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15 pages, 2496 KiB

Open AccessArticle

Investigating Peri-Ictal MRI Abnormalities: A Prospective Neuroimaging Study on Status Epilepticus, Seizure Clusters, and Single Seizures

by Angelo Pascarella, Lucia Manzo, Oreste Marsico, Emilio Africa, Alessandra Coglitore, Vittoria Cianci, Alessandro Bulgari, Domenico Abelardo, Sara Gasparini, Antonio Armentano, Umberto Aguglia, Giorgi Kuchukhidze, Eugen Trinka and Edoardo Ferlazzo

J. Clin. Med. 2025, 14(8), 2711; https://doi.org/10.3390/jcm14082711 - 15 Apr 2025

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Abstract

Background/Objectives: Brain magnetic resonance imaging (MRI) often reveals acute peri-ictal abnormalities (PMAs) during or shortly after status epilepticus (SE) but also following single seizures (SiS) or clusters of seizures (CS). However, the incidence, characteristics, and progression remain not clearly known. This study [...] Read more.

Background/Objectives: Brain magnetic resonance imaging (MRI) often reveals acute peri-ictal abnormalities (PMAs) during or shortly after status epilepticus (SE) but also following single seizures (SiS) or clusters of seizures (CS). However, the incidence, characteristics, and progression remain not clearly known. This study aimed to investigate incidence, clinical correlations, and evolution of PMAs in SE, CS, and SiS patients. Methods: This prospective observational study enrolled patients with SE, CS, and SiS who underwent MRI within 120 h of the ictal event. Demographic, clinical, EEG, and MRI data were collected. Patients with PMAs (PMAs+) underwent serial follow-up MRI. Incidence, association with clinical characteristics, and progression of PMAs were analyzed across the three groups. Results: Among 76 patients (30 SE, 22 CS, 24 SiS), PMAs were observed in 31 (41%), with a significant difference between groups (p = 0.011), as PMAs were less frequent in SiS (17%) compared to SE (57%) and CS (45%) patients. Acute symptomatic SE/seizures were significantly more common in PMAs+ compared to PMAs− in the overall cohort (52% vs. 29%; p = 0.045) and in the SiS group (100% vs. 25%; p = 0.031). History of epilepsy was less frequent in PMAs+ in the whole cohort (13% vs. 40%; p = 0.011) and in SE in particular (12% vs. 46%, p = 0.049). No association between PMAs and seizure type, SE duration, etiology, time to MRI, and EEG findings (p > 0.005) was found. The temporal cortex and hippocampus were most frequently affected by PMAs. Follow-up MRI performed in 16 patients showed resolution of PMAs in 75% (5/7 SE, 3/6 CS, 3/3 SiS) within a median time of 24 days (IQR: 8–39). Conclusions: PMAs were more common in SE and CS than in SiS. Acute underlying pathology was frequently associated with PMAs. While duration of ictal activity is an important factor, it was not the sole determinant. Most PMAs resolved, particularly in SiS. Further studies are needed to clarify the pathophysiological mechanism and clinical implications of PMAs. Full article

(This article belongs to the Special Issue New Trends in Diagnosis and Treatment of Epilepsy)

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11 pages, 1379 KiB

Open AccessFeature PaperArticle

Stable Yet Destabilised: Towards Understanding Brain Network Dynamics in Psychogenic Disorders

by Mostafa Badr, Timo Bröhl, Nayrin Dissouky, Christoph Helmstaedter and Klaus Lehnertz

J. Clin. Med. 2025, 14(3), 666; https://doi.org/10.3390/jcm14030666 - 21 Jan 2025

Viewed by 762

Abstract

Background: Psychogenic non-epileptic seizures (PNES) are seizure-like episodes that resemble behavioral aspects observed for epileptic seizures but are without the abnormal electrical activity typically seen in epilepsy. The lack of an etiologic model for PNES as well as limitations of available diagnostic methods [...] Read more.

