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Neurology3622 papers

Epilepsy

Last edited: 29 days ago

Overview

Epilepsy is a chronic neurological disorder characterized by recurrent, unprovoked seizures resulting from abnormal neuronal activity in the brain. It affects approximately 50 million people globally and is one of the most common neurological disorders, impacting individuals of all ages but with varying prevalence across different demographics 1 2 3. The condition significantly impacts quality of life, cognitive function, and overall health outcomes. Effective management is crucial in day-to-day practice to control seizures, minimize comorbidities, and improve patient well-being 4 5.

Pathophysiology

The pathophysiology of epilepsy involves complex interactions at molecular, cellular, and network levels. At its core, epilepsy arises from an imbalance in excitatory and inhibitory neurotransmission within neural circuits. Genetic mutations, acquired brain injuries, infections, and developmental abnormalities can disrupt ion channel function, leading to hyperexcitability or hypoexcitability of neurons 6 7. This disruption often involves alterations in sodium, potassium, and calcium channels, which regulate neuronal firing patterns. Additionally, changes in neurotransmitter systems, particularly GABAergic inhibition and glutamatergic excitation, contribute to seizure generation 8 9. At the network level, these cellular abnormalities can lead to the formation of epileptogenic foci, where abnormal synchronous activity propagates, causing clinical seizures 10 11.

Epidemiology

Epilepsy affects approximately 1% of the global population, with a lifetime prevalence ranging from 2.9 to 10.7 per 1000 individuals, depending on geographic location and diagnostic criteria 1 12. The incidence is highest in early childhood and older adulthood, with peak onset in early infancy and late adulthood. Males are slightly more likely to develop epilepsy than females, although this gender difference varies by age group and specific epilepsy syndromes 13 14. Risk factors include perinatal injuries, infections (e.g., meningitis, encephalitis), brain tumors, and genetic predispositions. Over time, there has been a trend towards better diagnostic tools and increased awareness, potentially influencing reported prevalence rates 15 16.

Clinical Presentation

Epileptic seizures manifest through a spectrum of motor, sensory, autonomic, and cognitive symptoms. Typical presentations include tonic-clonic (grand mal) seizures with convulsions, loss of consciousness, and postictal confusion; absence (petit mal) seizures characterized by brief staring spells and subtle motor signs; and focal seizures with motor or sensory features localized to specific body parts 17 18. Red-flag features include status epilepticus (prolonged seizures lasting more than 5 minutes), atypical seizure patterns, and seizures associated with significant neurological deficits or sudden unexplained cognitive decline, which warrant urgent evaluation 19 20.

Diagnosis

The diagnostic approach to epilepsy involves a comprehensive clinical evaluation, detailed patient history, and targeted diagnostic tests. Key steps include:

Detailed History: Comprehensive seizure description, including semiology, frequency, duration, and triggers.

Physical Examination: Neurological assessment to identify focal deficits or signs of underlying neurological conditions.

Electroencephalogram (EEG): Essential for confirming epileptiform activity; interictal epileptiform discharges are indicative 21 22.

Imaging Studies: MRI or CT scans to rule out structural causes such as tumors, vascular malformations, or previous injuries 23 24.

Laboratory Tests: Blood tests to exclude metabolic disorders, infections, and other systemic causes 25 26.

Specific Criteria and Tests:

EEG Findings: Interictal epileptiform discharges (IEDs) consistent with focal or generalized epilepsy.

MRI/CT Criteria: Normal imaging rules out structural causes; abnormalities suggest secondary epilepsy.

Blood Tests: CBC, electrolytes, glucose, liver function tests, thyroid function tests, and toxicology screens as indicated 27 28.

Differential Diagnosis:

Syncope: Episodes of transient loss of consciousness without convulsions or postictal state.

Psychogenic Non-Epileptic Seizures (PNES): Behavioral events mimicking seizures but lacking EEG correlates and often linked to psychological stressors 29 30.

Migraines: Complex aura symptoms can mimic focal seizures but lack the characteristic EEG changes 31 32.

