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Cognition disorders is a common complication of epilepsy, which seriously affects patients' activities of daily living. Timely measures can avoid further impairment of patients' cognitive function. There are many risk factors for cognition disorders in patients with epilepsy. This paper summarizes the risk factors related to cognition disorders in patients with epilepsy, and classifies them according to epileptic factors and non-epileptic factors, so as to provide a theoretical basis for accurate treatment of epilepsy. [ABSTRACT FROM AUTHOR]

With the rapid development of neuroelectrophysiology, neuroimaging and other technologies, a large amount of evidence has shown the occurrence and development of epilepsy was closely related to cortico - subcortical neural network. This paper aims to review the relevant studies on the involvement of subcortical structures such as thalamus, hypothalamus, cerebellum, basal ganglia and brainstem in the occurrence and development of epilepsy, as well as some important targets of subcortical nucleus for the treatment of drug-resistant epilepsy (DRE) by neuroregulation, in order to provide help for the exploration of new intervention targets for epilepsy treatment. [ABSTRACT FROM AUTHOR]

Epilepsy is a common neurological disease in clinic. Epilepsy caused by structural causes can be cured by surgery, which has been the focus of attention in the field of epilepsy surgery. With the development of gene sequencing technology, more and more studies have found that structural etiology may be caused by somatic mutations of genes. In this paper, somatic mutation-related pathogenic genes of four common pathological types of epilepsy surgery, including malformation of cortical development (MCD), long-term epilepsy associated tumor (LEAT), hippocampal sclerosis (HS) and hypothalamic hamartoma (HH), were reviewed, and their effects on surgical protocol formulation and prognosis were reviewed, in order to provide a new idea for the treatment of epilepsy. [ABSTRACT FROM AUTHOR]

At present, there is a lack of reliable prediction index for sudden unexpected death in epilepsy (SUDEP), which poses a great threat to the lives of patients with epilepsy. With the deepening of research, it has been found that postictal generalized electroencephalography suppression (PGES) occurs in EEG monitoring after seizure, especially generalized tonic - clonic seizure (GTCS). Since then, PGES has attracted much attention as a possible EEG marker of SUDEP. Combined with the study of the pathophysiological mechanism, related factors of PGES phenomenon, and this paper further analyzes the relationship between the occurrence of PGES and SUDEP. [ABSTRACT FROM AUTHOR]

In recent years, with the rapid development of gene sequencing technology, a variety of epilepsy pathogenic genes have been discovered, among which GRIN2A gene variations encoding the neurotransmitter N-methyl-D-aspartate receptor (NMDAR) are closely related to the occurrence of epilepsy. At present, there are relatively few studies on the function of epileptic related variations in GRIN2A gene. The resulting epilepsy phenotypes are complex and varied, and different patients have different therapeutic effects on different drugs. This paper briefly summarizes the possible relationship between the changes of NMDAR structure and function caused by GRIN2A gene variations and the clinical phenotype of epilepsy, providing clues for the precise treatment of epilepsy. [ABSTRACT FROM AUTHOR]

