The neurodevelopmental outcome of infants with early-onset epilepsies varies widely, ranging from typical development to global developmental delay. Visual skills, which emerge during infancy, are crucial for the development of cognitive functions. The aim of this observational cohort study was to explore gaze behavior in infants with early-onset epilepsy and evaluate if eye tracking could support prognostication of their neurodevelopment.

Tuberous Sclerosis Complex (TSC) is a rare autosomal dominant disorder that is characterized by multisystem involvement and significant neurological manifestations. TSC1 and TSC2 pathogenic variants lead to hyperactivation of the mammalian target of rapamycin (mTOR) pathway, which disrupts cellular growth and differentiation. Epilepsy, affecting 85-90% of individuals with TSC, often presents within the first year of life and is commonly resistant to conventional therapies. This paper provides a comprehensive overview of the diagnostic criteria, pathophysiology, and current treatment strategies for TSC-associated epilepsy, including pharmacological approaches such as vigabatrin, cannabidiol, and mTOR inhibitors, as well as non-pharmacological interventions such as ketogenic diet and epilepsy surgery. Preventive strategies, highlighted by robust trials, delay seizure onset and reduce its severity but have a limited impact on neurodevelopmental outcomes. Challenges include the heterogeneity of cortical tubers, suboptimal seizure control with existing therapies, and underutilization of neuropsychiatric care for TSC-associated neuropsychiatric disorders. Advances in biomarkers, precision medicine, and surgical techniques have paved the way for personalized treatment approaches. Future research providing earlier detection strategies and integrating therapies targeting both the neurological and behavioral dimensions of TSC is ongoing. By addressing these needs, clinicians and researchers can enhance the quality of life and developmental outcomes of individuals with TSC.

Chromosomal disorders are multisystemic conditions frequently presenting developmental delay and epilepsy as primary neurological symptoms. Epilepsy in these syndromes significantly impacts morbidity, quality of life, and neurodevelopment. Angelman syndrome, ring chromosome 20, Down syndrome, Dup15q syndrome, and others display suggestive electroclinical profiles that may help diagnose and treatment. Understanding the associated electroencephalographic (EEG) findings is critical for clinicians to tailor interventions and optimize outcomes. This review highlights the prevalence, onset, seizure types, EEG characteristics, and treatment approaches for epilepsy in major chromosomal disorders. Angelman syndrome features epilepsy with atypical absences and myoclonic seizures, often associated with specific EEG patterns such as rhythmic delta activity. Ring chromosome 20 syndrome presents with focal frontal seizures, including non-convulsive status epilepticus. Down syndrome has a biphasic epilepsy distribution, from infantile spasms to late-onset myoclonic epilepsy. Similarly, Dup15q syndrome is marked by drug-resistant epilepsy, with EEG showing beta rhythms and hypsarrhythmia. Knowing the electroclinical patterns associated with chromosomal disorders may improve diagnosis and epilepsy management, which enhances patient care and prognosis accuracy.

Lennox-Gastaut syndrome (LGS) and Dravet syndrome (DS) are rare and debilitating forms of epilepsy, characterised by recurrent, severe, drug-resistant seizures and neurodevelopmental impairments. A non-euphoric, plant-derived, highly purified formulation of cannabidiol (CBD; Epidyolex®, 100 mg/mL oral solution) is approved in the European Union and United Kingdom for use in patients aged ≥2 years for the adjunctive treatment of seizures associated with LGS or DS in conjunction with clobazam (CLB), and for the adjunctive treatment of seizures associated with tuberous sclerosis complex in patients aged ≥2 years.

Artificial intelligence (AI) tools like ChatGPT hold promise for enhancing diagnostic accuracy and efficiency in clinical practice. This exploratory study evaluates ChatGPT's performance in diagnosing and classifying epileptic seizures, epilepsy, and underlying etiologies in adult patients compared to epileptologists and neurologists.

Synesthesia is a condition in which the stimulation of one sensory modality triggers unusual experiences in a second sensory modality such as colors or shapes. Synesthesia has been linked to specific conditions such as autism spectrum disorder, although the mechanisms underlying synesthesia remain largely unclear.

The impairment of sleep quality and the occurrence of frequent nocturnal awakenings significantly contribute to the reduction of effective sleep duration in individuals diagnosed with epilepsy. This deterioration not only compromises overall life satisfaction but also adversely affects cognitive functioning and concentration on daily living activities. Therefore, the imperative for enhanced management strategies for this disorder among individuals with epilepsy is critically important. This study is designed to systematically assess the impact of an educational-support program grounded in the Continuous Care Model on the daily living activities and sleep quality of individuals with epilepsy.