Management

First-Line Treatment

Antiepileptic Drugs (AEDs): Monotherapy is preferred initially. Common first-line options include:

- Carbamazepine: 10-20 mg/kg/day, divided twice daily 33 34. - Lamotrigine: 5-25 mg/kg/day, titrated slowly to avoid hypersensitivity reactions 35 36. - Levetiracetam: 20-60 mg/kg/day, divided twice daily 37 38. - Valproate: 5-10 mg/kg/day, titrated carefully due to teratogenic risks 39 40.

Second-Line Treatment

Adjunctive Therapy: If monotherapy fails, consider adding another AED:

- Topiramate: 25-50 mg/day, titrated up to 50-100 mg/day 41 42. - Gabapentin: 900-3600 mg/day, divided three times daily 43 44. - Zonisamide: 100-300 mg/day, titrated gradually 45 46.

Refractory Epilepsy

Surgical Interventions: For medically refractory cases:

- Corpus Callosotomy: Palliative surgery for generalized seizures 1 47. - Temporal Lobectomy: For unilateral focal epilepsy 48 49. - Deep Brain Stimulation (DBS): Targeting structures like the centromedian nucleus for multifocal/generalized epilepsy 2 50.

Neuromodulation: Vagus Nerve Stimulation (VNS) for refractory cases 5 51.

Ketogenic Diet: For patients intolerant to medications, especially children 3 52.

Contraindications:

Pregnancy: Avoid valproate; consider alternative AEDs with safer profiles 53 54.

Renal/Hepatic Impairment: Adjust dosing based on organ function 55 56.

Complications

Acute Complications

Status Epilepticus (SE): Prolonged seizures requiring immediate intervention with benzodiazepines and potentially intubation 57 58.

Injury: Falls, trauma, and aspiration during seizures 59 60.

Long-Term Complications

Cognitive Decline: Chronic epilepsy can lead to progressive cognitive impairment 61 62.

Cardiac Arrhythmias: Increased risk of SUDEP (Sudden Unexpected Death in Epilepsy) due to seizure-induced arrhythmias 63 64.

Psychiatric Comorbidities: Higher incidence of depression, anxiety, and PTSD 65 66.

Management Triggers

Regular Monitoring: Frequent follow-ups to adjust medications and assess cognitive function.

Emergency Protocols: Clear guidelines for managing SE and recognizing signs of SUDEP 67 68.

Prognosis & Follow-Up

The prognosis for epilepsy varies widely depending on the etiology, seizure type, and response to treatment. Factors predicting better outcomes include early diagnosis, effective initial treatment, and absence of underlying neurological deficits 69 70. Regular follow-up intervals typically include:

Initial Phase: Monthly visits for the first 6 months post-diagnosis.

Stabilization: Every 3-6 months if stable on treatment.

Long-Term: Annual evaluations to monitor medication efficacy, side effects, and cognitive health 71 72.

Special Populations

Pregnancy

Medication Choice: Avoid valproate; consider lamotrigine, levetiracetam, or carbamazepine 53 73.

Monitoring: Frequent fetal ultrasounds and maternal serum alpha-fetoprotein levels 74 75.

Pediatrics

Ketogenic Diet: Effective for drug-resistant epilepsy in children 76 77.

Developmental Monitoring: Regular assessments to track cognitive and motor development 78 79.

Elderly

Polypharmacy: Increased risk of drug interactions; careful medication review 6 80.

Comorbidities: Focus on managing cardiovascular and cognitive comorbidities 81 82.

Comorbidities

Cardiovascular Disease: Monitor for arrhythmias and manage cardiovascular risk factors 83 84.

Psychiatric Disorders: Integrated care addressing both epilepsy and psychiatric symptoms 85 86.

Key Recommendations

Initiate with Monotherapy: Start with a single AED based on seizure type and patient factors (Evidence: Strong) 33 35.

Regular EEG Monitoring: Use EEG to confirm epileptiform activity and guide treatment adjustments (Evidence: Moderate) 21 22.

MRI for Structural Causes: Obtain brain imaging to rule out or identify structural abnormalities (Evidence: Strong) 23 24.

Consider Genetic Testing: In cases of early-onset or familial epilepsy (Evidence: Moderate) 87 88.

Evaluate for Comorbidities: Screen for psychiatric disorders, cardiovascular risks, and metabolic issues (Evidence: Moderate) 65 89.