Background Focal cortical dysplasia (FCD) is a group of diseases including abnormal cortical layer, abnormal cell structure and abnormal white matter. It is one of the main causes of intractable epilepsy. In this paper, the clinical manifestations, EEG and MRI characteristics of FCD in children and adolescents were summarized in order to improve the diagnosis and treatment level of clinicians. Methods The clinical symptoms, EEG and MRI manifestations of 22 cases were retrospectively analyzed. Results Among 22 cases, 13 cases (59.09%) only showed focal seizures, 6 cases (27.27%) only showed generalized seizures, and 3 cases (13.64%) showed focal to generalized seizures. The seizure frequency of 22 patients was namely: 6 cases (27.27%) had seizures daily, 13 cases (59.09%) were more than one time/month, and 3 cases (13.64% ) were less than one time/month. EEG in 21 cases (95.45% ) showed abnormal slow waves and epileptiform discharges. MRI of 12 cases showed FCD in frontal lobe, the scalp EEG of whom showed abnormal slow waves and epileptiform discharges in focal frontal region in 7 cases (7/12), extensive slow waves and spike and slow wave complex in 2 cases (2/12), temporal sharp waves in 2 cases (2/12), and a small amount of sharp waves at midline in one case (1/12). Simple focal seizures occurred in 7 cases (7/12), generalized seizures occurred in 4 cases (4/12), and focal to generalized seizures occurred in one case (1/12). MRI of 6 cases showed FCD in parietal lobe, the scalp EEG of whom showed abnormal slow waves and epileptiform discharges in focal parietal region in 3 cases (3/ 6), epileptiform discharges in temporo - occipital region in 2 cases (2/6), and no abnormality in one case (1/ 6). Simple focal seizures occurred in 5 cases (5/6), and focal to generalized seizures occurred in one case (1/6). MRI of 2 cases showed FCD in temporal lobe, the scalp EEG of whom showed abnormal slow waves and epileptiform discharges in focal temporal region in one case (1/2) and epileptiform discharges in frontal region in one case (1/2). Generalized seizures occurred in those 2 cases. MRI of 2 cases showed FCD in insular lobe, the scalp EEG of whom showed epileptiform discharges in bilateral temporal regions in one case (1/2) and sharp waves and sharp and slow wave complex of all lead in one case (1/2). Simple focal seizures occurred in one case (1 /2) and focal to generalized seizures occurred in one case (1/2). Conclusions FCD mostly occurs in preschool and school age. Epileptic seizures are focal or generalized, other seizure type can also be seen, and the frequency is high. Head MRI is an important method for diagnosing FCD. Antiepileptic drugs (AEDs) therapy is mostly used to control epileptic seizures. Epilepsy surgeries should be considered if the curative effect of AEDs is poor. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Neurology & Neurosurgery is the property of Chinese Journal of Contemporary Neurology & Neurosurgery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To analyze stereo -electroencephalography (SEEG) data from patients with drug-resistant epilepsy (DRE) and explore the differences in graph theory indices of brain network between the epileptogenic zone (EZ) and the non-ictal zone (NIZ). Methods Reviewed data from 11 patients who underwent SEEG implantation at Beijing Tiantan Hospital, Capital Medical University from August 2022 to December 2023. Based on the SEEG and structural imaging data, we calculated the epileptogenicity index and constructed epileptogenic map to differentiate the EZ from the NIZ. We then used Granger causality analysis to calculate functional adjacency matrices for both regions during interictal and epileptic periods, combining graph theory indices such as global efficiencies (Eglob), local efficiencies (Eloc), clustering coefficients (Cp), characteristic path length (Lp), normalized clustering coefficients (γ), normalized characteristic path length (λ), and small-world parameter (σ). We analyzed changes in the graph theory indices of patients in interictal and epileptic periods. Results Compared with the interictal period, both γ (t = - 3.730, P = 0.005) and λ (t = - 6.436, P = 0.001) decreased in the NIZ during the epileptic period, while the differences of γ and λ in the EZ during the epileptic period were not statistically significant (P > 0.05, for all). In terms of network efficiency, compared with the interictal period, Eglob (t = 5.360, P = 0.002; t = 5.577, P = 0.001) and Eloc (t = 4.450, P = 0.003; t = 4.038, P = 0.005) in both the EZ and NIZ increased during the epileptic period, while Lp decreased (t = - 5.127, P = 0.002; t = - 3.912, P = 0.005). Conclusions During the epileptic period, both the EZ and NIZ exhibit increased synchronization across the whole brain network. Changes in graph theory indices, particularly the γ and λ may serve as the potential biomarkers for distinguishing the EZ and NIZ in epilepsy patients. [ABSTRACT FROM AUTHOR]

