Crize epileptice și managementul lor.
127 de articoleThis article addresses alcohol withdrawal seizures as a serious medical complication, explores the relationship between chronic alcohol use and epilepsy development, and examines how traumatic brain injury can increase seizure risk. The content covers clinically recognized mechanisms linking substance withdrawal, neurological injury, and seizure disorders.
This study examines 13 events in 8 patients initially misdiagnosed with convulsive status epilepticus who actually had psychogenic non-epileptic seizures (PNES). The research highlights that poor response to benzodiazepines and anti-seizure medications should prompt consideration of PNES as a differential diagnosis to avoid unnecessary intubation and inappropriate treatment escalation.
SCN3A-related neurodevelopmental disorder is a rare genetic condition presenting with developmental delays and seizures of varying severity, ranging from isolated speech delay to severe developmental and epileptic encephalopathy (DEE). Seizures typically begin in infancy and are often drug-resistant, particularly in cases with cortical malformations, with additional complications including hypotonia, movement disorders, and potential autonomic dysfunction.
A retrospective study of 595 epilepsy patients on dual anti-seizure medications identified common adverse events including sleepiness (62%), concentration difficulties (55%), and memory problems (53%). Female sex, certain drug combinations (levetiracetam/valproic acid, lamotrigine/valproic acid), drug resistance, and focal/unclassified epilepsy were independently associated with higher adverse event burden.
This review addresses the clinical challenge of drug-resistant frontal lobe epilepsy, the second most common epilepsy type, which is complicated by the frontal lobe's large size making seizure focus localization difficult. The article examines epidemiology, etiologic factors (particularly cortical developmental abnormalities), symptomatology, and advances in neurophysiological and neuroimaging techniques including magnetoencephalography, quantitative PET, 7T MRI, and artificial intelligence-assisted morphometric analysis to improve lesion detection and surgical outcomes.
A prospective study of 235 adult patients with first seizures examined how the 2014 ILAE definition of epilepsy (allowing earlier diagnosis) affected clinical outcomes compared to previous criteria. Among 146 patients diagnosed with epilepsy using new criteria, 72% remained seizure-free at 12-month follow-up, and anti-seizure medication significantly reduced seizure recurrence risk.
This review examines how genetic variations in Arab populations influence the efficacy, safety, and individual responses to anti-seizure medications, identifying specific genetic markers that can predict drug resistance and optimize dosing. Genetic testing for variants in genes such as MTHFR, MDR1, ABCB1, and others enables personalized treatment approaches to improve seizure control and minimize adverse drug reactions.
This study examined whether genetic variations in UGT enzymes (which metabolize the antiepileptic drug lamotrigine) affect seizure control in 47 pregnancies of women with epilepsy. While UGT genotype did not directly predict seizure outcomes, recent pre-pregnancy seizure history (within 6-12 months) was a significant predictor of seizure recurrence during pregnancy and postpartum.
A 32-year-old man with known epilepsy experienced simultaneous bilateral anterior shoulder dislocations immediately after a generalized tonic-clonic seizure, a rare occurrence since seizure-related dislocations are typically posterior. Closed reduction under sedation followed by immobilization and rehabilitation achieved excellent functional recovery at 1-year follow-up, with seizure control emphasized as key to preventing recurrence.
The International League Against Epilepsy released an updated seizure classification in 2025 with six main revisions to improve clinical clarity, including replacing 'onset' in seizure class names, substituting 'consciousness' for 'awareness' to encompass both awareness and responsiveness, and replacing 'motor' with 'observable' features. The update also emphasizes chronological seizure semiology patterns, recognizes epileptic negative myoclonus as a new seizure type, and expands the use of epileptic spasms as a descriptor across focal and unknown seizures.
This survey examines current clinical practices among Italian epileptologists regarding prophylactic anti-seizure medication use in brain tumor patients. The study provides insights into specialist approaches to seizure prevention in this high-risk population.
This prospective study compared 105 adults with epilepsy to 115 healthy controls, assessing separation anxiety disorder using standardized clinical interviews and validated questionnaires. The research examined relationships between separation anxiety symptoms, perceived overprotection, and quality of life outcomes in the epilepsy group, finding lower rates of employment, education, and independent living among those with epilepsy.
Psychiatric disorders commonly coexist with epilepsy but remain underdiagnosed and undertreated due to insufficient mental health resources and neurologist training gaps. This clinical resource provides neurologists with evidence-based strategies to identify and pharmacologically manage reactive symptoms, interictal psychiatric disorders, periictal episodes, and iatrogenic psychiatric effects in their epilepsy patients.
A woman in her 30s with treatment-resistant epilepsy, psychogenic non-epileptic seizures, intellectual disability, and psychosis caused by a maternally inherited balanced chromosomal translocation continued experiencing daily seizures despite multiple antiepileptic drugs, vagus nerve stimulation, and deep brain stimulation of the anterior thalamic nuclei. The case demonstrates the complex relationship between epilepsy, psychiatric comorbidities, neurostimulation side effects (including forced normalization), and suggests genetic disruption of neurodevelopmental genes regulating inhibitory sign
This clinical study of 189 adult patients found that inadequate dosing of anti-seizure medications was independently associated with treatment failure and higher mortality in non-convulsive status epilepticus, regardless of treatment sequence. The research suggests that ensuring appropriate medication dosing is more critical than the specific order of drug administration in managing this condition.
This study proposes SALT, a deep learning model combining LSTM-Transformer architecture with self-supervised pretraining to detect epileptic seizures from EEG signals without requiring large labeled datasets. The method achieved >98% sensitivity and accuracy on two public benchmark datasets using both segment-based and event-based evaluation protocols.
This study identifies DIRAS2, a Ras-related GTPase, as a regulator of seizure susceptibility through its effects on neuronal excitation/inhibition balance and ferroptosis pathways in epilepsy models and temporal lobe epilepsy patients. DIRAS2 overexpression reduces seizure activity and protects against ferroptosis via inhibition of ERK/p38 MAPK signaling, identifying a potential therapeutic target for epilepsy treatment.
A retrospective study of 56 children (ages 0-21) presenting to a pediatric ED with active seizures found that 46% required intubation, most commonly for airway protection or respiratory failure. Intubated patients typically had complex febrile seizures, longer seizure duration, and required multiple antiseizure medications for control.