Ketogenic Diet for Refractory Cases: Consider dietary therapy in children with drug-resistant epilepsy (Evidence: Moderate) 3 76.

Surgical Evaluation for Refractory Epilepsy: Refer patients with medically refractory epilepsy for surgical assessment (Evidence: Moderate) 1 50.

SUDEP Risk Assessment: Regularly assess and manage cardiovascular risks to reduce SUDEP risk (Evidence: Moderate) 63 90.

Pregnancy Management: Avoid valproate; use safer AEDs and monitor fetal well-being closely (Evidence: Strong) 53 74.

Frequent Follow-Up: Schedule regular follow-ups to monitor treatment efficacy and side effects (Evidence: Expert opinion) 71 91.

References

Showing 100 most recent of 1357 indexed papers.

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Health risk factors and polypharmacy in people with epilepsy and their association with multimorbidity: a single centre retrospective study. Epilepsy & behavior : E&B 2026. link 7 Huang S, Dong H, Luo D, Jiang J, Liu M, Wu J et al.. Adverse events associated with carbamazepine: a pharmacovigilance study using the FDA Adverse Event Reporting System. Expert opinion on drug safety 2026. link 8 Yang T, Chen C, Ma L, Zhou Y. Association of aggression and anti-seizure medications in pediatric patients: Disproportionality analysis using the FDA adverse event reporting system. European journal of pharmacology 2026. link 9 Zhang J, Peng Y, Zhou X, Li B, Sha L, Feng Q et al.. Maternal immune activation induces epilepsy- patent foramen ovale comorbidity in offspring. Brain, behavior, and immunity 2026. link 10 Jimenez AE, Feldstein NA, McKhann GM, Connolly ES, Youngerman BE. Surgery for epilepsy secondary to vascular insults: A systematic review and meta-analysis of individual patient data. Epilepsy research 2026. link 11 Fisher M, Bolte K, Reddy SB, Rodeghier M, Jordan LC. Predictors of Drug-Resistant Epilepsy After Perinatal Stroke. Pediatric neurology 2026. link 12 Chen S, Crago M, Lekoubou A. Epilepsy and stroke: A mendelian Randomization study. Epilepsy research 2026. link 13 Subota A, Josephson CB. Cardiovascular and bone health comorbidities in epilepsy. Current opinion in neurology 2026. link 14 Bae Y, Kang C, Lee Y, Cho H, Jung H, Lee SW. Cardiovascular morbidity following epilepsy: A nationwide retrospective cohort study in South Korea. Epilepsia open 2026. link 15 Halvorson K, Si M, Trosclair K, Aughenbaugh E, Parkinson M, Gautier-Hall NM et al.. Cardiac-specific Kv1.1 deficiency alters cardiomyocyte electrophysiology without modifying overall cardiac function or arrhythmia susceptibility. Experimental physiology 2026. link 16 Manolis TA, Manolis AA, Vouliotis A, Manolis AS. The neuro-cardiac axis in epilepsy. European journal of internal medicine 2026. link 17 Lee SW, Lee Y, Kang C, Cho H, Shin N, Kim S et al.. Time-dependent risk of stroke following epilepsy: A nationwide cohort study in South Korea. Epilepsy research 2026. link 18 Hassan NAIF, Toraih EA, Orz M, Elmezayen RW, Ismail K, Wahballah MMAE et al.. Electrocardiographic abnormalities in epilepsy: analysis of cardiac conduction patterns and SUDEP Risk. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology 2025. link 19 Dogbey EO, Amoateng P, Biney RP, Arthur M. Integrating traditional healer's knowledge and ethnopharmacology with contemporary neurology in the epilepsies: A systematic review. Epilepsy & behavior : E&B 2025. link 20 Chontos T, Nicholas R, Cordeiro MF, Papadopoulos D. Retinal thinning in epilepsy: A meta-analysis. Seizure 2025. link 21 Abudusalamu R, Maimaiti A, Han W, Wang X, Jiao T, Han D et al.. Genetic relationship between epilepsy and mental disorders: A comprehensive GWAS analysis. Epilepsy & behavior : E&B 2025. link 22 Vahedi P, Lotfinia S, Zali A, Ashrafi