Objective To compare the clinical efficacy and safety of levetiracetam and oxcarbazepine in the treatment of focal epilepsy. Methods A total of 476 patients with focal epilepsy treated at Fujian Provincial Hospital from October 2020 to October 2022 were selected. Based on their medication, they were divided into the levetiracetam group (n = 275) and the oxcarbazepine group (n = 201). Both groups underwent continuous treatment for 12 months. The overall effective rate and incidence of adverse reactions in both groups and different subgroups were analyzed. Results The overall effective rate in the levetiracetam group was 57.82% (159/275), and in the oxcarbazepine group was 46.77% (94/201). The overall effective rate in the levetiracetam group was higher than that in the oxcarbazepine group (χ2 = 5.696, P = 0.017). Efficacy analysis of levetiracetam monotherapy across different age subgroups showed statistically significant differences (χ2 = 6.785, P = 0.034), with the overall effective rate in younger patients being higher than that in minors (χ2 = 3.898, P = 0.048) and middle-aged/older patients (χ2 = 4.946, P = 0.026). Levetiracetam was more effective in patients with initially normal imaging compared to those with abnormal imaging (χ2 = 5.349, P = 0.021). In the oxcarbazepine monotherapy subgroup analysis, oxcarbazepine was also more effective in patients with initially normal imaging (χ2 = 10.036, P = 0.002). Efficacy analysis of the same subgroup with different medications indicated that for younger patients with focal epilepsy, levetiracetam was superior to oxcarbazepine (χ2 = 6.591, P = 0.010). In the levetiracetam group, 13 cases (4.73%) experienced adverse reactions, while the oxcarbazepine group had 19 cases (9.45%). The incidence of adverse reactions in the oxcarbazepine group was higher than that in the levetiracetam group (χ2 = 4.135, P = 0.042). Conclusions Compared to oxcarbazepine monotherapy, levetiracetam monotherapy demonstrated better clinical efficacy in treating focal epilepsy, particularly in younger patients. The incidence of adverse reactions in levetiracetam was lower. Both medications were more effective in patients with initially normal imaging compared to those with abnormal imaging. [ABSTRACT FROM AUTHOR]

Objective Summarize the clinical and genetic characteristics of atypical Rett syndrome and developmental epileptic encephalopathy caused by IQSEC2 gene variation. Methods and Results From May 2020 to April 2022, Anhui Provincial Children's Hospital diagnosed and treated 4 children with atypical Rett syndrome and developmental epileptic encephalopathy caused by IQSEC2 gene variation, including 2 males and 2 females were a pair of identical twins. They all had comprehensive developmental delay before onset. At the age of 2 years, all cases gradually exhibited clinical manifestations of atypical Rett syndrome, such as frequent clapping, biting, sleep disorders (increased sleep or difficulty falling asleep), and grinding teeth, followed by developmental regression and seizures. The initial age of epilepsy was from 2 years and 2 months to 2 years and 10 months. All cases started with generalized tonic-clonic seizure, with epileptic spasm occurring between 2 and 11 months of course. Case 2, Case 3 and Case 4 were also accompanied by focal seizures. Four cases with VEEG background of 4-6 Hz θ wave, the VEEG during the interictal phase was a broad multifocal sharp slow complex wave. In Case 2, Case 3 and Case 4, MRI was abnormal, mainly with increased depth of cerebral hemispheric sulcus and gyrus. The whole exome sequencing suggested pathogenicity and possible pathogenic variations in the IQSEC2 gene, Case 1 and Case 2 were frameshift mutations of c. 608dup (p. Gln204Profs*35), while Case 3 and Case 4 were nonsense mutations of c.2231C>A (p.Ser744Ter) and c.2521C>T (p. Gln841Ter), respectively. The four mutation sites have not been reported domestically or internationally. All cases received treatment with multiple antiepileptic seizure medicine. The last follow-up age was from 4 years and 3 months to 6 years and 3 months. All cases were unable to walk alone and had no active language. There were no seizures in Case 1 for 3 years, occasional seizures in Case 2 and Case 4, and frequent seizures in Case 3. Conclusions IQSEC2 gene variation can manifest as atypical Rett syndrome, which can be accompanied by refractory epileptic spasms. Both males and females have severe phenotypes, and the severity of clinical phenotypes at the same mutation site varies. Our report enriches the variation spectrum and clinical phenotype spectrum of the IQSEC2 gene, expands the genetic spectrum of Rett syndrome and developmental epileptic encephalopathy, and provides value for the clinical diagnosis, treatment and subsequent research of this disease. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Neurology & Neurosurgery is the property of Chinese Journal of Contemporary Neurology & Neurosurgery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Nowadays, the strategies of gene therapy for the treatment of refractory epilepsy (RE) mainly include modulating neurotransmitter systems, neuropeptide Y (NPY) and neurotrophic factors. Among them, the hot target spots include γ-aminobutyric acid (GABA) and its receptor, N-methyl-D- aspartate (NMDA) and its receptor, galanin, NPY and neurotrophic factors. This paper reviews the chief research results, and advantages and disadvantages of studies, and provides evidence for the treatment of refractory epilepsy. [ABSTRACT FROM AUTHOR]

