Acta Epileptologica

Abstract Post-stroke epilepsy (PSE) is a common complication of stroke, significantly impacting patient’s quality of life. Repetitive transcranial magnetic stimulation (rTMS) is an emerging potential non-invasive treatment for PSE. This review explores current evidence for rTMS in PSE, highlighting its potential benefits and limitations. Initial studies suggested that rTMS may reduce the seizure burden. Some studies observed a trend towards fewer seizures within two weeks of treatment initiation, indicating a relatively rapid response. Additionally, rTMS may be more effective when used in combination with medication, particularly for patients with specific lesion locations (frontal/temporal lobes) and seizure types (complex partial seizures). This points towards the potential of personalized treatment protocols. However, current evidence has limitations. Studies often involve small sample sizes and methodological variations, necessitating larger, well-designed trials with standardized protocols to confirm the efficacy and safety of rTMS in PSE. Future research should also focus on the optimization of treatment parameters, including stimulation frequency, duration, coil placement, and treatment course. Long-term studies are needed to evaluate the persistence of treatment effects on seizure control, cognitive function, and overall patient outcomes. Refining patient selection criteria and investigating the underlying mechanisms of therapeutic effects of rTMS in PSE are also crucial areas for future exploration.

Nicholas Aderinto

Gbolahan Olatunji

Emmanuel Kokori

Ikponmwosa Jude Ogieuhi

Abdulrahmon Moradeyo

Owolabi Samuel

Adetola Emmanuel Babalola

Tejiri Napoleon

Wuraola Awosan

Oluwaseun Oyewo

Chidinma Udojike

Oluwatobi Omoworare

Yewande Abigail Adebayo

Repetitive transcranial magnetic stimulation for post-stroke epilepsy: a mini-review

重复经颅磁刺激治疗卒中后癫痫：一篇小综述

Abstract Background Liver damage, coagulopathy, hyperammonemia, fracture, menstrual disorder and amenorrhea are the most concerned adverse drug reactions of valproic acid (VPA). This study was aimed to retrospectively investigate the incidence of adverse drug reactions of VPA in the real world and its association with the age of patients and duration of treatment in order to obtain the safety data of VPA in children with epilepsy. Methods A total of 1943 patients diagnosed as epilepsy by the Pediatric Neurology Department of Shenzhen Children’s Hospital between December 2013 and December 2023, were included in the study. They received VPA as an initial treatment, and had followed up examinations over a time span of at least two years focusing on the adverse drug reactions of VPA. Results There was no significant difference in the incidence of liver damage, coagulation test abnormalities, and nasal bleeding during VPA monotherapy (30–90 days, 90–180 days, and &gt; 2 years). Adolescent female patients (first visit age ≥ 12 years) showed no significant difference in the incidence of adverse reactions and abnormal ultrasound of the reproductive system pre- versus post-treatment at the first visit, similar for those below 12 years. However, laboratory blood tests revealed significantly age-dependent changes in certain biochemical markers. Two patients stopped VPA treatment due to thrombocytopenia and ovarian cystic mass comorbid with endometrial hyperplasia, recovering after VPA withdrawal. Conclusions The initial monotherapy of VPA is generally safe in children with epilepsy of all age ranges. In the real world, VPA does not increase the risk of liver damage, coagulation disorder, elevated blood ammonia, fractures, or low serum sodium, but may significantly decrease the platelet count at 3, 6, 12, and 24 months of treatment. There is no evidence showing that VPA may increase the incidence of impairment of adolescent female reproductive system. Among children under 1 year old, it is recommended to monitor the levels of serum ammonia and aspartate aminotransferase carefully. Trial registration ChiCTR2300075115.

Xiner Chen

Yujie Zhang

Xinan Liu

Ruoyu Tan

Dezhi Cao

Li Chen

Yan Hu

Bing Li

Tieshuan Huang

Qiang Zhou

Jialun Wen

Jianxiang Liao

The safety of valproic acid treatment in children with epilepsy: a retrospective real-world research

