Objective: The aim of this study is to examine the relationship between the level of intolerance to uncertainty in parents of children with epilepsy and cyberchondria. Methods: The study design was descriptive and cross-sectional. Data were collected between March and August of 2025. A total of 402 parents of children with epilepsy participated in the study. Data were collected using the sociodemographic data form, the Intolerance of Uncertainty Scale, and the Cyberchondria Severity Scale-Short Form. Results: The findings show a moderate, positive, and significant relationship between intolerance of uncertainty and cyberchondria (r=0.397, p<0.001). Regression analysis indicates that intolerance of uncertainty significantly predicts cyberchondria severity (β=0.380, p<0.001), and the model explains 15.8% of the total variance. Conclusion: As the intolerance of uncertainty among parents of children diagnosed with epilepsy increase, their levels of cyberchondria also increase, highlighting the importance of psychoeducation and digital health literacy programs for parents.
Objective: Although advances in diagnosis and treatment have improved seizure control in epilepsy, the psychosocial burden of the condition remains substantial. Stigma, social misconceptions, and perceived barriers in education, employment, and interpersonal relationships continue to shape the lived experience of people with epilepsy. Understanding these challenges in contemporary clinical populations is essential for informing patient-centered care and public awareness strategies. To investigate the social, educational, occupational, and relational experiences of adults with epilepsy, with particular emphasis on perceived stigma and societal attitudes. Methods: In this cross-sectional study conducted at a tertiary epilepsy clinic, 90 adult patients (mean age 36.8±12.0 years) completed a structured questionnaire consisting of Likert-type items and open-ended questions exploring experiences related to education, employment, social relationships, and stigma. Clinical data, including epilepsy type, seizure frequency, and treatment characteristics, were obtained from medical records. Responses were analyzed descriptively, and open-ended questions were thematically categorized. Results: Participants reported a range of psychosocial challenges, including perceived negative reactions from others, concerns regarding relationships and family life, and difficulties in educational and occupational settings. A notable proportion of patients reported difficulties related to societal attitudes (38.8%). Open-ended responses indicated that difficulty in socializing (26.7%), fear of seizures (20%), and challenges in finding employment (15.6%) were among the most frequently reported concerns. Misconceptions in the community included beliefs that people with epilepsy may be dangerous to others (37.7%) or may be less productive at work (11.1%). Conclusion: Despite advances in clinical management, epilepsy remains associated with substantial psychosocial burden and perceived stigma. These findings highlight the need for ongoing efforts to address public misconceptions, support patients in social and professional domains, and integrate psychosocial considerations into routine epilepsy care.
Objective: We aim to documented genetic etiology of epilepsy at a single-center epilepsy outpatient clinic in state hospital. Methods: The patients’ demographic data, clinical and electrophysiologic features, and gene analysis were re-evaluated from medical records of patients with epilepsies between August 2021 and January 2024. The detected variants were searched in gnomAD, ClinVar, DECIPHER, and PubMed databases. The common and distinct features of the phenotype of patients were compared with the literature. Results: The medical records of 354 patients with epilepsy were reviewed. Forty (11.2%) patients were diagnosed with genetic generalized epilepsy. Among them, 37 patients (10.4%) were diagnosed with idiopathic generalized epilepsy, and 3 patients (0.8%) were diagnosed with epilepsy with eyelid myoclonia. We included patients with epilepsy and confirmed genetic etiology at diagnosis. Nine (2.5%) patients with epilepsy and confirmed genetic etiology were included; seven (1.9%) patients had rare monogenic variants in (ZNF142, ZMYND11, DLG4, PEX11B, SCARB2 and GRM-1) genes and two (0.5%) had chromosomal abnormalities (1p36 deletion and 15q15.1 deletion). Conclusion: This study reported genetic etiologies of epilepsy were determined in single-center state hospital. The reported families demonstrate that similar genotypic variations can lead to different phenotypic outcomes. Indeed, similar phenotypic features may result from two distinct genotypic alterations. Specifying the variants and their phenotypic features with diagnostic tools in every single-center are important starting to investigate across the country.