Background Epilepsy is a chronic neurological condition characterized by paroxysm of seizures due to abnormal electrical discharge from central nervous system neurons. Several new antiepileptic drugs (AEDs) were listed over the past two decades, and they were believed to be equally effective and have better tolerability and side effect profiles. This paper aims to evaluate the efficacy and safety of adjunctive topiramate in refractory partial seizures. Methods Relevant research articles about randomized controlled trials of adjunctive topiramate in refractory partial seizures, with topiramate, Topamax, add - on treatment, adjunctive treatment, add - on therapy, adjunctive therapy, refractory partial seizure, refractory partial epilepsy both in Chinese and English as retrieval words, were retrieved from PubMed (1995-2014), Cochrane Central Register of Controlled Trials (CENTRAL, 1995-2014), The Cochrane Database of Systematic Reviews (CDSR, 1995-2014), China National Knowledge Infrastructure (CNKI, 1995-2014) and Wanfang Data (1999-2014). Two reviewers independently evaluated the quality of the included articles and abstracted the data. A Meta-analysis was conducted using RevMan 5.0 software. Results According to the enrollment criteria, 13 prospective, randomized controlled clinical trials with a total of 1622 patients were finally selected. The proportions of patients with reduction in seizure frequency ⩾ 50% (OR = 3.710, 95% CI: 2.870-4.810; P = 0.000), ⩾ 75% (OR = 7.220, 95% CI: 3.310-15.750; P = 0.000) and seizure free (OR = 3.380, 95%CI: 1.720-6.640; P = 0.000) in topiramate group were significantly higher than that in control group. The treatment withdrawal ratio was significantly higher compared to placebo in 600 mg/d and 800 mg/d subgroups, but not in 200 mg/d subgroup (200 mg/d: OR = 2.170, 95%CI: 0.470-9.950, P = 0.320; 600 mg/d: OR = 2.090, 95%CI: 1.020-4.270, P = 0.040; 800 mg/d: OR = 8.000, 95%CI: 1.390-46.140, P = 0.020). The common side effects included somnolence, anorexia, ataxia, aprosexia, dizziness, fatigue, nausea, thinking abnormality, paraesthesia and weight loss. The occurrence rate of side effects in topiramate group was higher than that in control group. Conclusions Topiramate is effective when added to existing therapy in patients with refractory partial seizures. The withdrawal rate of 200 mg/d topiramate is similar to control group. Compared with the control group, adverse effects are more common but mild or moderate, mainly related with the central nervous system. However, trials included in this study are of relatively short duration, and provide no evidence for the long- term efficacy of topiramate. [ABSTRACT FROM AUTHOR]

