19 seizures (OR = 0.75, 95 % CI 0.21-2.74), while mildly ill patients were found to be more likely to had COVID-19-induced seizures (OR = 2.08, 95 % CI 0.86-5.06). Our results show a slight prevalence of seizures in COVID-19 patients. In addition, we found that the groups analyzed had differences in the odds of having COVID-19-induced seizures.