Background: Psychogenic non-epileptic seizures (PNES) are seizure-like episodes that resemble behavioral aspects observed for epileptic seizures but are without the abnormal electrical activity typically seen in epilepsy. The lack of an etiologic model for PNES as well as limitations of available diagnostic methods largely hinders a clear-cut distinction from epilepsy and from a normal functioning brain. Methods: In this study, we investigate the brain dynamics of people with PNES and people with epilepsy during phases far-off seizures and seizure-like events as well as the brain dynamics of a control group. Probing for differences between these groups, we utilise the network ansatz and explore local and global characteristics of time-evolving functional brain networks. We observe subject-specific differences in local network characteristics across the groups, highlighting the physiological functioning of specific brain regions. Furthermore, we observe significant differences in global network characteristics—relating to communication, robustness, and stability aspects of the brain. Conclusions: Our findings may provide new insights into the mechanisms underlying PNES and offer a promising diagnostic approach to differentiate them from epilepsy. Full article

(This article belongs to the Special Issue New Trends in Diagnosis and Treatment of Epilepsy)

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17 pages, 2055 KiB

Open AccessFeature PaperArticle

The Influence of Climatic Factors on the Provocation of Epileptic Seizures

by Thilo Hammen, Sebastian Treib, Philipp Treib, Hermann Stefan, Hajo M. Hamer, Ralf Landwehr, Lynn Lohmann, Sebastian Koch, Johannes Treib and Werner Adler

J. Clin. Med. 2024, 13(12), 3404; https://doi.org/10.3390/jcm13123404 - 11 Jun 2024

Cited by 2 | Viewed by 1591

Abstract

Background/Objectives: Recent studies provide the first indications of the impact of climate factors on human health, especially with individuals already grappling with internal and neurological conditions being particularly vulnerable. In the face of escalating climate change, our research delves into the specific influence [...] Read more.

Background/Objectives: Recent studies provide the first indications of the impact of climate factors on human health, especially with individuals already grappling with internal and neurological conditions being particularly vulnerable. In the face of escalating climate change, our research delves into the specific influence of a spectrum of climatic factors and seasonal variations on the hospital admissions of patients receiving treatment for epileptic seizures at our clinic in Kaiserslautern. Methods: Our study encompassed data from 9366 epilepsy patients who were admitted to hospital due to epileptic seizures. We considered seven climate parameters that Germany’s National Meteorological Service made available. We employed the Kruskal–Wallis test to examine the correlation between the frequency of admittance to our hospital in the mentioned patient group and seasons. Furthermore, we used conditional Poisson regression and distributed lag linear models (DLMs) to scrutinize the coherence of the frequency of patient admittance and the investigated climate parameters. The mentioned parameters were also analyzed in a subgroup analysis regarding the gender and age of patients and the classification of seizures according to ILAE 2017. Results: Our results demonstrate that climatic factors, such as precipitation and air pressure, can increase the frequency of hospital admissions for seizures in patients with general-onset epilepsy. In contrast, patients with focal seizures are less prone to climatic changes. Consequently, admittance to the hospital for seizures is less affected by climatic factors in the latter patient group. Conclusions: The present study demonstrated that climatic factors are possible trigger factors for the provocation of seizures, particularly in patients with generalized seizures. This was determined indirectly by analyzing the frequency of seizure-related emergency admissions and their relation to prevailing climate factors. Our study is consistent with other studies showing that climate factors, such as cerebral infarcts or cerebral hemorrhages, influence patients’ health. Full article

(This article belongs to the Special Issue New Trends in Diagnosis and Treatment of Epilepsy)

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Review

Jump to: Research

13 pages, 580 KiB

Open AccessReview

Imaging of Status Epilepticus

by Pilar Bosque Varela, Lukas Machegger, Bernardo Crespo Pimentel and Giorgi Kuchukhidze

J. Clin. Med. 2025, 14(9), 2922; https://doi.org/10.3390/jcm14092922 - 23 Apr 2025

Viewed by 290

Abstract

MRI plays an increasingly important role in the diagnosis of status epilepticus (SE). Approximately half of patients with SE do not have pre-existing epilepsy, and the cause of de novo SE is frequently unknown. The role of MRI in the identification of causes [...] Read more.