Objective: Juvenile myoclonic epilepsy (JME) is an idiopathic generalized epilepsy syndrome with age-dependent onset. The corpus callosum (CC), the largest commissural pathway connecting the two cerebral hemispheres, has been reported to undergo structural alterations in epilepsy. However, data regarding morphometric CC changes in JME patients and their prognostic implications remain limited. This study aimed to determine whether regional differences exist in CC morphometric measurements in JME patients and whether these measurements have prognostic value. Methods: Magnetic resonance imaging scans of 40 JME patients and 20 age- and sex-matched healthy controls were evaluated. CC measurements were obtained from midsagittal T1-weighted images and included the anterior-posterior (A-P) diameter and the perpendicular diameters of the genu, truncus, and splenium. Results: A total of 40 patients with JME and 20 healthy controls were included. The genu thickness of the CC was significantly reduced in patients compared with controls, whereas the truncus, splenium, and A-P diameters did not differ. In sex-based analyses, male patients showed a greater A-P diameter than female patients, while no sex differences were observed among controls. No correlations were identified between CC measurements and age, disease duration, seizure type, or seizure frequency. Patients receiving polytherapy and patients treated with valproic acid exhibited significantly larger A-P diameters than patients receiving monotherapy and patients treated with levetiracetam, respectively. Conclusion: JME is associated with region-specific structural alterations of the CC, particularly a reduced thickness of the genu. These changes appear unrelated to clinical severity markers such as seizure type, frequency, or disease duration, suggesting a predominantly developmental or genetic basis. The enlarged A-P diameter observed in male patients and those receiving valproic acid or polytherapy may reflect sex- or treatment-related influences on callosal morphology. Further prospective studies using advanced imaging modalities are needed to clarify the clinical significance of these findings.
Objective: Individuals with epilepsy often face challenges with medication adherence and health monitoring because communication difficulties that hinder self-expression and information exchange, thereby complicating effective disease management. This study aimed to examine the health communication problems experienced by individuals with epilepsy. Methods: This descriptive, cross-sectional study was conducted among 172 individuals with epilepsy who presented to the neurology outpatient clinic in eastern and northern T & uuml;rkiye between August 2023 and August 2024. Study data were collected using the descriptive data form and the health communication problems scale. The independent groups t-test, one-way ANOVA, and Tukey test were used to evaluate the data. Results: On the health communication problems scale, individuals with epilepsy had mean scores of 2.41 +/- 0.53 for the effective communication problems sub-dimension, 2.88 +/- 0.80 for the social communication problems sub-dimension, and 2.68 +/- 0.72 for the communication barriers sub-dimension. No significant differences were detected in the mean scores for health communication problems among individuals with epilepsy by sex, health expenditure, seizure type, or seizure characteristics (p>0.05). Conclusion: The study revealed that individuals with epilepsy experienced moderate difficulty with health communication. Those who were married, had higher educational attainment, were unemployed, had lower income levels, and were receiving polytherapy experienced greater communication challenges with healthcare professionals.
Objective: Negative attitudes toward epilepsy remain a common social or personal challenges for individuals with epilepsy. Limited knowledge levels and misconceptions are the main factors underlying stigmatization. This study aimed to evaluate the effects of neurology rotation on medical students' knowledge about epilepsy, approach to acute seizures, and attitudes toward epilepsy. The influence of epilepsy-related knowledge on attitudes toward the disease was also Methods: A total of 116 fifth-year medical students were included in the study and assessed twice: on the first day of the neurology rotation (pre-test) and on the final day of the 3-week rotation (post-test). All assessments were administered online using the "knowledge about epilepsy", "approach to epileptic seizure" and "attitudes toward epilepsy" questionnaires. Pre-post changes in total scores were analyzed, and regression analysis was used to identify factors associated Results: Students' total knowledge scores increased significantly following the rotation (p=0.001). In contrast, no significant difference was observed in total attitudes score between pre-test and post-test (p=0.202). Regression analysis demonstrated that higher knowledge levels and male gender were independently Conclusion: The neurology rotation resulted in a significant improvement in medical students' knowledge about epilepsy; however, it did not lead to measurable changes in attitudes. These findings indicate that additional or alternative educational strategies may be necessary to influence attitudes toward epilepsy.
