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International epilepsy day

International Epilepsy Day

International Epilepsy Day, a joint initiative created by the International Bureau for Epilepsy (IBE) and the International League Against Epilepsy (ILAE), is a global event celebrated annually on the 2nd Monday of February, to promote awareness on epilepsy right around the world. International Epilepsy Day


Adults – Diagnosis and treatment


Paediatrics - Diagnosis and treatment

Cochrane Library











Reducing epilepsy diagnostic and treatment gaps: Standardized paediatric epilepsy training courses for health care professionals
This was the largest evaluation of a global epilepsy training course. Participants reported high course satisfaction, showed knowledge gain, and described improvements in clinical behaviour 6 months later. Paediatric epilepsy training (PET) supports the global reduction in the epilepsy ‘treatment gap’ as promoted by the World Health Organization. Developmental medicine & child neurology  1 February 2024

Using a standalone ear-EEG device for focal-onset seizure detection
These preliminary results demonstrate the potential of using ear-EEG to enable routine collection of complementary, prolonged, and remote neurophysiological evidence, which may permit real-time detection of paroxysmal events such as seizures and epileptiform discharges. This study suggests that the ear-EEG device may assist clinicians in making an epilepsy diagnosis, assessing treatment efficacy, and optimizing medication titration. Bioelectronic medicine 7 February 2024 

Focal electroclinical features in generalized tonic–clonic seizures: Decision flowchart for a diagnostic challenge
Key Points

  • Focal semiology and interictal electroencephalography (EEG) are common in generalized tonic–clonic seizures and should not exclude IGE diagnosis.
  • Focal ictal EEG onset of tonic–clonic seizures is rare in idiopathic generalized epilepsy (IGE), and when present, it points to different location than the interictal epileptiform discharges (IEDs).
  • The most common focal semiological feature is forced head version
  • Presence of focal features in IGE does not seem to affect the patient's therapeutic response.
  • The flowchart assessing concordance between interictal and ictal EEG localization accurately classifies these difficult cases.

Epilepsia 27 January 2024

Utility of Exome Sequencing for diagnosis in unexplained Pediatric-Onset Epilepsy
These findings suggest that pediatric-onset epilepsy is genetically heterogeneous and that some patients with previously unexplained pediatric-onset epilepsy had genetic diagnoses with direct clinical implications. JAMA 20 July 2023

Diagnostic value of Video Electroencephalography combined with Magnetic Resonance Imaging-diffusion tensor imaging in epilepsy
The application of magnetic resonance imaging diffusion tensor imaging (MRI-DTI) combined with video electroencephalography (VEEG) to diagnose patients with epilepsy allows for the identification of abnormal structural changes in brain and the location of lesions. Combining both approaches can improve the diagnostic accuracy of each technique alone and provide a reference for the formulation and adjustment of disease management plans. Pakistan Journal of Medical Sciences 3 February 2024

Artificial intelligence in epilepsy phenotyping
Clinical applications of AI-based automated and semi-automated analysis of audio and video recordings of people with epilepsy, allow significant data reduction and reliable detection and classification of major motor seizures. AI models can accurately identify electrographic biomarkers of epilepsy, such as spikes, high-frequency oscillations, and seizure patterns. Integrating AI analysis of electroencephalographic, clinical, and behavioral data will contribute to optimizing therapy for patients with epilepsy. Epilepsia 20 November 2023



Long-term physical and psychiatric morbidities and mortality of untreated, deferred, and immediately treated epilepsy

Key Points

  • Nearly one third of adult patients with newly diagnosed epilepsy were not treated or had deferred treatment in specialist clinical practice.
  • Immediately treated patients had significantly higher health care utilization, likely reflecting differences in epilepsy etiology.
  • Patients undergoing deferred or no treatment did not have higher mortality or seizure-related deaths or a higher incidence of physical and psychiatric comorbidities.
  • These findings support the practice of individualizing epilepsy treatment.
  • Newly diagnosed epilepsy patients had higher rates of psychiatric and physical comorbidities, stressing prompt recognition and intervention.

Epilepsia 28 November 2023

Development of an online calculator for the prediction of seizure freedom following pediatric hemispherectomy using the Hemispherectomy Outcome Prediction Scale (HOPS)
Key points

  • The Hemispherectomy Outcome Prediction Scale (HOPS) Online Calculator predicts the probability of seizure freedom at 1-, 2- and 5-years post-hemispherectomy.
  • The calculator output has an area under the curve (AUC) of 73.0% based on eight variables, including five from the original HOPS study.
  • Online calculators are cost-free tools that can assist physicians in risk estimation and inform joint decision-making with families.