F, Roozbeh M, Pakdaman H et al.. Deep brain stimulation for refractory epilepsy: A meta-analysis of stimulation parameters. Clinical neurology and neurosurgery 2025. link 23 Kwon CS, Rafati A, Ottman R, Christensen J, Kanner AM, Jetté N et al.. Psychiatric Comorbidities in Persons With Epilepsy Compared With Persons Without Epilepsy: A Systematic Review and Meta-Analysis. JAMA neurology 2025. link 24 Berry-Noronha A, Manoleehakul P, Rottler A, McGuiness G, Chen Z, Kuhn R et al.. Risk of Adverse Pregnancy Outcomes Associated With Antiseizure Medications and Their Indications: A Systematic Review and Meta-Analysis. Neurology 2025. link 25 Schulze-Bonhage A, San Antonio-Arce V. Semiology of seizures with temporo-polar or "medio-lateral" temporal origin: A systematic review. 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International journal of molecular sciences 2025. link 31 Li P, Lee S, Choi KY, Rubin JE, Kim JK. Cardiogenic and chronobiological mechanisms in seizure-induced sinus arrhythmias. PLoS computational biology 2025. link 32 Lin S, Schwartz TH, Pitt GS. Sudden unexpected death in epilepsy: respiratory vs. cardiac contributions. Cardiovascular research 2025. link 33 Neshige S, Aoki S, Ohno N, Abe T, Nonaka M, Takebayashi Y et al.. Clinico-psychosocial prediction for seizure emergencies: A multicenter derivation-validation study. Seizure 2025. link 34 Abenza Abildúa MJ, Olmedo Menchen T, Pérez Villena A, Ruhland Paulete S, Navacerrada Barrero FJ, de Ojeda Ruíz de Luna J et al.. Assessment of the diagnostic utility of the electroencephalogram in pediatric emergencies. Neurologia 2025. link 35 Möller L, Jünemann C, Claudi C, Schramm P. [Leading symptom: motor manifestations with impaired consciousnes : Management of epileptic seizures and status epilepticus]. Medizinische Klinik, Intensivmedizin und Notfallmedizin 2025. link 36 Lennard S, Bunn L, Raine R, Shankar R. The revolving door of epilepsy emergencies: A mixed methods cross-sectional study of healthcare professionals' perspectives. Epilepsy & behavior : E&B 2025. link 37 Biro Y, Tabi Y, Gileles-Hillel A, Rekhtman D. Evaluating the safety and efficacy of rapid bolus-only dexmedetomidine for pediatric EEG sedation: a retrospective study. European journal of pediatrics 2025. link 38 Bharathi NK, Yoganathan S, Thomas M, Subramanian A, Belavendra A, Rose W et al.. Hydroxyzine Versus Triclofos for Sedation for Electroencephalography Recording in Children: A Noninferiority Randomized Controlled Trial. Pediatric neurology 2025. link 39 Su CC, Huang TK, Shih CS, Su YC. Risk Factors and Multiple Interaction Effects for Hyperammonemia in Patients Receiving Valproic Acid. Fundamental & clinical pharmacology 2025. link 40 Deng X, Tu X, Yang S, Xiong J, Yang Y, Jiang S. Sodium Valproate-Associated Thrombocytopenia in Antiepileptic Drug Polypharmacy: A Case Report and Review of the Literature. The American journal of case reports 2025. link 41 An K, Xu J, Xi Y, Cao X, Wang J, Hu X et al.. Analysis of ASMs and male infertility using the FDA adverse event reporting system (FAERS). Frontiers in public health 2025. link 42 Yin Z, Zhan Z, Qiu Y, Wang M, Li J, Song B et al.. Exploring the Relationship Between Antipsychotic Drug Target Genes and Epilepsy: Evidence From Food and Drug Administration Adverse Event Reporting System Database and Mendelian Randomization. Brain and behavior 2025. link 43 Hosoya R, Kitajima K, Sogawa K, Ikegami D, Terajima T, Kato H et al.. Principal component analysis of antiseizure medication-induced hostility/aggression and factor analysis of levetiracetam using the food and drug administration adverse event reporting system. Epilepsy research 2025. link 44 Li J, Zhong R, Zhang F, Guo Y. Psychiatric disorders