Objective: Temporal lobe epilepsy (TLE) is the most common focal epilepsy syndrome and remains medically refractory in a substantial proportion of patients. Dual pathology, defined as the coexistence of hippocampal sclerosis with an additional neocortical lesion, is an important cause of surgical failure when not adequately recognized. This study aimed to evaluate the clinical characteristics and postoperative seizure outcomes of patients with dual pathology compared with those with isolated mesial temporal sclerosis. Methods: We retrospectively reviewed 125 patients who underwent surgery for TLE between January 2005 and February 2023. Thirty-one patients with dual pathology, defined as hippocampal sclerosis accompanied by a neocortical tumor, were included. A control group consisted of 34 age-matched patients with isolated mesial temporal sclerosis. Clinical features, seizure characteristics, surgical procedures, postoperative outcomes assessed using the Engel classification, and complications were analyzed. Results: The mean age was similar between the dual pathology and control groups. However, the age at seizure onset was significantly later in patients with dual pathology (26.5 +/- 15.9 years vs. 9.2 +/- 7.8 years; p<0.001). Generalized tonic-clonic seizures were more frequent in the dual-pathology group, whereas focal seizures with impaired awareness predominated in patients with isolated mesial temporal sclerosis. Engel class I seizure freedom was achieved in 61.3% of patients with dual pathology and in 67.6% of controls, with no significant difference between groups. Postoperative complication rates were comparable. Conclusion: Despite differences in seizure characteristics and age at seizure onset, postoperative seizure outcomes in patients with dual pathology were comparable to those in patients with isolated mesial temporal sclerosis when both the mesial temporal structures and the associated neocortical lesion were adequately resected. Dual pathology should be considered in patients with TLE who present with mesial temporal sclerosis accompanied by a neocortical tumor, particularly in those with a relatively late age at seizure onset.
Objective: This study aimed to measure serum brain-derived neurotrophic factor (BDNF) and neuronal nitric oxide synthase (nNOS) levels in Egyptian children with epilepsy, to calculate the frequencies of BDNF gene polymorphisms to elucidate their usefulness as biomarkers for diagnosing epilepsy and assessing drug response. Methods: Serum BDNF and nNOS levels were measured by enzyme-linked immunosorbent assay in 60 epileptic children as well as in 30 healthy children of the same age and sex. The BDNF rs6265 polymorphism was evaluated by genomic TaqMan genotyping. Results: The genotyping distribution of the BDNF gene did not differ significantly between the controls and epileptic cases. The homozygous (G/G) responded to treatment far better. Mean serum BDNF was substantially less than the controls. However, children with epilepsy had considerably higher mean serum nNOS concentration. Conclusion: BDNF genotypes have a big impact on responsiveness to therapy. In epileptic children, the mechanism of epileptogenesis is influenced by serum BDNF and nNOS.