Epilepsia 22 June 2023

Migraine - a borderland disease to epilepsy: near it but not of it
Migraine and epilepsy show a high number of similarities in their mechanisms and clinical presentation. A deeper understanding of the intricate relationship will positively advance patient–oriented research and clinical work. The journal of headache and pain 26 January 2024

Continuous cardiac monitoring in epilepsy: an implantable loop manual activation algorithm for improving ECG signal acquisition accuracy
Arrhythmias with varying clinical outcomes are expected in epilepsy patients and have been monitored continuously. The specified loop recorder external activation algorithm can improve the clinically relevant cardiac arrhythmia detection accuracy in epilepsy patients and the value of future studies. BMC cardiovascular disorders 13 January 2024

Neurodevelopmental outcomes after prenatal exposure to lamotrigine monotherapy in women with epilepsy: a systematic review and meta-analysis
Prenatal exposure to lamotrigine monotherapy is not found to be statistically associated with neurodevelopmental disorders as a whole, language disorders or delay, diagnosis or risk of ASD and diagnosis or risk of ADHD. However, the MA found an increased risk of psychomotor developmental disorders or delay and cognitive developmental delay in less than 3 years old children. Nevertheless, these findings were based exclusively on observational studies presenting biases and on a limited number of included children. More studies should assess neurodevelopmental outcomes in children prenatally exposed to lamotrigine. BMC pregnancy and childbirth 2 February 2024

Behavioral outcomes and neurodevelopmental disorders among children of women with Epilepsy
This study suggests that adaptive functioning of children of women with epilepsy taking commonly used antiseizure medications (ASMs) did not significantly differ from that of children of women without epilepsy, but there was an exposure-dependent association of ASMs with functioning. Thus, psychiatric or psychological screening and referral of women with epilepsy and their offspring are recommended when appropriate. Additional research is needed to confirm these findings. JAMA 20 November 2023

Potential merits and flaws of large language models in epilepsy care: A critical review
Key points

  • Although large language models (LLMs) are applied increasingly in medical care, few studies have applied this strategy in epilepsy care.
  • Epilepsy care could benefit from integrating LLMs to accelerate diagnosis and to facilitate clinical evaluation and patient counseling.
  • A stepwise introduction of LLMs into epilepsy care is proposed to avoid misinterpretation and inappropriate use in daily practice.

Epilespia 2 February 2024

Challenges and directions in epilepsy diagnostics and therapeutics: Proceedings of the 17th Epilepsy Therapies and Diagnostics Development conference
Key points

  • Robust programs are in place to screen and develop novel epilepsy therapeutics, with particular attention to eliminating investigational therapeutics that might paradoxically aggravate seizure burden
  • After compound identification, challenges remain in conducting clinical trials, particularly in minimizing placebo risks, maximizing subject recruitment, and navigating the complex regulatory environment
  • Key challenges remain in terms of identifying interventions that are disease-modifying rather than just seizure-suppressing, and biomarkers and measures to track seizures and nonseizure outcomes

Epilepsia 22 December 2023



Identification of potential crucial genes and therapeutic targets for epilepsy
The results of this study highlight protein tyrosine phosphatase receptor-type O gene (PTPRO) and growth arrest and DNA damage inducible alpha gene (GADD45A) as potential genes for the diagnosis and treatment of epilepsy. European journal of medical research 11 January 2024

Genetic prediction of antihyperglycemic drug targets and risk of epilepsy: a mendelian randomisation study
A connection between diabetes and an increased risk of epilepsy has been suggested by observational studies. Animal studies have also shown that antihyperglycemic drugs can improve seizures. However, it is unclear whether antihyperglycemic drugs have a causal role in epilepsy in humans. To investigate this potential causal relationship, a Mendelian randomisation study was conducted using International League Against Epilepsy data as the discovery set and FinnGen data as the replication set. It was discovered that three antidiabetic drug target genes, ETFDH, CYP21A2 and CYP2D6, were involved in the occurrence of epilepsy. BMC pharmacology and toxicology 2 January 2024