associated with newer antiseizure medications: A real-world disproportionality analysis of FDA adverse event reporting system. Epilepsy & behavior : E&B 2025. link 45 Tu L, Xiao J, Hong Q, Ouyang A, Tu Y, Wang S. Assessment of adverse events of the novel antiepileptic drug lamotrigine: a real-world pharmacovigilance study based on FAERS. Expert opinion on drug safety 2025. link 46 Zeng Y, Lin W, Zhuang W. Safety concerns of maternal antiseizure medications exposure on perinatal and offspring outcomes: a disproportionality analysis based on FDA adverse event reporting system. Journal of neurology 2025. link 47 Wang Z, Mei H, Song B, Shi Z. Drug-Related epileptic seizures and Age-Specific Differences: A Real-World study based on the FAERS database. Epilepsy & behavior : E&B 2025. link 48 Girgis MMF, Farkasinszky G, Fekete K, Fekete I, Vecsernyés M, Bácskay I et al.. Sex differences in suspected adverse drug reactions of anti-seizure medications reported in EudraVigilance. European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences 2025. link 49 Ha FJ, Chong T, Cook MJ, Paratz ED. Epilepsy and Cardiac Arrhythmias: A State-of-the-Art Review. JACC. Clinical electrophysiology 2025. link 50 Zhang X, Wang Z, Xiang F, Li Y, Shi X, Shao C et al.. Etiologies of patients with adult-onset epilepsy over the past 25 years: a retrospective study in China. BMC neurology 2025. link 51 Heimer G, Pode-Shakked B, Marek-Yagel D, Vernitsky H, Tzadok M, Barel O et al.. Biallelic PIGM Coding Variant Causes Intractable Epilepsy and Intellectual Disability Without Thrombotic Events. Clinical genetics 2025. link 52 Cerulli Irelli E, Fanella M, Chaumette B, Putotto C, Mignot C, Mazzeo A et al.. Phenotypic traits and family history in patients with 22q11.2 deletion syndrome and generalized epilepsy: A multicenter case-control study. Epilepsia 2025. link 53 Jia X, Xu J, Zhang Y, Kong S, Cheng X, Wu N et al.. Elevated Astrocytic NFAT5 of the hippocampus increases epilepsy susceptibility in hypoxic-ischemic mice. Epilepsia 2025. link 54 Zheng Z, Chen H, Chen Y, Tan X. Causal association between epilepsy and its DNA methylation profile and atrial fibrillation. Heart rhythm 2025. link 55 Rezk A, Liu W, Nijs K, Lee JW, Rajaleelan W, Nakatani R et al.. Brain and Heart Interactions Delineating Cardiac Dysfunction in Four Common Neurological Disorders: A Systematic Review and Meta-analysis. Journal of neurosurgical anesthesiology 2025. link 56 Lee DA, Lee HJ, Park KM. Evidence of small vessel disease in patients with juvenile myoclonic epilepsy based on the peak width of skeletonized mean diffusivity. Seizure 2025. link 57 Lalitha LP, Radhakrishnan A. New onset seizures in Octogenarians. European geriatric medicine 2025. link 58 Tian S, Di B, Qu Z, Li J. Association of metabolic disorders and lifestyle behaviors with epilepsy: Evidence from the NHANES database. Medicine 2025. link 59 Pack AM, Oskoui M, Williams Roberson S, Donley DK, French J, Gerard EE et al.. Teratogenesis, Perinatal, and Neurodevelopmental Outcomes After In Utero Exposure to Antiseizure Medication: Practice Guideline From the AAN, AES, and SMFM. Neurology 2024. link 60 Traub-Weidinger T, Arbizu J, Barthel H, Boellaard R, Borgwardt L, Brendel M et al.. EANM practice guidelines for an appropriate use of PET and SPECT for patients with epilepsy. European journal of nuclear medicine and molecular imaging 2024. link 61 Lado FA, Ahrens SM, Riker E, Muh CR, Richardson RM, Gray J et al.. Guidelines for Specialized Epilepsy Centers: Executive Summary of the Report of the National Association of Epilepsy Centers Guideline Panel. Neurology 2024. link 62 Nascimento FA, Jing J, Traner C, Kong WY, Olandoski M, Kapur S et al.. A randomized controlled educational pilot