Objective: The detection rate of interictal epileptiform discharges (IEDs) varies among electroencephalography (EEG) recordings in patients with epilepsy. This study aimed to compare the yield of IED detection across three recording protocols of varying durations routinely used at our center: routine 20-30 minutes EEG, 1-3 hours daytime video-EEG (vEEG), and whole-night (8-12 hours) vEEG. Methods: The EEG reports of adult patients treated at the Dokuz Eyl & uuml;l University Hospital epilepsy outpatient clinic between 2006 and 2024 were retrospectively reviewed. Patients older than 18 years who had undergone at least one routine EEG, one 1-3 hours daytime vEEG, and one whole-night vEEG on separate occasions were included. The detection rates of IEDs across the three modalities, along with patients' clinical characteristics, were analyzed. Results: Seventy-three patients (43 women and 30 men) were included in the study. For the initial EEG, the IED detection rate was 17.8% for routine EEG, 45.2% for 1-3 hours daytime vEEG, and 46.6% for whole-night vEEG. The routine EEG detection rate was significantly lower (p=0.001). With repeated examinations, the yield of routine EEG increased to 41.1%, daytime vEEG to 52.1%, and whole night vEEG to 56.2%; with no significant difference between the modalities (p=0.099). Conclusion: Although IED detection was highest with whole-night vEEG, daytime 1-3 hours vEEG recordings that included sleep achieved a comparable yield and may be preferred to reduce laboratory workload. The recording duration can be individualized according to the laboratory resources and patient preferences.
Objective: To examine overprotection in people with epilepsy and the demographic and clinical factors affecting it. Methods: The study was a descriptive, cross-sectional investigation involving 104 people with epilepsy attending the neurology outpatient clinic of Giresun Training and Research Hospital between September 2022 and February 2023. While a descriptive information form and an overprotection scale were used to collect research data, descriptive statistics (percentages, mean, and standard deviation) and linear regression analysis were used to analyze the data. Results: It was determined that 66.3% of the participants were male; 53.8% were primary school graduates; 53.8% were married; 34.6% had generalized epilepsy; and 69.2% did not have seizure control. The overall mean score on the perceived overprotection scale was 29.09 +/- 12.63. The linear regression analysis using the significant regression model (F=5.111; p=0.000) revealed that 24.2% (R2=0.242) of the change in overprotection was explained by demographic and clinical variables. Conclusion: Primary and high school education, polytherapy, and generalized epilepsy were associated with higher perceived overprotection, whereas being married was associated with lower perceived overprotection. These findings underscore the importance of interventions focusing on patient and family education.
Objective: This study aimed to this study was to determine the effect of levetiracetam (LEV) monotherapy on complete blood count parameters and inflammatory markers at six and 12 months in children with epilepsy. Methods: Files from 66 patients with epilepsy who were on LEV monotherapy were examined. Age, sex, and type of epilepsy, electroencephalography and cranial magnetic resonance imaging results at presentation, and complete blood count data at the start of treatment and at six and 12 months were recorded from the patients' files. Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and red cell distribution width/lymphocyte ratio (RDW/LYM) values were calculated from complete blood counts and used as inflammatory markers. Results: The mean age of 66 patients was 10.18 +/- 4.88 years. The patients were equally distributed by gender. A comparison of complete blood parameters in patients receiving LEV monotherapy at baseline and at six and 12 months revealed a significant decrease in RDW values at 12 months (p<0.05), with no significant differences in other hematological parameters (p>0.05). Also, no significant differences were observed in inflammatory markers (NLR, MLR, PLR, and the RDW/LYM ratio) calculated from complete blood count parameters (p>0.05). Conclusion: Use of LEV altered multiple complete blood count parameters. In addition, NLR, MLR, PLR, and the RDW/LYM ratio, recognized inflammatory markers, also changed during LEV therapy.