Impact of prenatal, neonatal, and postnatal factors on epilepsy risk in children and adolescents: a systematic review and meta-analysis
Epilepsy in children and adolescents can be attributed to a multitude of intricate factors, notably those during pregnancy, delivery and the postnatal period. These findings highlight the crucial role of prenatal and postnatal care in reducing the impact of these factors on epilepsy occurrence. Acta Epileptologica 2 January 2024

Maternal sevoflurane exposure increases the epilepsy susceptibility of adolescent offspring by interrupting interneuron development
The authors findings demonstrate that maternal anesthesia impairs interneuron migration through the CXCL12/CXCR4 signaling pathway, and influences the interneuron properties, leading to the increased epilepsy susceptibility in adolescent offspring. This study provides a novel perspective on the developmental neurotoxicity of the mechanistic link between maternal use of general anesthesia and increased susceptibility to epilepsy. BMC medicine 21 December 2023

Risk factors for in-hospital seizure and new-onset epilepsy in coiling and clipping treatment of aneurysmal subarachnoid hemorrhage
The occurrence of epilepsy following aneurysmal subarachnoid hemorrhage was relatively common. Clipping surgery and brain edema emerged as independent predictive factors for in-hospital seizures, while onset seizures and in-hospital seizures were identified as independent predictors of epilepsy during follow-up. Patients presenting these risk factors may benefit from long-term electroencephalogram monitoring and should be considered for prophylactic antiepileptic drugs. Additionally, lumbar drainage proved effective in improving both early and late epileptic outcomes in the Fisher III-IV group. World neurosurgery 3 February 2024



Management of epilepsy during pregnancy and lactation
For women with epilepsy in their childbearing years, the safety profile is important for them and their unborn children, because treatment is often required to protect them from seizures during pregnancy and lactation. BMJ 8 September 2023

Management of status epilepticus in pregnancy: a clinician survey
Levetiracetam is the most frequently used anti-seizure medication (ASM) for benzodiazepine-refractory SEP. Survey participants tended to manage SEP differently than in non-pregnant patients including greater involvement of interdisciplinary teams as well as avoidance of ASMs associated with known teratogenicity. Neurological research and practice 18 January 2024

Current state of the art of traditional and minimal invasive epilepsy surgery approaches

  • This manuscript aims to provide an overview of surgical approaches in epilepsy surgery.
  • Respective advantages and disadvantages of each approach have been summarized.
  • Not all procedures are appropriate for all patients.
  • A trend has emerged to shift from large open surgeries to minimally invasive surgical techniques.

Brain and spine 27 January 2024

Repurposing dimethyl fumarate as an antiepileptogenic and disease-modifying treatment for drug-resistant epilepsy
Taken together, these findings suggest that Dimethyl fumarate (DMF), through the activation of Nrf2, has the potential to serve as a therapeutic target for preventing epileptogenesis and modifying epilepsy. Journal of translational medicine 8 November 2023

Levetiracetam vs Lamotrigine as first-line antiseizure medication in female patients with Idiopathic Generalized Epilepsy
Results of this comparative effectiveness research study suggest the use of levetiracetam as initial alternative monotherapy in female patients with juvenile myoclonic epilepsy (JME). Further studies are needed to identify the most effective antiseizure medications (ASMs) alternative in other idiopathic generalized epilepsy (IGE) syndromes. JAMA 2 October 2023

Topiramate ban in women of childbearing potential with idiopathic generalized epilepsy: Does effectiveness offset the teratogenic risks?
Regulatory agencies have recently discouraged the prescription of topiramate (TPM) to women of childbearing potential with epilepsy due to growing evidence of the teratogenic and neurodevelopmental risks associated with its use during pregnancy. It remains, however, unclear whether the use of TPM in this population can be supported to some extent by its high effectiveness. In this multicenter, retrospective, cohort study performed at 22 epilepsy centers, we investigated the comparative effectiveness of TPM and levetiracetam (LEV) given as first-line antiseizure medication in a cohort of women of childbearing potential with idiopathic generalized epilepsy (IGE). A total of 336 participants were included, of whom 24 (7.1%) received TPM and 312 (92.9%) LEV. Women treated with TPM had significantly higher risks of treatment failure and treatment withdrawal and were less likely to achieve seizure freedom at 12 months compared to women treated with LEV. In conclusion, this study highlighted a low tendency among clinicians to use TPM in women of childbearing potential with IGE, anticipating the recently released restrictions on its use. Furthermore, the available data on effectiveness do not appear to support the use of TPM in this population. Epilepsia 31 July 2023



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