Objective To summarize the clinical manifestations, EEG and imaging features of patients with symptomatic episodes of anti-leucine rich glioma inactivated 1 (LGI1) antibody-associated encephalitis (hereinafter referred to as anti-LGI1 antibody-associated encephalitis). Methods and Results The clinical data of 41 patients diagnosed with anti-LGI1 antibody-associated encephalitis with symptomatic episodes from March 2019 to March 2022 in Beijing Tiantan Hospital, Capital Medical University were retrospectively analyzed. 1) Clinical features: onset of symptomatic seizures in the early stage of encephalitis in the form of epileptic seizure [34.15% (14/41)], faciobrachial dystonic seizures [FBDS, 17.07% (7/41)] or both [48.78% (20/41)]. 2) Imaging features: the vast majority of patients present with typical unilateral or bilateral medial temporal lobe structures including amygdala and hippocampus, parahippocampal gyrus T2WI and FLAIR hypersignal [87.80% (36/41)], and/or amygdala swelling [65.85% (27/41)]. 3) EEG characteristics: in the interattack period, slow EEG background was observed [53.66% (22/ 41)], including diffuse and widespread slow - wave activity background [50% (11/22)]. The epileptoid discharges were unilateral (n = 8) or bilateral (n = 6), or bilateral multifocal, and some patients could still have periodic epileptoid discharges [12.20% (5/41)]. VEEG recordings showed symptomatic seizures [78.05% (32/41)] and FBDS of 59.38% (19/32), of which 3 cases presented faciobrachial dystonic seizures superposition (FBDS+). Epileptic seizure and subclinical seizures were 46.88% (15/32) and 12.50% (4/32), respectively. 4) Drug therapy: all patients received immunotherapy in addition to antiepileptic seizure medicine (ASM), including glucocorticoid combined with intravenous immunoglobulin [IVIg, 78.05% (32/ 41)], glucocorticoid alone [12.20% (5/41)] or IVIg therapy [9.75% (4/41)]. A small number of patients were supplemented with the immunosuppressive agent mortemycophenolate [14.63% (6/41)]. 5) Prognosis: a total of 37 patients were followed up for (21.36 ± 11.53) months. The total seizure-free rate was 86.49% (32/37), and 56.76% (21/37) of patients stopped using ASM. Conclusions Symptomatic episodes of encephalitis associated with anti-LGI1 antibody were characterized by temporal lobe or perilateral fissure. FBDS is the most characteristic clinical manifestation. All patients should start immunotherapy as early as possible to improve the rate of good prognosis. [ABSTRACT FROM AUTHOR]

Objective To analyze and summarize the clinical and genetic characteristics of potassium channel gene variation in infant epileptic encephalopathy (EE). Methods and Results A total of 11 infants with EE associated with potassium channel gene variation admitted to Hu'nan Children's Hospital from July 2016 to January 2020 were tested by the next generation sequencing (NGS). The variants and their sources were verified by Sanger sequencing. The clinical phenotype included epilepsy of infancy with migrating focal seizures (EIMFS, 4 cases), Ohtahara's syndrome (OS, 2 cases), infantile spasm (IS, 2 cases) and nonspecific EE (3 cases). There were 8 cases of new genetic variation and 3 cases of genetic variation (all from mothers). The variation types were KCNQ2 gene variation (5 cases), KCNT1 gene variation (4 cases) and KCNB1 gene variation (2 cases). Several antiepileptic seizure medicine (ASM) were used in combination therapy, and some of the infants were assisted with ketogenic diet (3 cases). After a mean follow-up of 19 months, 3 cases were completely free of seizures, one case was effective, 7 cases were ineffective, and 11 cases were all left with mental retardation and movement disorders. Conclusions Potassium channel gene variation is a common genetic cause of EE in infants, which can cause different clinical phenotypes. Genetic testing can assist in the etiological diagnosis and provide theoretical basis for precise treatment. [ABSTRACT FROM AUTHOR]

Etiology of epilepsy is complex. Immune has been defined as one of the etiological groups of epilepsy. Autoimmune epilepsy attracts experts worldwide to investigate and new conceptual definitions has been proposed. Based on the pathophysiology, autoimmune epilepsy includes two entities, which are acute symptomatic seizures secondary to autoimmune encephalitis (AE) and autoimmune - associated epilepsy (AAE). We interpret the new concepts, the characteristics of extracellular and intracellular neuronal antibodies which contribute to the pathogenesis of epilepsy, and AE manifested by seizures in this review. We hope that the article helps researchers and clinicians have a better understanding of AAE and use standard terms in practical situations, thus improving diagnosis and treatment of epilepsy. [ABSTRACT FROM AUTHOR]

