Jun 2026· Journal of Society Medicine· Vol 5, pp. 220-225· 0 citations
TL;DR
It is indicated that seizure recurrence is associated with the etiology of epilepsy, as well as with lifestyle and behavioral factors such as sleep deprivation, psychological stress, alcohol consumption, smoking, and non-adherence to antiepileptic drugs.
Abstract
Epilepsy is a chronic neurological disorder characterized by recurrent seizures resulting from abnormal electrical activity in the brain. It remains a significant global health concern, particularly in low- and middle-income countries (LMICs). The recurrence of seizures in patients with epilepsy is influenced by multiple clinical and nonclinical factors involved in epileptogenesis. This literature review aims to summarize the risk factors for recurrent seizures in patients with epilepsy based on recent scientific evidence. The literature was obtained from PubMed, Google Scholar, and manual searches and included articles published in English and Indonesian between 2010 and 2026. The study designs included meta-analyses, systematic reviews, cohort studies, case-control studies, cross-sectional studies, and case reports. The findings indicate that seizure recurrence is associated with the etiology of epilepsy (structural, genetic, infectious, metabolic, immunological, and idiopathic), as well as with lifestyle and behavioral factors such as sleep deprivation, psychological stress, alcohol consumption, smoking, and non-adherence to antiepileptic drugs. Abnormal MRI findings also increase the risk of disease recurrence. Furthermore, neuroinflammatory mechanisms, particularly microglial activation and proinflammatory cytokine release, contribute to increased neuronal excitability. In conclusion, recurrent seizures in epilepsy result from complex interactions among biological, clinical, and behavioral factors. Early identification and management of these risk factors are essential to reduce seizure recurrence and improve the quality of life of patients.
Abstract Objective Epilepsy is a neurological disorder characterized by recurrent spontaneous seizures due to excessive brain electrical activity. Identifying factors associated with seizure recurrence may help improve patient's management. This study aims to identify factors associated with recurrent spontaneous seizures in epilepsy patients. Method This study was an analytical cross-sectional study with consecutive samples of epilepsy patients at Sanjiwani Gianyar Regional General Hospital. Data were collected through structured patient interviews and review medical records, capturing demographic characteristics, clinical history, and seizure-related variables. Samples were classified into two groups based on the presence or absence of seizure recurrence within the past year. Comparative analysis between groups was conducted using the Chi-square test. Results A total of 41 samples were obtained: 21 from the group without seizures and 20 from the group with seizures. Of several variables, those associated with recurrent spontaneous seizures were electroencephalography (EEG) results ( p = 0.012), history of status epilepticus ( p = 0.048), seizures during sleep ( p = 0.020), and recurrent seizures within the first 3 months after the first seizure ( p <0.001). Conclusion Recurrent spontaneous seizures in epilepsy patients are associated with EEG findings, history of status epilepticus, seizures during sleep, and recurrent seizures within the first 3 months after the first seizure. Within the limitations of this study, EEG abnormalities appear to be associated with seizure recurrence. These findings are still preliminary and should be interpreted with caution.
S. Harkitasari, K. Sumadewi, Ida Bagus et al.· International Journal of Epi...· 0 citations
0.5–1% of children worldwide suffer from epilepsy, a widespread neurological condition that affects people of all genders and demographics. It is a collection of disorders rather than a single illness that is typified by frequent, erratic seizures brought on by aberrant brain activity. These seizures can take many different forms, such as convulsions, sensory or behavioral abnormalities, or loss of consciousness. Recurrent unprovoked seizures, a high likelihood of recurrence, or an epileptic syndrome are the criteria used by the International League Against epileptic (ILAE) to describe epilepsy. Patients' neurological, emotional, and social well-being are greatly impacted by epilepsy, which is caused by neuronal hyperexcitability. Seizure type, EEG results, and related neurological characteristics determine classification. All things considered, epilepsy is a complicated condition with a wide range of causes and symptoms. In children, epilepsy and Attention Deficincy Hyperactivity Disorder (ADHD) often co-occur; approximately 30–40% of children with epilepsy also have ADHD. There are two types of epileptic seizures: focal and generalized. Automatisms, atonic or tonic episodes, clonic jerks, spasms, hyperkinetic movements, or myoclonus are examples of motor symptoms that can accompany focal seizures. Non-motor symptoms include autonomic changes, behavior arrest, cognitive disturbances, emotional changes, or sensory abnormalities. Absence seizures, myoclonic seizures, atonic seizures, tonic seizures, and tonic-clonic seizures are examples of generalized seizures that affect both hemispheres of the brain. This categorization aids in the diagnosis, management, and comprehension of epileptic seizure patterns. A common neurological condition in children, epilepsy is most common in the first year of life and is more common in low- and middle-income nations, where the majority of cases go untreated. The six main categories of its causes are structural, genetic, infectious, metabolic, immunological, and unknown. An imbalance between neuronal excitation and inhibition causes aberrant electrical activity during seizures, which can extend to different parts of the brain. Ion channel malfunction, neurotransmitter imbalance, and altered neuronal circuitry are some of the factors that lead to epileptogenesis and can have long-term repercussions on cognition, particularly following protracted or frequent seizures. When assessing epilepsy, a physical examination is crucial. This includes measuring blood pressure, looking for signs of neurocutaneous syndromes on the skin, and looking for anomalies in the skull that can point to underlying neurological conditions. Electroencephalography (EEG), neuroimaging, and genetic testing are used to diagnose epilepsy in children. Sleep EEG is crucial for focal epilepsies and epileptic encephalopathies. EEG is an easy-to-use method for identifying aberrant cortical excitability. While genetic testing, including next-generation sequencing, has identified over 265 genes associated with epilepsy, increasing the identification of genetic epilepsies, neuroimaging detects structural abnormalities in the brain. Antiepileptic medications including carbamazepine, ethosuximide, and levetiracetam are used in treatment; each is customized for a particular type of seizure and age group while taking side effects and effectiveness into account. An alternate strategy is offered by dietary therapy, especially the ketogenic diet, which lowers seizure frequency by altering neurotransmitter activity and brain metabolism. Together, these therapeutic and diagnostic approaches allow children with epilepsy to be Effecetiveiy managed.