Infantile epileptic spasms syndrome is a rare and severe epilepsy syndrome in infants. It is identified by clusters of spasms, developmental regression, and hypsarrhythmia. Although there are many different therapeutic options that include the use of vigabatrin (VGB) along with hormonal treatments, the best approach has still not reached a consensus. In this regard, a systematic review of oral suspension VGB is warranted to evaluate efficacy, safety, and its effects on different subpopulations of patients. A systematic review was conducted in accordance with the PRISMA 2020 guidelines (Oxford, UK). Randomized controlled trials, cohort studies, and retrospective analyses conducted in children aged 2 months to 2 years with infantile spasms were selected. Data on spasm cessation, electroencephalography (EEG) normalization, adverse events, and other treatment-specific outcomes were extracted. Bias was assessed through ROBINS-I tool (Cochrane, UK) and Cochrane RoB 2.0 tool (Cochrane, UK). Six studies (34 to 377 participants) from 1999 to 2022 were included. Mean age ranged between 5 and 13.5 months, and male predominance was present. Spasm cessation rates with VGB monotherapy were between 11% and 78%, whereas hormonal therapies reached up to 75%. The response rates for combination therapies that included VGB with hormones stood at 71.5%. The EEG normalization achieved the highest rate of 75% with cosyntropin monotherapy. The VGB had lower rates. Adverse event rates ranged from 0% to 86%, and adverse severe events, including visual field defects, occurred in as many as 19% of participants. Hormonal therapies were associated with irritability and weight gain, and some adverse effects that seemed mitigated by combination therapy. Hormonal therapies were not found to be noticeably better than VGB monotherapy, but combination therapies added better outcomes while maintaining balance between efficacy and safety. Tailored treatment strategy is critical, and further research is required.
Objective: Physical exercise has been shown to improve mood, memory, and overall quality of life in people with epilepsy. Still, studies indicate that individuals with epilepsy are less active than the general population. We aimed to determine the physical activity levels of individuals with epilepsy and to gain insight into their perspectives on it. Methods: This study administered a survey to patients with epilepsy at a single tertiary care center between July 2024 and February 2025. The questionnaire developed by the research team had 21 questions and three sections. The survey assessed participants’ frequency of physical activity, their opinions on sports and epilepsy, and sociodemographic information. Results: A total of 202 participants (59.4% female) completed the survey. 49.0% of the patients did not exercise regularly, while 13.9% exercised more than three times a week. The most preferred sports were walking (16.8%) and running (11.4%). The patients stated the reasons for not exercisingr of having a seizure (35.1%), lack of time (33.2%), lack of motivation (21.3%), not seeing it as necessary (20.8%), and side effects of epilepsy medications (4.5%). 77.2% of patients had not asked their doctor any questions about physical exercise, and 66.8% had never been informed by their doctor about the importance of physical activity. 45.5% of the patients were supported by their environment regarding physical exercise, while 25.7% were discouraged from engaging in physical exercise. Conclusion: Patients with epilepsy require improved information regarding the benefits of physical exercise, and neurologists should address this need.
Objective: Post-traumatic epilepsy (PTE) is a significant sequela of traumatic brain injury (TBI), with a high incidence of drug-resistant epilepsy. The role of prophylactic antiseizure medications (ASM) remains controversial. This study investigates the demographic, clinical, radiological, and electrophysiological characteristics of PTE and evaluates the impact of ASM use. Methods: We retrospectively analyzed patients diagnosed with PTE at & Idot;stanbul University, & Idot;stanbul Faculty of Medicine Hospital (1994-2024). Clinical characteristics, imaging findings, electroencephalography results, and ASM use were assessed. Statistical analyses were conducted to explore correlations between trauma severity, epilepsy latency, and ASM efficacy. Results: There were 67 patients diagnosed with PTE, 73% of whom were male. Severe TBI (bone fracture, hemorrhage, or loss of consciousness >24 hours) was observed in 60% of patients. Bilateral magnetic resonance imagining (MRI) lesions were significantly associated with shorter epilepsy latency (p<0.01). Drug-resistant epilepsy was more common in severe TBI cases (p<0.03) and patients with longer periods of unconsciousness. ASM use did not influence epilepsy latency or seizure frequency. Three patients exhibited psychogenic non-epileptic seizures. Conclusion: ASM fails to prevent epileptogenesis and should not be routinely prescribed for seizure prophylaxis in patients with TBI. Trauma severity is a critical predictor of epilepsy onset and drug resistance. The presence of bilateral MRI lesions warrants closer monitoring. Given the complex consequences of TBI, these patients should be closely monitored by multidisciplinary teams.