儿童癫痫患者使用丙戊酸治疗的安全性：一项回顾性真实世界研究

Abstract Background Studies on the association between oxidative stress and epilepsy have yielded varied results. In this study, we aimed to investigate the causal relationship between oxidative stress markers and epilepsy. Methods A bidirectional two-sample Mendelian randomization (MR) study was performed based on publicly available statistics from genome-wide association studies. To explore the causal effects, single nucleotide polymorphisms were selected as instrumental variables. Inverse-variance weighted method was performed for primary analysis, supplemented by weighted median, MR-Egger, simple mode, and weighted mode. Furthermore, sensitivity analyses were performed to detect heterogeneity and pleiotropy. Results Our results showed that part of the oxidative stress biomarkers are associated with epilepsy and its subtypes. Zinc is associated with increased risk of epilepsy and generalized epilepsy (odds ratio [OR] = 1.064 and 1.125, respectively). Glutathione transferase is associated with increased risk of generalized epilepsy (OR = 1.055), while albumin is associated with decreased risk of generalized epilepsy (OR = 0.723). Inverse MR analysis revealed that epilepsy is associated with increased levels of uric acid and total bilirubin (beta = 1.266 and 0.081, respectively), as well as decreased zinc level (beta = − 0.278). Furthermore, generalized epilepsy is associated with decreased ascorbate and retinol levels (beta = − 0.029 and − 0.038, respectively). Conclusions Our study presented novel evidence of potential causal relationships between oxidative stress and epilepsy, suggesting potential therapeutic targets for epilepsy.

Lan Zhang

Ningning Zhang

Xuyan Sun

Sirui Chen

Yuanhang Xu

Yaqing Liu

Junqiang Li

Dadong Luo

Xin Tian

Tiancheng Wang

The associations between oxidative stress and epilepsy: a bidirectional two-sample Mendelian randomization study

氧化应激与癫痫的关联：一项双向两样本孟德尔随机化研究

John Agbo

Zainab G. Ibrahim

Shehu Y. Magaji

Yahkub Babatunde Mutalub

Philemon Paul Mshelia

Daniel H. Mhya

Correction: Therapeutic efficacy of voltage-gated sodium channel inhibitors in epilepsy

更正：电压门控钠通道抑制剂在癫痫治疗中的疗效

Abstract Background The TSC1 gene encodes a growth inhibitory protein hamartin, which plays a crucial role in negative regulation of the activity of mTORC1 (mechanistic target of rapamycin complex 1). TSC1 has been associated with tuberous sclerosis complex (TSC). This study aims to investigate the association between TSC1 variants and common epilepsy. Methods Trio-based whole-exome sequencing was performed in epilepsy patients without acquired etiologies from the China Epilepsy Gene 1.0 Project platform. The pathogenicity of the variants was evaluated according to the American College of Medical Genetics and Genomic (ACMG) guidelines. Results Two TSC1 de novo variants, including c.1498 C &gt; T/p.Arg500* and c.2356 C &gt; T/p.Arg786*, were identified in two patients with developmental and epileptic encephalopathy (DEE). The patients exhibited frequent seizures and neurodevelopmental delay. Additionally, we identified two heterozygous TSC1 variants that affected four individuals with focal epilepsy from two unrelated families. The four probands did not present any typical symptom of TSC and had normal brain MRI findings. The four variants were absent in the Genome Aggregation Database (gnomAD) and were predicted to be damaging with a in silico prediction tool. Based on the ACMG guidelines, the four variants were evaluated to be “pathogenic” or “likely pathogenic”. Of the patients in the China Epilepsy Gene 1.0 Project, 22 patients carried TSC1 variants and were diagnosed with TSC. The ratio of patients carrying TSC1 variants with or without TSC is about 5:1. Conclusions TSC1 is potentially associated with common epilepsy without tuberous sclerosis.

Nanxiang Shen

Zhihong Zhuo

Xiangyun Luo

Bingmei Li

Xuqing Lin

Sheng Luo

Zilong Ye

Pengyu Wang

Na He

Yiwu Shi

Weiping Liao

Variants of TSC1 are associated with developmental and epileptic encephalopathy and focal epilepsy without tuberous sclerosis

TSC1变异与发育性和癫痫性脑病及无结节性硬化症的局灶性癫痫相关

Abbreviation	Acta Epileptol.
Journal Impact	1.28
Quartiles(Global)	CLINICAL NEUROLOGY(Q4)

Publication Information	Publisher: BioMed Central Ltd，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2019，Proportion of original research papers: ，Self Citation Rate:， Gold OA Rate:

Acta Epileptologica

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Repetitive transcranial magnetic stimulation for post-stroke epilepsy: a mini-review

The safety of valproic acid treatment in children with epilepsy: a retrospective real-world research

The associations between oxidative stress and epilepsy: a bidirectional two-sample Mendelian randomization study

Correction: Therapeutic efficacy of voltage-gated sodium channel inhibitors in epilepsy

Variants of TSC1 are associated with developmental and epileptic encephalopathy and focal epilepsy without tuberous sclerosis

Repetitive transcranial magnetic stimulation for post-stroke epilepsy: a mini-review

The safety of valproic acid treatment in children with epilepsy: a retrospective real-world research

The associations between oxidative stress and epilepsy: a bidirectional two-sample Mendelian randomization study

Correction: Therapeutic efficacy of voltage-gated sodium channel inhibitors in epilepsy

Variants of TSC1 are associated with developmental and epileptic encephalopathy and focal epilepsy without tuberous sclerosis

ISSN	2096-9384, 2524-4434
h-index	7