MRI plays an increasingly important role in the diagnosis of status epilepticus (SE). Approximately half of patients with SE do not have pre-existing epilepsy, and the cause of de novo SE is frequently unknown. The role of MRI in the identification of causes of SE is invaluable. MRI is often helpful as a diagnostic tool in cases of non-convulsive status epilepticus (NCSE) with ambiguous EEG findings. Thus, MRI is recommended for all patients presenting with de novo SE, patients with known epilepsy with the first episode of SE and NCSE with equivocal EEG. Different peri-ictal MRI (PMA) alterations may be seen during ongoing SE or briefly after its cessation. They commonly present as peri-ictal hyper-perfusion, diffusion restriction and/or FLAIR-hyperintensity affecting specific brain areas such as the cortex, hippocampus, pulvinar of the thalamus, splenium of the corpus callosum, claustrum or cerebellum, frequently in combination, suggesting the existence of a “status epilepticus network”. MRI sequences, which are necessary for detecting PMA, include diffusion-weighted imaging, fluid attenuated inversion recovery, T1-weighted imaging with and without contrast application, as well as perfusion sequences such as arterial spin labeling. Recent research suggests that they may serve as biomarkers for predicting an outcome in SE. Patients with PMA seem to have a higher mortality rate compared to those without PMA. However, there is still a substantial knowledge gap and there are many open questions related to imaging in SE. Further prospective quantitative MRI studies with uniform protocols, timing and follow-up periods are needed to answer these important and clinically relevant questions. Full article

(This article belongs to the Special Issue New Trends in Diagnosis and Treatment of Epilepsy)

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9 pages, 191 KiB

Open AccessReview

Epilepsies and Mirror Movements: An Underrecognized Association?

by Raffaele Nardone and Eugen Trinka

J. Clin. Med. 2025, 14(8), 2738; https://doi.org/10.3390/jcm14082738 - 16 Apr 2025

Viewed by 237

Abstract

Mirror movements (MMs) are related to structural alterations of the pyramidal tract or transcallosal pathways, as well as functional impairment of the interhemispheric inhibitory effects on motor planning skills, leading to the inability to perform limb movements independently. On the other hand, white [...] Read more.

Mirror movements (MMs) are related to structural alterations of the pyramidal tract or transcallosal pathways, as well as functional impairment of the interhemispheric inhibitory effects on motor planning skills, leading to the inability to perform limb movements independently. On the other hand, white matter bundles that connect distant cortical regions are thought to be the anatomical substrate of seizure propagation in epileptic subjects, and the spread of excitation through intracortical and transcallosal pathways is a well-recognized pathophysiological abnormality in epilepsies. To investigate this possible association, we searched the MEDLINE and Embase electronic databases, and only original articles were considered eligible for inclusion; we found thirteen patients from eleven articles, all of them case study reports. Therefore, epilepsy and MM co-morbidity has rarely been reported in the same subjects, even if changes in interhemispheric modulation are shared by both conditions. However, the study of this co-morbidity may help in elucidating the exact pathophysiological mechanisms of MMs and to better understand the pathological interhemispheric connections in epilepsy patients. Full article

(This article belongs to the Special Issue New Trends in Diagnosis and Treatment of Epilepsy)

18 pages, 305 KiB

Open AccessReview

Narrative Review on Common Traits of Parkinson’s Disease and Epilepsy

by Christian Tilz and Ying Wang-Tilz

J. Clin. Med. 2025, 14(8), 2716; https://doi.org/10.3390/jcm14082716 - 15 Apr 2025

Viewed by 331

Abstract

Epilepsy and Parkinson’s disease (PD) are two common neurological disorders, with a lifetime prevalence of approximately 1% and 0.4%, respectively. Both conditions affect movement and brain function and were traditionally considered distinct, with different pathophysiological mechanisms. However, recent research suggests potential links between [...] Read more.

Epilepsy and Parkinson’s disease (PD) are two common neurological disorders, with a lifetime prevalence of approximately 1% and 0.4%, respectively. Both conditions affect movement and brain function and were traditionally considered distinct, with different pathophysiological mechanisms. However, recent research suggests potential links between them. Some studies indicate that epilepsy may contribute to the development of PD due to chronic neuroinflammation, excitotoxicity, and neuronal loss. Conversely, PD-related neurodegeneration in dopaminergic pathways might increase susceptibility to seizures. This article presents a narrative review of the limited literature on the pathophysiological mechanisms linking epilepsy and PD, including shared genetic factors, neurodegenerative processes, and alterations in the neurotransmitter system. It also examines the influence of anti-seizure medications and dopaminergic treatments on the symptoms and progression of both disorders, as well as their common clinical features. Additionally, the limitations of the existing data on this topic are discussed. Understanding the true relationship between these two disorders is crucial, as it could provide insight into common neurobiological mechanisms and lead to improved therapeutic strategies. Full article

(This article belongs to the Special Issue New Trends in Diagnosis and Treatment of Epilepsy)