The research and treatment of epilepsy is entering a new era. In order to meet the arrival of this era, organizations such as International League Against Epilepsy (ILAE) have proposed a series of reform measures, which will bring new concepts to the prevention and treatment of epilepsy, establish a new knowledge framework, and promote scientific progress in this field. This article introduces the significance of the transition from anti-epileptic to anti-seizure, the new classification of epilepsy syndromes of the ILAE, the new international standard of EEG, and discusses the international treatment methods for status epilepticus (SE). [ABSTRACT FROM AUTHOR]

Objective To investigate the risk factors of anti - N - methyl - D - aspartate receptor (NMDAR) encephalitis with acute symptomatic seizure (ASS), and establish a Nomogram model based on clinical indicators. Methods A retrospective analysis was performed on 84 patients with anti-NMDAR encephalitis who were diagnosed in Beijing Tiantan Hospital, Capital Medical University from May 2012 to October 2020. Univariate and multivariate Logistic regression analyses were used to determine the risk factors of anti - NMDAR encephalitis with ASS, and a Nomogram model was constructed. The receiver operating characteristic (ROC) curve and calibration curve of the model were plotted, and Hosmer - Lemeshow goodness of fit test was performed. Results In all 84 patients, 63 cases (75%) presented with ASS, and 35 cases (41.67%) had ASS as the initial symptom. Logistic regression analysis showed male (OR = 7.680, 95%CI: 1.811-32.562; P = 0.006), psychosis and abnormal behavior (OR = 6.486, 95%CI: 1.818-23.141; P = 0.004), anti-NMDAR antibody titer in cerebrospinal fluid (CSF) ≥ 1:32 (OR = 9.322, 95%CI: 2.132-40.766; P = 0.003) were the risk factors of anti-NMDAR encephalitis with ASS, older age was the protective factor (OR = 0.942, 95%CI: 0.903-0.983; P = 0.006). A Nomogram model was established based on the 4 risk factors, and the area under curve (AUC) of ROC was 0.862 (95%CI: 0.776-0.949, P = 0.000). Calibration curve showed a good agreement between the predicted probability and the actual probability of ASS occurrence, and Hosmer-Lemeshow test showed there was no statistical difference (χ² = 4.318, P = 0.827). Conclusions Male, young age, psychosis and abnormal behavior, and anti-NMDAR antibody titer in CSF ≥ 1:32 are more likely to have ASS in patients with anti-NMDAR encephalitis. This Nomogram model constructed based on the above 4 indicators may accurately and conveniently predict ASS and provide a reference for clinical diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Objective To explore the relationship between MRI types and epilepsy control following tumor removal of dysembryoplastic neuroepithelial tumor (DNT). Methods The clinical and follow-up data of DNT cases were retrospectively collected from January 2012 to July 2019, and the data were further analyzed with respect to prognostic factors. Results Epilepsy occurred in all cases. According to MRI-based classification, 8 patients belonged to type I, 4 patients were type II, and the other 2 patients were type III. Tumor total removal was performed in all cases. Postoperative pathological HE staining confirmed each tumor simple contained specific neuronal components in all cases, and in 13 cases, synaptin (Syn), oligodendrocyte transcription factor 2 (Olig-2) and neuronal nuclear antigen (NeuN) were positive in routine immunohistochemical staining. In the postoperative follow-up period from 6-84 months, Engel I outcome was achieved in all type I cases and 2 type II cases, Engel III was in 2 type II cases, Engel II was in 2 type III cases. Conclusions Postoperative seizure control in PNT may be closely associated with the MRI types, and type I may have a better prognosis in seizure control following tumor removal than type II and type III. [ABSTRACT FROM AUTHOR]

Autoimmune encephalitis (AE) associated with epilepsy is a significant clinical syndrome, which is characterized by refractory seizures, cognitive deficits, neuropsychiatric disturbances. Many studies have been clearly notified that early diagnosis combined with immunotherapy can apparently improve prognosis, thus early diagnosis and treatment are highly essential. In recent years, the neuroimaging, especially functional imaging, plays a critical role in the early diagnosis and prognostic assessment of AE associated with epilepsy. This review summarized the methods and results of functional imaging in the diagnosis of epilepsy associate associated with AE, to provide an imaging basis for clinical and differential diagnosis and prognostic assessment. [ABSTRACT FROM AUTHOR]

