Crize epileptice și managementul lor.
127 de articoleThis scientific commentary examines how anti-seizure medications affect brain network organization following an initial seizure event. The work provides insights into neurobiological mechanisms underlying individual differences in medication response in epilepsy patients.
This 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.
Researchers demonstrated in awake mice that low-current deep brain stimulation of the central thalamus can occasionally trigger electrographic seizures. This finding highlights important safety considerations for thalamic stimulation as a therapeutic approach.
Researchers have identified key language-processing areas in the cerebral cortex that function as interconnected hubs, similar to social networks, which could help surgeons better preserve language function during brain tumor or epilepsy surgery. This study advances understanding of how language is encoded in the brain and provides insights to guide surgical decision-making for improved post-operative language outcomes.
An experimental drug called zorevunersen shows significant promise for children with Dravet syndrome by reducing seizures up to 91% and improving quality of life through enhanced gene function in nerve cell signaling. Positive trial results have prompted researchers to advance to larger Phase 3 clinical trials.
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