31 pages, 2196 KiB

Open AccessReview

MicroRNAs as Epigenetic Biomarkers of Pathogenetic Mechanisms of the Metabolic Syndrome Induced by Antiseizure Medications: Systematic Review

by Natalia A. Shnayder, Nikolai A. Pekarets, Natalia I. Pekarets, Diana V. Dmitrenko, Violetta V. Grechkina, Marina M. Petrova, Mustafa Al-Zamil and Regina F. Nasyrova

J. Clin. Med. 2025, 14(7), 2432; https://doi.org/10.3390/jcm14072432 - 2 Apr 2025

Viewed by 306

Abstract

Antiseizure medication (ASM) induced metabolic syndrome (AIMetS) is a common adverse drug reaction (ADR) of pharmacotherapy for epilepsy and psychiatric disorders. However, the sensitivity and specificity of blood biomarkers may be insufficient due to the influence of combined pathology, concomitant diseases, and the [...] Read more.

Antiseizure medication (ASM) induced metabolic syndrome (AIMetS) is a common adverse drug reaction (ADR) of pharmacotherapy for epilepsy and psychiatric disorders. However, the sensitivity and specificity of blood biomarkers may be insufficient due to the influence of combined pathology, concomitant diseases, and the peculiarities of the metabolism of ASMs in patients with epilepsy. Methods: The presented results of experimental and clinical studies of microRNAs (miRs) as epigenetic biomarkers of MetS and AIMetS, which were entered into the different databases, were analyzed for the last decade (2014–2024). Results: A systematic review demonstrated that miRs can act as promising epigenetic biomarkers of key AIMetS domains. However, the results of the review demonstrated the variable role of various miRs and their paralogs in the pathogenesis of AIMetS. Therefore, as part of this study, an miRs signature was proposed that allows us to assess the risk of developing and the severity of AIMetS as low risk, medium risk, and high risk. Conclusions: The mechanisms of development and biomarkers of AIMetS are an actual problem of epileptology, which is still far from being resolved. The development of panels (signatures) of epigenetic biomarkers of this widespread ADR may help to increase the safety of pharmacotherapy of epilepsy. However, to increase the sensitivity and specificity of circulating miRs in the blood as biomarkers of AIMetS, it is necessary to conduct “bridge” studies in order to replicate the results of preclinical and clinical studies into real clinical practice. Full article

(This article belongs to the Special Issue New Trends in Diagnosis and Treatment of Epilepsy)

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15 pages, 1905 KiB

Open AccessReview

Mapping the Epileptogenic Brain Using Low-Frequency Stimulation: Two Decades of Advances and Uncertainties

by Samuel B. Tomlinson, Michael E. Baumgartner, Timothy R. Darlington, Eric D. Marsh and Benjamin C. Kennedy

J. Clin. Med. 2025, 14(6), 1956; https://doi.org/10.3390/jcm14061956 - 13 Mar 2025

Viewed by 535

Abstract

Cortical stimulation is the process of delivering brief pulses of electrical current and visualizing the distributed pattern of evoked responses across the brain. Compared to high-frequency stimulation, which has long been used for seizure provocation and functional mapping, low-frequency stimulation (<1–2 Hz) is [...] Read more.

Cortical stimulation is the process of delivering brief pulses of electrical current and visualizing the distributed pattern of evoked responses across the brain. Compared to high-frequency stimulation, which has long been used for seizure provocation and functional mapping, low-frequency stimulation (<1–2 Hz) is rarely incorporated into the epilepsy surgery evaluation. Increasingly, researchers have demonstrated that various cortico-cortical evoked potential (CCEP) features, including early and delayed responses, evoked high-frequency oscillations, and derived network metrics, may be useful biomarkers of tissue excitability and abnormal connectivity. Emerging evidence also highlights a potential role of CCEPs in guiding neuromodulatory therapies like responsive neurostimulation. In this review, we examine the past two decades of innovation in low-frequency stimulation as it pertains to pre-surgical evaluation. We begin with a basic overview of single-pulse electrical stimulation and CCEPs, including definitions, methodology, physiology, and traditional interpretation. We then explore the literature examining CCEPs as markers of cortical excitability, seizure onset, and network-level dysfunction. Finally, the relationship between stimulation-induced and spontaneous seizures is considered. By examining these questions, we identify both opportunities and pitfalls along the path towards integrating low-frequency stimulation into clinical practice. Full article

