Epilepsy & Surgery

1. Tractography from T1-weighted MRI: Empirically exploring the clinical viability of streamline propagation without diffusion MRI

   Over the last few decades, diffusion MRI (dMRI) streamline tractography has emerged as the dominant method forin vivoestimation of white matter (WM) pathways in the brain. One key limitation to this technique is that modern tractography implementations require high angular resolution diffusion imaging (HARDI). However, HARDI can be difficult to collect clinically, limiting the reach of tractography analyses to research cohorts and thus limiting many WM investigations to certain populations and...

2. Exploring Chinese family caregiver vigilance in preventing hospitalized children falls from the attention network theory perspective: a qualitative study

   CONCLUSIONS: Family caregivers have a low level of vigilance in preventing falls among hospitalized children, and they do not pay sufficient attention to the prevention of such incidents, with attention bias existing. Medical staff should change the attention allocation of family caregivers through multiple educational ways to reduce the occurrence of falls.

3. Real-world comparison of first-line antiseizure monotherapy and the role of age at treatment initiation in newly diagnosed childhood epilepsy: A cohort study from a tertiary center

   OBJECTIVE: This study was undertaken to evaluate the real-world effectiveness and tolerability of first-line antiseizure medication (ASM) monotherapy in children with newly diagnosed epilepsy, focusing on comparative outcomes across developmental age groups and ASM types, and identifying clinical risk factors of treatment failure.

4. Factors associated with lateralized cognitive dysfunction using the Cognitive Lateralization Rating Index in pediatric epilepsy

   CONCLUSIONS: Results establish the CLRI as a potentially useful tool for both research and clinical care to quantitively stratify cognitive risk profiles for pediatric epilepsy surgery evaluations.

5. Theta-phase locking of single neurons during human spatial memory

   Memory processes may rely on complex interactions between single-neuron activity and local field potentials. To better understand such spike-field relationships in humans, we examined human theta-phase locking-neuronal firing at similar theta phases over time-using single-neuron recordings in epilepsy patients performing a spatial memory task. Applying frequency-adaptive theta-phase estimation in a broad 1-10 Hz frequency range, we found that theta-phase locking was widespread in the human...

6. Spatiotemporal Dynamics of Language Information Representation within the Left Inferior Parietal Lobule Network: An Intracranial SEEG Study

   The left inferior parietal lobe (IPL) supports diverse cognitive functions through the finely differentiated yet coordinated interactions of its subregions, including the supramarginal gyrus (SMG), angular gyrus (AG) and lateral bank of the intraparietal sulcus (lbIPS). However, how these subregions dynamically represent and exchange information during cognitive processing remains unclear. Language processing, integrating visual form, phonology, and semantics, provides an ideal model for...

7. Seizure and psychosocial outcomes in patients with DBS for intractable epilepsy

   CONCLUSION: DBS therapy resulted in > 50 % seizure reduction in 59 % of patients with intractable epilepsy, with responders exhibiting a higher median ASM burden. While psychosocial factors were not significantly linked to seizure outcomes, TR patients demonstrated a relative worsening of Depression T-scores compared to non-responders, warranting further investigation.

8. Efficacy of cenobamate in tumor-related epilepsy

   CONCLUSIONS: This study demonstrates that adjunctive therapy with cenobamate treatment for TRE is a feasible and potentially effective option. Clinical history, including drug resistance, did not predict drug efficacy. No adverse effects were reported in those treated with chemotherapy. Further studies are needed to validate treatment response and safety.

9. A Nonlinear Method to Identify Seizure Dynamic Trajectory Based on Variance of Recurrence Rate in Human Epilepsy Patients Using EEG

   CONCLUSIONS: This approach could pinpoint brain regions involved in seizures at any stage and could be useful for clinical monitoring and surgical planning. The method's simplicity and strong performance suggest it is promising for the real-time application during epilepsy treatment.

10. The well-being of mothers caregiving for children with cerebral palsy: a Tunisian cross-sectional study

    CONCLUSION: our findings highlight the prevalence of fatigue, burden, serious psychological distress, and SDs among mothers of children with CP. Consequently, medical personnel and social workers should be more attentive to the needs of these mothers who often silently endure the emotional and physical strains of caregiving.

11. Daridorexant and Insomnia in Clinical Practice: A Nominal Group Technique Consensus Study among Italian Sleep and Insomnia Experts

    CONCLUSION: The expert consensus provides a comprehensive framework for daridorexant clinical application, advocating for further research to expand the evidence base and refine best practices, as well as underscoring the importance of a multidisciplinary approach that combines both pharmacological and psychosocial interventions to optimize outcomes.