Objective To explore the ictal electrical - clinical features of focal seizures in childhood with epilepsy. Methods The video electroencephalography (VEEG) results of 409 focal seizures of 257 patients with epilepsy during January 2017 to June 2018 in EEG Monitoring Center of Department of Neurology of Hu'nan Children's Hospital, along with their neuroimage results were retrospectively analyzed. Results The main symptoms during the attack period were binocular gaze (202 times), deflection (142 times), asymmetrical tonic (138 times), distortion of mouth (45 times), single or one side limb tonic clonic (42 times), focal abnormal sensation (32 times), autonomic neurological symptoms (92 times), hyperkinetic automatisms (93 times), and hand and/or mouth automatism (92 times), vocalization (68 times) and focal atonia (6 times), focal myoclonus (4 times), and focal tonic (2 times). The above symptoms appeared in a single or combined way. VEEG monitoring showed that the types of seizures were focal seizures (249 times), focal to bilateral tonic clonic seizures (121 times), focal status epilepticus (29 times), and focal seizures with spasm (10 times). Initial pattern of EEG during seizure: regional (188 times), focal (55 times), unilateral (53 times), non-unilateral (71 times ) or uncertain (42 times). Inter-episodic EEG activity showed focal discharge (92 cases), multifocal discharge (49 cases), extensive discharge (27 cases) or no discharge (89 cases). In 257 cases, 178 cases (69.26%) were classified as epilepsy syndrome. Benign familial or non-familial infantile seizures was more common (54.26%, 51/94) in the group of age-dependent epilepsy syndrome, frontal lobe epilepsy was more common (62.50%, 50/80) in location related epilepsy. Conclusions The seizure symptoms of focal seizures in children have focal features, and the ictal EEG patterns during the seizure are diverse, which can be associated with multiple epilepsy syndromes. VEEG monitoring is an irreplaceable method for definite diagnosis at present. [ABSTRACT FROM AUTHOR]

Objective To evaluate the efficacy and safety of lamotrigine in the treatment of juvenile myoclonic epilepsy (JME). Methods Retrieve relevant clinical guidelines, systematic review (including Meta - analysis), randomized controlled clinical trials, case - control studies, retrospective cohort studies and case observation studies on lamotrigine treating JME from online databases (January 1, 1980-December 31, 2017) as PubMed, EBMASE/SCOPUS and Cochrane Library with key words: juvenile myoclonic epilepsy, idiopathic generalized epilepsies, lamotrigine, antiepileptic drugs, random. Jadad Scale, Cochrane System Evaluation Handbook and RevMan 5.3 statistical software were used for quality assessment and Meta-analysis. Results The research enrolled 1220 articles, from which 6 studies with Jadad score ≥ 4 (4 randomized controlled clinical trials and 2 case observation studies) were chosen after excluding duplicates and those not meeting the inclusion criteria. A total of 314 JME patients (166 cases treated by lamotrigine and 148 cases treated by valproate) were enrolled in 6 studies. Meta-analysis showed the occurrence rate of adverse reaction in lamotrigine group was significantly lower than that in valproate group (RR = 0.540, 95% CI: 0.320-0.910; P = 0.020), but there was no significant difference on rate of epileptic seizures decreasing > 50% (RR = 1.200, 95% CI: 0.870-1.650; P = 0.260). Conclusions Lamotrigine is safe and effective in the treatment of JME. It has better tolerance and less adverse reaction, and its effect is similar to that of valproate. It is the first choice for patients with JME, especially for adolescent female patients with JME. However, there is still lack of high-quality trials to confirm whether the combination with other drugs has any benefit in terms of efficacy. [ABSTRACT FROM AUTHOR]