N. P. Patil, Divakar. R. Patil, Akash S. Jain et al.· Research Journal of Pharmaco...· 0 citations
The evidence indicates that epilepsy management should extend beyond seizure control to incorporate routine cognitive surveillance, and practical screening tools such as the Montreal Cognitive Assessment demonstrate higher sensitivity than the Mini-Mental State Examination for detecting mild impairment.
Y. Imran, Ainaya Az Zahra· Journal of Society Medicine· 0 citations
OBJECTIVE
Subclinical seizures (SCSs) remain an understudied aspect of presurgical evaluation in patients with drug-resistant epilepsy (DRE), with uncertain prevalence, distribution among epilepsy types, and predictive value for surgical outcomes. This systematic review and meta-analysis aims to explore the occurrence of SCSs, their concordance with the seizure-onset zone (SOZ), and their association with postoperative seizure outcomes.
METHODS
A systematic search of Medline, Embase, and Web of Science was performed to identify studies reporting SCSs during scalp electroencephalography (EEG) monitoring or intracranial EEG (iEEG) monitoring in patients with DRE undergoing epilepsy surgery. Data on SCS prevalence, concordance with SOZ, and postoperative outcomes were extracted. Pooled proportions and odds ratios (ORs) were estimated using random-effects generalized linear mixed models. Subgroup analyses evaluated the proportions of SCSs in temporal vs extratemporal epilepsy.
RESULTS
Thirteen studies comprising 1174 patients met the inclusion criteria. The pooled prevalence of SCSs was 32% (95% confidence interval [CI] 8-73) during scalp EEG monitoring and 50% (95% CI 38-62) during iEEG monitoring. Concordant SCSs with SOZ occurred in 37% of patients undergoing iEEG. Non-concordant SCSs were associated with a nearly fivefold higher odds of poor postoperative seizure control (OR 4.82, 95% CI 1.80-12.96; p = 0.002). SCSs were more frequent in temporal lobe epilepsy than in extratemporal epilepsy (57% vs 44%, p = 0.046). Within temporal lobe epilepsy, the highest prevalence was observed in the mesiotemporal region (69%). Overall, the presence of SCSs alone was not associated with a poor outcome, but the spatial non-concordance with the SOZ was highly predictive for poor seizure outcome.
SIGNIFICANCE
SCSs are common in presurgical evaluation, particularly in temporal lobe epilepsy. Although their presence alone is not prognostic, non-concordant SCSs are associated with worse postoperative outcomes. Systematic assessment, especially using iEEG, may improve delineation of the epileptogenic zone and surgical planning in DRE.
P. Bosque-Varela, Panagiota-Eleni Tsalouchidou, Petra Levicka et al.· Epilepsia· 0 citations
Epilepsy is one of the most prevalent neurological disorders, affecting approximately 1% of the population, with one-third of patients developing drug-resistant epilepsy (DRE). In addition, metabolic syndrome (MetS), through inflammation and oxidative stress mechanisms, may influence epilepsy outcomes. The main objective of the current study is to determine the prevalence of MetS among patients with epilepsy (PWE) and evaluate its association with DRE. This cross-sectional study was conducted between March and October 2024 at a regional hospital in Tehran, involving 180 PWE aged 18 to 70 years. Participants were classified into well-controlled epilepsy and DRE groups based on the International League Against Epilepsy criteria. MetS was also diagnosed using the International Diabetes Federation guidelines. Data were analyzed using SPSS software, which illustrated that MetS was present in 33.8% of participants, with a significantly higher prevalence in well-controlled epilepsy patients (47.7%) compared with those with DRE (20%, P < .001), and it played a role in predicting response to treatment in PWE. Furthermore, body mass index, waist circumference, and blood pressure were significantly higher in the well-controlled group (P = .012 and P = .007, respectively). MetS was more prevalent in well-controlled epilepsy patients and was associated with a decreased risk of DRE. However, further research is needed to explore the relationship between MetS and DRE.
Afshan Davari, Amir Reza Bahadori, Azadeh Imeni Kashan et al.· Medicine· 0 citations
Comprehensive care extends beyond seizure management and includes addressing developmental, educational, and psychosocial needs, and a multidisciplinary, family-centred approach involving neurologists, dietitians, psychologists, and educators is essential.
Jayesh S. Patil, Hitendra S. Chaudhari, S. Pawar et al.· Research and reviews : a jou...· 0 citations