Episodic memory tasks employing verbal material are generally sensitive to material-specific memory impairments in individuals with left mesial temporal lobe epilepsy (LTLE), whereas visuospatial memory tasks are less consistently failed by individuals with right mesial temporal lobe epilepsy (RTLE). A limitation of these tasks is the possibility for the examinee to use verbalization strategies when tested with visuospatial stimuli, and visualization strategies with verbal material. In this study, we aimed to develop two new analogous computerized recognition tasks to identify material-specific memory impairments, adapted from those previously developed in our lab: one using verbal material (i.e., pseudowords), and the other visuospatial material (i.e., pictures depicting similar landscapes of mountains, trees, and lakes). Each task consists of a 3-trial learning phase and delayed recognition trials after 30 min. and two weeks. After having established normative data for adults (N = 124), we assessed the ability of each task to detect material-specific memory impairments in patients who have had surgery for LTLE (n = 16) or RTLE (n = 12). Both tasks have good psychometric properties. The RTLE group showed significantly poorer performance on the visuospatial than on the verbal memory test on all trials. The LTLE group showed significantly poorer performance on the verbal than on the visuospatial memory test on delayed (30-min. and 2-week) recognition trials. Memory profile on delayed recognition trials was concordant with the lateralization of epilepsy surgery in 87.5% of LTLE and in 83.3% of the RTLE group. This study provides preliminary clinical validation for our novel tasks to detect material-specific memory impairments in individuals with temporal lobe epilepsy.

Epileptic seizures can present with various clinical manifestations, often resembling other conditions-referred to as "imitators of epileptic seizures"-making differential diagnosis challenging. Among them, psychogenic non-epileptic seizures (PNES) or functional/dissociative seizures (FDS) are particularly prevalent in females. This study aimed to evaluate the ability of various non-epileptologist physicians to distinguish epileptic seizures from imitators by viewing video recordings of several paroxysmal events. We also assessed whether variables, such as medical specialty and years of professional experience, could impact diagnostic accuracy.

Suicide rates among persons with epilepsy (PWE) are high and a reliable and valid tool to screen for suicidality in this population is needed. The aim of this study is to validate the Russian version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) Item 4 as a screening tool for suicidality in PWE.

The aim of this study was to perform a systematic review and meta-analysis to identify sociodemographic barriers that could contribute to the underutilization of epilepsy surgery.

Epilepsy presents multifaceted challenges, including sexual dysfunction and psychiatric comorbidities in men. Understanding the interplay between epilepsy, antiseizure medications, hormonal alterations, and sexual dysfunction is crucial for tailored interventions and improved quality of life.

Transcutaneous auricular vagal nerve stimulation (tVNS) has been investigated as a potential non-invasive therapy in addition to standard medical care in patients with drug-resistant epilepsy (DRE). This meta-analysis evaluates the efficacy and safety of tVNS compared to sham stimulation in patients with DRE.

This study aimed to establish referral criteria, based on the Hattori precedent, to assist in the easy identification and referral of pediatric patients with suspected Dravet syndrome (DS) at first-line care facilities to support early diagnosis and appropriate management.

Focal cortical dysplasia (FCD) is a common cause of pharmacoresistant epilepsy. However, it can be challenging to detect FCD using MRI alone. This study aimed to review and analyze studies that used machine learning and artificial neural networks (ANN) methods as an additional tool to enhance MRI findings in FCD patients.

Dravet syndrome (DS) is a rare developmental and epileptic encephalopathy that places a substantial burden on both affected individuals and their informal caregivers. The aim of this review is to examine the multifaceted impact of DS on informal caregivers, focusing on key factors that contribute to their challenges and overall burden.

Tuberous Sclerosis Complex (TSC) is a neurocutaneous disorder associated with epilepsy (70-90% of cases) and neuropsychiatric symptoms (NPS). However, the influence of epilepsy on NPS remains unclear.

Epilepsy is a common neurological condition that affects over 65 million people worldwide. Despite an increasing number of anti-seizure medications being made available, many patients do not find seizure freedom with medication. The leading cause of death in this refractory population is sudden unexpected death in epilepsy (SUDEP). Both human and animal research has implicated serotonin (5-HT) in modulating seizure proclivity, severity, and mortality. More recently, evidence has pointed to the 5-HT receptor as a salient target for investigating the mechanisms of seizure facilitation and mortality. Various seizures models have been used previously to assess the role of the 5-HT receptor in seizure expression and morphology. However, limbic kindling models have been underutilized in this endeavor. We used the selective 5-HT receptor agonist MK-212 to examine the effect of 5-HT receptor activation in amygdala kindled mice. C57BL/6J mice were instrumented with an EEG/EMG headmount and a bipolar electrode in the basolateral amygdala (BLA). The animals then received vehicle or MK-212 (10, 30 mg/kg) prior to seizure induction. 12.5% of WT animals that received 10 mg/kg MK-212 experienced seizure-induced respiratory arrest and died following seizure induction. When the dose was raised to 30 mg/kg, 100% of the animals succumbed following a seizure. These fatal seizures persisted when the same doses of MK-212 were administered to mice lacking the 5-HT receptor. This suggests that a non-5-HT mediated effect of MK-212 facilitates seizure-induced death in a dose-dependent manner. While amygdala kindling is not a model that is traditionally associated with seizure-induced death, these results suggest that there are circuits that, when recruited, will cause death following kindled seizures. Uncovering these circuits will both deepen our understanding of the amygdala kindling model and provide a new technique for researchers to test novel therapeutic interventions to lessen SUDEP risk.