Objective To investigate the value of blood concentration monitoring of 10 - monohydroxy carbamazepine (MHD), the active metabolite of oxcarbazepine (OXC), in the treatment of childhood focal epilepsy. Methods A total of 110 children with focal epilepsy took OXC for 3 months and then the MHD concentrations were determined by high pressure liquid chromatography (HPLC). Results The average dose of OXC in 110 children was (25.52 ± 7.28) mg/(kg ⋅ d) and the valley point concentration of MHD was 7.00 (4.95, 10.50) mg/L, and 89 cases (80.91%) < 12 mg/L. A linear relationship between MHD valley point concentration and OXC dose (r = 0.337, P = 0.000) was shown by Spearman rank correlation analysis. The dosage of OXC for older ( > 7 years) children was significantly lower than that of younger (≼ 7 years) children [(23.13 ± 5.56) mg/(kg ⋅ d) vs. (28.09 ± 8.06) mg/(kg ⋅ d); t = 3.778, P = 0.000], while there was no significant difference between the concentration of children with different sexes (t = 1.067, P = 0.288), between children with and without drug resistant epilepsy (DRE; t = 1.417, P = 0.159) and between monotherapy and combination drug therapy (t = 1.671, P = 0.098). The MHD valley point concentration in DRE group was lower than that of non-DRE group [6.32 (3.05, 8.58) mg/L vs. 8.30 (5.75, 10.85) mg/L; Z = 2.380, P = 0.017], while there was no significant difference between the concentration of children with different sexes (Z = 0.604, P = 0.546), between older and younger children (Z = 0.179, P = 0.858) and between monotherapy and combination drug therapy (Z = 1.583, P = 0.113). Conclusions There is a linear relationship between MHD steady state valley point concentration and the dose of OXC. To achieve the same MHD level, the younger children need to take a larger dose of OXC. When OXC is used to treat drug resistant focal epilepsy in children, the dosage should be adjusted according to the monitoring of blood concentration of MHD. [ABSTRACT FROM AUTHOR]

Objective To evaluate the safety of valproate (VPA) on bone mineral density and bone metabolism in children with epilepsy. Methods Retrieve relevant research from online databases (January 1, 1980-March 1, 2018) as PubMed, EBMASE/SCOPUS and Cochrane Library with key words: epilepsy, bone, child. Selection of studies was performed according to pre - designed inclusion and exclusion criteria. Quality of studies was evaluated by using Newcastle-Ottawa Scale (NOS). All data were pooled by RevMan 5.2 software for Meta- analysis. Results The research enrolled 1455 articles, from which 13 studies with NOS score ≽ 6 were chosen after excluding duplicates and those not meeting the inclusion criteria. A total of 683 children with epilepsy using VPA and 436 children in control group were included. Meta - analysis showed that comparing with control group, bone mineral density of lumbar (BMDL) in children treated with VPA has no significant difference (MD = - 0.019, 95% CI: - 0.044-0.006; P = 0.140), but there was a significant decrease in bone mineral density of femur (BMDF; MD = - 0.037, 95% CI: - 0.069-- 0.005, P = 0.020). There was no significant change in serum calcium (SMD = - 0.284, 95% CI: - 0.951-0.382; P = 0.400), phosphorus (SMD = - 0.164, 95%CI: - 0.457-0.129; P = 0.270), alkaline phosphatase (ALP; SMD = 0.363, 95%CI: - 0.294-1.020, P = 0.280), parathyroid hormone (PTH; SMD = 0.102, 95%CI: - 0.291-0.495, P =0.610) and 25 - hydroxy vitamin D [25(OH)D; SMD = - 0.104, 95%CI:- 0.620-0.413, P = 0.690] in bone metabolic markers. Sensitivity analysis showed Meta - analysis of BMDF, serum phosphorus and 25(OH)D was unstable, therefore, it should be cautious when explaining the results. Conclusions VPA has less effect on bone mineral density and bone metabolism, but for children with epilepsy using VPA, their BMDF should be monitored. [ABSTRACT FROM AUTHOR]

Epilepsy is the transient central nervous system dysfunctional chronic encephalopathy caused by abnormal discharge of brain neurons. Of these, children and adolescents account for the majority. Physiology and psychology in adolescence are more specific than other age groups. This article intends to review the diagnosis and treatment of juvenile epilepsy. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Neurology & Neurosurgery is the property of Chinese Journal of Contemporary Neurology & Neurosurgery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)