(This article belongs to the Special Issue New Trends in Diagnosis and Treatment of Epilepsy)

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26 pages, 384 KiB

Open AccessFeature PaperReview

Seizure Detection Devices

by Christoph Baumgartner, Jakob Baumgartner, Clemens Lang, Tamara Lisy and Johannes P. Koren

J. Clin. Med. 2025, 14(3), 863; https://doi.org/10.3390/jcm14030863 - 28 Jan 2025

Viewed by 1542

Abstract

Goals of automated detection of epileptic seizures using wearable devices include objective documentation of seizures, prevention of sudden unexpected death in epilepsy (SUDEP) and seizure-related injuries, obviating both the unpredictability of seizures and potential social embarrassment, and finally to develop seizure-triggered on-demand therapies. [...] Read more.

Goals of automated detection of epileptic seizures using wearable devices include objective documentation of seizures, prevention of sudden unexpected death in epilepsy (SUDEP) and seizure-related injuries, obviating both the unpredictability of seizures and potential social embarrassment, and finally to develop seizure-triggered on-demand therapies. Automated seizure detection devices are based on the analysis of EEG signals (scalp-EEG, subcutaneous EEG and intracranial EEG), of motor manifestations of seizures (surface EMG, accelerometry), and of physiologic autonomic changes caused by seizures (heart and respiration rate, oxygen saturation, sweat secretion, body temperature). While the detection of generalized tonic-clonic and of focal to bilateral tonic-clonic seizures can be achieved with high sensitivity and low false alarm rates, the detection of focal seizures is still suboptimal, especially in the everyday ambulatory setting. Multimodal seizure detection devices in general provide better performance than devices based on single measurement parameters. Long-term use of seizure detection devices in home environments helps to improve the accuracy of seizure diaries and to reduce seizure-related injuries, while evidence for prevention of SUDEP is still lacking. Automated seizure detection devices are generally well accepted by patients and caregivers. Full article

(This article belongs to the Special Issue New Trends in Diagnosis and Treatment of Epilepsy)

9 pages, 215 KiB

Open AccessReview

Hyperphosphorylated Tau and Cognition in Epilepsy

by Juri-Alexander Witt, Johanna Andernach, Albert Becker and Christoph Helmstaedter

J. Clin. Med. 2025, 14(2), 514; https://doi.org/10.3390/jcm14020514 - 15 Jan 2025

Viewed by 796

Abstract

In light of the growing interest in the bidirectional relationship between epilepsy and dementia, this review aims to provide an overview of the role of hyperphosphorylated tau (pTau) in cognition in human epilepsy. A literature search identified five relevant studies. All of them [...] Read more.

In light of the growing interest in the bidirectional relationship between epilepsy and dementia, this review aims to provide an overview of the role of hyperphosphorylated tau (pTau) in cognition in human epilepsy. A literature search identified five relevant studies. All of them examined pTau burden in surgical biopsy specimens from patients with temporal lobe epilepsy. The prevalence of pTau reported across the five studies, encompassing a total of 142 patients, ranged from 3.5% to 95%. Findings also varied regarding the location of pTau in the hippocampus and/or temporal cortex. Two of five studies (40%) demonstrated an inverse relationship between pTau burden and cognitive performance, one study with regard to executive functions and the other with regard to naming and verbal short-term memory. The only longitudinal study found a significant link between pTau and cognitive decline in verbal learning and memory, and in part also in naming, from the pre- to the postoperative assessment and from three to 12 months postoperatively. Given the heterogeneity of the study cohorts and the neuropsychological and neuropathological methodologies and findings, no clear picture emerges regarding the association between pTau and cognition in temporal lobe epilepsy. Added to this is the multifactorial etiology of cognitive impairment in epilepsy, including the active epilepsy, the underlying and sometimes dynamic pathology, and anti-seizure medication. Some of these factors may affect pTau expression. Further research should aim to investigate pTau longitudinally and noninvasively on a whole-brain level, using targeted neuropsychological outcome measures and controlling for age and other factors potentially influencing cognitive trajectories in epilepsy. Full article

(This article belongs to the Special Issue New Trends in Diagnosis and Treatment of Epilepsy)