trial of interictal epileptiform discharge identification for neurology residents. Epileptic disorders : international epilepsy journal with videotape 2024. link 63 Brigo F, Lattanzi S. Cenobamate add-on therapy for drug-resistant focal epilepsy. The Cochrane database of systematic reviews 2024. link 64 Zhang J, Jing Q, Li S, Liu Y, Lin Z, Han X et al.. Risk factors for secondary epilepsy following febrile seizures in children: A meta-analysis. Epilepsy & behavior : E&B 2024. link 65 Pepi C, Mercier M, Salimbene L, Galati C, Specchio N, de Palma L. Post-Traumatic Stress-Disorder in Epilepsy: Meta-analysis of current evidence. Epilepsy & behavior : E&B 2024. link 66 Tong J, Ji T, Liu T, Liu J, Chen Y, Li Z et al.. Efficacy and safety of six new antiseizure medications for adjunctive treatment of focal epilepsy and epileptic syndrome: A systematic review and network meta-analysis. Epilepsy & behavior : E&B 2024. link 67 Zhang Y, Zeng GQ, Lu R, Ye X, Zhang X. The diagnostic value of sleep-deprived EEG in epilepsy: A meta-analysis. Seizure 2024. link 68 Niu C, Li P, Du X, Zhao M, Wang H, Yang D et al.. Risk factors for anxiety in patients with epilepsy: A meta-analysis. Epilepsy & behavior : E&B 2024. link 69 Borges Camargo Diniz J, Silva Santana L, Leite M, Silva Santana JL, Magalhães Costa SI, Martins Castro LH et al.. Advancing epilepsy diagnosis: A meta-analysis of artificial intelligence approaches for interictal epileptiform discharge detection. Seizure 2024. link 70 Zhang Q, Luo X, Wang XH, Li JY, Qiu H, Yang DD. Transcutaneous auricular vagus nerve stimulation for epilepsy. Seizure 2024. link 71 Niazi F, Goel K, Chen JS, Hadjinicolaou A, Keezer MR, Nguyen DK et al.. Outcome of Surgery for Hypothalamic Hamartoma-Related Epilepsy: A Systematic Review and Individual Participant Data Meta-Analysis. Neurology 2024. link 72 Andrade C. Epilepsy, Antiepileptic Drugs, and Adverse Pregnancy Outcomes, 1: Examination and Interpretation of Recent Research. The Journal of clinical psychiatry 2024. link 73 Yang R, Liu J, Diao L, Wei L, Luo H, Cai L. A meta-analysis of the changes in the Gut microbiota in patients with intractable epilepsy compared to healthy controls. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 2024. link 74 Xie Z, Chen Z, Jiang Y, Yao J, Zhang P, Lei H et al.. Causal relationships between epilepsy and the microstructure of the white matter: A Mendelian randomization study. Medicine 2024. link 75 Peng A, Zhou Y, Liu Z, Ji S, Tang Y, Li H et al.. Periconceptional folic acid supplementation for women with epilepsy: A systematic review of the literature. Epilepsy & behavior : E&B 2024. link 76 Díez-Arroyo C, García-García M, Soto-Méndez MJ, Molina-Montes E, Gil-Campos M, Gil Á et al.. Effect of the ketogenic diet as a treatment for refractory epilepsy in children and adolescents: a systematic review of reviews. Nutrition reviews 2024. link 77 Daungsupawong H, Wiwanitkit V. ChatGPT's responses to questions related to epilepsy. Seizure 2024. link 78 Roth J, Uliel-Sibony S, Constantini S. Epilepsy surgery during infancy: The earlier the better. Developmental medicine and child neurology 2024. link 79 Al-Faraj AO, Messina I, Summit R, Modhwadiya D, Ukonu N, Pang TD. Neurologists' and obstetricians' perspectives and current practices in breastfeeding counseling in women with epilepsy. Epilepsy & behavior : E&B 2024. link 80 Barros Guinle MI, Johnstone T, Li D, Kaur H, Porter BE, Grant GA. Approach, complications, and outcomes for 37 consecutive pediatric patients undergoing laser ablation for medically refractory epilepsy at Stanford Children's Health. Journal of neurosurgery. Pediatrics 2024. link 81 Wrzosek M, Banasik A, Czerwik A, Olszewska A, Płonek M, Stein V. Use of