12. Neuropsychological assessment for epileptic disease: From theory to practice

    CONCLUSIONS: Neuropsychological assessment is an indispensable component of epilepsy care, providing objective data to support individualized treatment. While limitations exist, ongoing refinement of assessment tools and training standards holds promise for broader clinical impact and integration into precision medicine frameworks.

13. Postneonatal epilepsy after acute provoked neonatal seizures: Incidence, predictors, and clinical burden in a multicenter cohort followed through early childhood

    OBJECTIVE: Epilepsy is a known potential outcome following acute provoked neonatal seizures, but its onset, treatment patterns, and health care utilization through childhood remain poorly characterized. This study aimed to define the incidence and timing of postneonatal epilepsy, identify perinatal predictors, and describe the clinical burden of epilepsy among survivors of acute provoked neonatal seizures through early childhood.

14. Emergent technologies in clinical neurophysiology to study the central nervous system: IFCN handbook chapter

    This chapter reviews recent breakthroughs in neurophysiological brain mapping, focusing on EEG, MEG, and MRI technologies and their integration with stimulation techniques. High-density and portable EEG systems now allow more precise, user-friendly, and mobile recordings. Machine learning enhances biomarker detection and diagnostic power, particularly in epilepsy, cognitive disorders, and sleep pathology. MEG has become more versatile with the development of wearable optically pumped...

15. Gingival enlargement following levetiracetam treatment: A clinical case analysis

    This report describes a 21-year-old female with a history of epilepsy, diagnosed at age 17, who developed gingival enlargement after being treated with levetiracetam. Her dosage was titrated to 750 mg twice daily, achieving satisfactory seizure control. Regular neurological evaluations and laboratory tests remained within normal limits for 3 years. However, the patient subsequently reported increased gingival size and a perception that her teeth appeared smaller. Examination confirmed gingival...

16. DNA methylation differences stratified by normalized fetal/placental weight ratios suggest neurodevelopmental deficits in neonates with congenital heart disease

    CONCLUSION: Gene ontology enrichment analysis of differential methylation regions revealed significant differences between normalized F/P weight ratio groups in neurogenesis genes. Furthermore, our data identified methylation differences between unbalanced and balanced normalized F/P weight ratio groups in gene pathways associated with ND dysfunction common in the aging CHD population suggesting converging pathways for ND disorders that should be investigated further.

17. Deep brain stimulation for neurological and neurodevelopmental disorders in children: Current applications and future perspectives

    Deep brain stimulation (DBS) has advanced the treatment of refractory neurological and neuropsychiatric conditions in adults, offering a reversible and adjustable therapy. While its application among children remains in its infancy, DBS holds potential for the treatment of conditions such as dystonia, epilepsy, and neurodevelopmental disorders including severe self-injurious behaviour. Paediatric DBS introduces unique opportunities for early intervention during critical periods of...

18. Neurological features of acute poisoning in paediatric patients presenting to the emergency department: a retrospective study

    CONCLUSIONS: Altered consciousness is the most common neurological feature in paediatric poisoning but is not directly linked to hospitalisation. While neurological symptoms are important in assessment, factors such as suicidal intent, mode of emergency access, and age are stronger predictors of hospitalization and should be prioritized in the initial evaluation.

19. Health Related Quality of Life Assessment in Children with Epilepsy Aged 3-11 at a Tertiary Care Hospital in Karachi

    Epilepsy has a global incidence ranging from 50 to 100 per 100 000 children per year in high-income countries, with a disproportionately higher burden in low- and middle-income countries. Limited data exist on the health-related quality of life of children with epilepsy. This study assessed the health-related quality of life of children with epilepsy, aged 3-11 years, using the Quality of Life in Childhood Epilepsy Questionnaire-55 (QOLCE-55). A cross-sectional survey was conducted at Aga Khan...

20. What determines the timing of epilepsy surgery in children with cortical malformations and low-grade epilepsy-associated tumors?

    OBJECTIVES: Timely referral and efficient presurgical evaluation are important to optimize postoperative seizure and developmental outcomes in epilepsy surgery patients. We aimed to identify determinants of time intervals from epilepsy diagnosis to referral to specialized centers and epilepsy surgery in children with malformations of cortical development (MCDs) and low-grade epilepsy-associated tumors (LEATs).