Electroencephalography (EEG) microstate analysis is widely used in the study of various neurological and psychiatric disorders. We aim to assess whether EEG microstates are altered in TLE patients with and without cognitive decline.

The effects of psychological factors such as self-efficacy, illness-related fear, and intolerance of uncertainty on illness management and quality of life of patients who have epilepsy have important roles in understanding the health behaviors of individuals.

Mental health comorbidities are highly prevalent and problematic in epilepsy, making it important for neurologists to be equipped to manage their patients' mental health concerns. This article explores the paradigm shift toward integrated mental health care approaches, aiming to educate early-career neurologists on their role within epilepsy care. We focus on depression and anxiety, how they present in epilepsy, and the role of integrated mental health care in managing these comorbidities. Key areas include the neurologist's role in identifying mental health issues through patient discussions and screening tools, and the basics of neurologist-led management. This covers the selection and adjustment of antiseizure medications and the use of psychopharmacology. Additionally, we emphasize the importance of providing psychoeducation and promoting healthy lifestyle choices that support mental well-being. Finally, we discuss the neurologist's role in facilitating referrals to mental health specialists, including information about the role of psychological interventions and psychiatry. This article aims to provide foundational knowledge to encourage early-career neurologists to actively engage in integrated mental health care approaches with their patients. This care can be flexible in how it incorporates different modalities and is tailored to local resources. It does not have to be extensive but should be meaningful enough to identify mental health concerns and facilitate patient access to appropriate resources and care.

In recent years, the cerebellum and its nuclei have become an essential target for understanding and suppressing the mechanisms of seizures. This study aimed to investigate the effects of electrical stimulation (ES) applied to the Lateral Cerebellar Nucleus (LCN) in rats at the early and fully developed pentylenetetrazol (PTZ) kindled seizures.

There are inconsistent results on health-related quality of life (HRQoL) in patients with functional/dissociative seizures (FDS), particularly in relation to the predictors. The aim of the present study was to investigate variables predicting HRQoL in a sample of patients with FDS who had been hospitalized for an average of 5.6 years.

This study aimed to evaluate the efficiency of an RF-TC Target Planning Software in enhancing outcomes of SEEG-guided RF-TC for pediatric drug-resistant epilepsy.

Responsive Neurostimulation (RNS) is a closed-loop neuromodulation therapy approved for treating drug resistant epilepsy (DRE) with 1 or 2 seizure foci, but its potential utility for treating complex seizure networks, such as in focal cortical dysplasia (FCD), remains uncertain. This review and commentary discuss the current practice of RNS use in focal cortical dysplasia-related drug-resistant epilepsy(FCD-DRE), and the potential of individualized approaches.

Temporal lobe epilepsy (TLE) is the most common type of drug-resistant epilepsy in adults, and surgery is a standard treatment, offering seizure freedom in 60-70 % of patients. Despite advanced imaging, many TLE patients show inconsistent MRI findings, making functional imaging such as 18-FDG PET-CT scans essential in identifying epileptogenic zones. This study aims to assess the association between concordant or non-concordant metabolic patterns in presurgical 18-FDG PET-CT scans and postoperative outcomes in TLE patients.

This study examined brain activation differences during paragraph reading between children with and without epilepsy and if findings were related to neuropsychological performance. Exploratory analyses assessed activation in a subset of struggling readers.

This study aimed to translate and validate the Health-Related Quality of Life Measure for Children with Epilepsy (CHEQOL-25) into Thai version (TH-CHEQOL-25), and to evaluate factors affecting quality of life (QOL).

Social cognition (e.g., theory of mind and emotion recognition) is frequently impaired in people with epilepsy (PWE) and plays a critical role in social functioning. The impact of the digital revolution on the social neuropsychology of PWE remains underexplored, while clinical neuropsychology has been slow to incorporate technological advancements. This study aims to (a) evaluate the impact of digital communication on social cognition and functioning in PWE, and (b) explore the potential of digital tools to enhance their assessment.

Patients with Frontal Lobe Epilepsy (FLE) face problems with social cognition (SC) since their difficulties in humor appreciation, facial and eye gaze emotional recognition. The effects of frontal (and temporal) seizures on SC may be understood in terms of emotion recognition (ER), Theory of Mind (ΤοΜ), empathy, and social behavior deficits in relation to their relevant pathophysiology. The impact of FLE on SC as expressed in digital environments still represents a terra incognita, as well as the objective of this exploratory work.