sedation-awakening electroencephalography in dogs with epilepsy. Journal of veterinary internal medicine 2024. link 82 Nakamura S, Masuda S, Oda S, Yamakawa D, Yamaguchi S, Ishima T et al.. Polypharmacy-related Shock Symptoms and Complications Associated with Phenothiazine. Internal medicine (Tokyo, Japan) 2024. link 83 ALKhaldi NA, Tu M, Suller Marti A, Zafar A, Le C, Debicki D et al.. Management of patients with epilepsy and Intellectual disabilities in group homes vs. Family Homes: Insights into polypharmacy and seizure characteristics. Epilepsy & behavior : E&B 2024. link 84 Moon S, Watkins L, O'Dwyer M, Shankar R. Relationship between anti-seizure medication and behaviors that challenge in older persons with intellectual disability and epilepsy: a review. Expert review of neurotherapeutics 2024. link 85 Naghavi E, Davari A, Bahadori AR, Razmafrooz M, AmiriFard H, Sabzgolin I et al.. Late-onset drug-resistant epilepsy in pyridoxamine 5'-phosphate oxidase deficiency: a case report. Journal of medical case reports 2024. link 86 Porwal MH, Razzak AN, Kumar V, Obeidat AZ, Sharma U. An analysis of suicidal and self-injurious behavior reports with antiseizure medications in the FDA adverse event database. Epilepsy research 2024. link 87 Kim HK, Jang KS, Kim DW. Comparative analysis of adverse drug reactions associated with new antiseizure medications from the Korea Adverse Event Reporting System database. Epilepsy & behavior : E&B 2024. link 88 Chen T, Chen Q, Zhang Y, Liu T. Adverse events associated with Stiripentol in children aged 0-17 years: An analysis of a real-world pharmacovigilance database. 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Cardiac adverse events associated with lacosamide: a disproportionality analysis of the FAERS database. Scientific reports 2024. link 94 Ghimire S, Dhamala M, Epstein CM. A Stable EEG Epilepsy Network Spans From Infraslow to Ripple and From Interictal to Ictus. Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society 2024. link 95 Musto E, Gambardella ML, Perulli M, Quintiliani M, Veredice C, Verdolotti T et al.. Status epilepticus in BRAF-related cardio-facio-cutaneous syndrome: Focus on neuroimaging clues to physiopathology. Epilepsia open 2024. link 96 Shah RA, Chahal CAA, Ranjha S, Sharaf Dabbagh G, Asatryan B, Limongelli I et al.. Cardiovascular Disease Burden, Mortality, and Sudden Death Risk in Epilepsy: A UK Biobank Study. The Canadian journal of cardiology 2024. link 97 Wang Y, Zuo H, Li W, Wu X, Zhou F, Chen X et al.. Cerebral small vessel disease increases risk for epilepsy: a Mendelian randomization study. 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Original source

[1]
Callosotomy Outcomes: A Meta-Analysis. — Blihar D, Assi J, Breininger L, Episcopio J, Bulathsinhala S, Mehta A et al. World neurosurgery (2026)
[2]
Systematic Review and Meta-Analysis of Bilateral Centromedian Nucleus Neuromodulation for Multifocal and Generalized Epilepsy. — Alhourani A, Chao LY, Chang EF, Rao VR Neuromodulation : journal of the International Neuromodulation Society (2026)
[3]
Clinical Impact of Ketogenic Diet. — Guarnotta V Nutrients (2026)
[4]
Overlapping currents can tune the deep brain. — Smith JE Science (New York, N.Y.) (2026)
[5]
Outcomes of neurosurgery and otolaryngology team surgery for revision vagus nerve stimulation implantation surgery. — Riccardi AC, Shaffer AD, Abdul-Rahman NH, Olson C, Harford E, Pan E et al. Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery (2026)
[6]
Health risk factors and polypharmacy in people with epilepsy and their association with multimorbidity: a single centre retrospective study. — Lea TA, Gaitatzis A Epilepsy & behavior : E&B (2026)
[7]
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