13 pages, 403 KiB

Open AccessReview

MEG in MRI-Negative Patients with Focal Epilepsy

by Rudolf Kreidenhuber, Kai-Nicolas Poppert, Matthias Mauritz, Hajo M. Hamer, Daniel Delev, Oliver Schnell and Stefan Rampp

J. Clin. Med. 2024, 13(19), 5746; https://doi.org/10.3390/jcm13195746 - 26 Sep 2024

Cited by 2 | Viewed by 1341

Abstract

Objectives: To review the evidence on the clinical value of magnetic source imaging (MSI) in patients with refractory focal epilepsy without evidence for an epileptogenic lesion on magnetic resonance imaging (“MRI-negative” or “non-lesional MRI”). Methods: We conducted a systematic literature search on PUBMED, [...] Read more.

Objectives: To review the evidence on the clinical value of magnetic source imaging (MSI) in patients with refractory focal epilepsy without evidence for an epileptogenic lesion on magnetic resonance imaging (“MRI-negative” or “non-lesional MRI”). Methods: We conducted a systematic literature search on PUBMED, which was extended by researchrabbit.ai using predefined criteria to identify studies that applied MSI in MRI-negative patients with epilepsy. We extracted data on patient characteristics, MSI methods, localization results, surgical outcomes, and correlation with other modalities. Results: We included 23 studies with a total of 512 non-lesional epilepsy patients who underwent MSI. Most studies used equivalent current dipole (ECD) models to estimate the sources of interictal epileptic discharges (IEDs). MEG detected IEDs in 32–100% of patients. MSI results were concordant with other modalities, such as EEG, PET, and SPECT, in 3892% of cases. If MSI concordant surgery was performed, 52–89% of patients achieved seizure freedom. MSI contributed to the decision-making process in 28–75% of cases and altered the surgical plan in 5–33% of cases. Conclusions: MSI is a valuable diagnostic tool for MRI-negative patients with epilepsy, as it can detect and localize IEDs with high accuracy and sensitivity, and provides useful information for surgical planning and predicts outcomes. MSI can also complement and refine the results of other modalities, such as EEG and PET, and optimize the use of invasive recordings. MSI should be considered as part of the presurgical evaluation, especially in patients with non-lesional refractory epilepsy. Full article

(This article belongs to the Special Issue New Trends in Diagnosis and Treatment of Epilepsy)

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19 pages, 345 KiB

Open AccessReview

New Pharmacological Therapies in the Treatment of Epilepsy in the Pediatric Population

by Karolina Daniłowska, Natalia Picheta, Dominika Żyła, Julia Piekarz, Katarzyna Zych and Paulina Gil-Kulik

J. Clin. Med. 2024, 13(12), 3567; https://doi.org/10.3390/jcm13123567 - 18 Jun 2024

Viewed by 2462

Abstract

Epilepsy is a disorder characterized by abnormal brain neuron activity, predisposing individuals to seizures. The International League Against Epilepsy (ILAE) categorizes epilepsy into the following groups: focal, generalized, generalized and focal, and unknown. Infants are the most vulnerable pediatric group to the condition, [...] Read more.

Epilepsy is a disorder characterized by abnormal brain neuron activity, predisposing individuals to seizures. The International League Against Epilepsy (ILAE) categorizes epilepsy into the following groups: focal, generalized, generalized and focal, and unknown. Infants are the most vulnerable pediatric group to the condition, with the cause of epilepsy development being attributed to congenital brain developmental defects, white matter damage, intraventricular hemorrhage, perinatal hypoxic-ischemic injury, perinatal stroke, or genetic factors such as mutations in the Sodium Channel Protein Type 1 Subunit Alpha (SCN1A) gene. Due to the risks associated with this condition, we have investigated how the latest pharmacological treatments for epilepsy in children impact the reduction or complete elimination of seizures. We reviewed literature from 2018 to 2024, focusing on the age group from 1 month to 18 years old, with some studies including this age group as well as older individuals. The significance of this review is to present and compile research findings on the latest antiseizure drugs (ASDs), their effectiveness, dosing, and adverse effects in the pediatric population, which can contribute to selecting the best drug for a particular patient. The medications described in this review have shown significant efficacy and safety in the studied patient group, outweighing the observed adverse effects. The main aim of this review is to provide a comprehensive summary of the current state of knowledge regarding the newest pharmacotherapy for childhood epilepsy. Full article

(This article belongs to the Special Issue New Trends in Diagnosis and Treatment of Epilepsy)

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