The occurrence of seizures after hemorrhagic stroke is a significant contributor to mortality in patients with hemorrhagic stroke. Compared with ischemic stroke， hemorrhagic stroke is more frequently to cause seizures， with high disability and high mortality. If not detected early and treated in time， seizures may aggravate patient’s conditions in the acute stage， and cause accidental injuries in the recovery stage， increasing the burden on patient’s family. Early prediction and timely treatment of seizures can improve the survival rate and quality of life of patients. With science and technology advances， domestic and international researchers have established prediction models for seizures after hemorrhagic stroke， which use machine learning methods to process and identify relevant data， improving the accuracy of prediction for the disease. This review aims to summarize risk factors for post-hemorrhagic stroke seizures and related prediction models， so as to provide guidance for clinical diagnosis and treatment.

Despite the availability of novel anti-seizure medications （ASMs） in their third generation， one-third of the patients with epilepsy may progress to drug-resistant epilepsy （DRE）. In 2010， the International League Against Epilepsy （ILAE） introduced the concept of DRE， which is still used today， and early diagnosis of DRE can facilitate timely preoperative evaluation for individuals with no response to ASMs， helping them to benefit from epilepsy surgery. Since the incidence rate of DRE remains high and there is a lack of update in related concepts， the ILAE/American Epilepsy Society （AES） Joint Translational Task Force discussed the heterogeneity， complexity， and dynamic changes of DRE manifestations and mechanisms throughout the lifespan and across various species from the perspective of coordinating preclinical and clinical studies. The Joint Translational Task Force advocates the necessity of revisiting the current definition of DRE to enhance the clinical management of DRE， steer future research efforts towards DRE， and provide patients with more effective and individualized treatment strategies， so as to reduce the incidence rate of DRE and improve the quality of life of patients. This article provides a concise overview and interpretation of the ILAE/AES report.

Epilepsy is often comorbid with other neuropsychiatric conditions， which are known as epilepsy comorbidities. Among these conditions， the comorbidity of epilepsy and migraine is very common. Although they are two different diseases， they overlap in terms of pathophysiological features and clinical symptoms， and several anti-seizure medications （ASMs） have been proved to be effective in migraine. However， there are still controversies over the concept of epilepsy comorbid with migraine， and there is often a lack of effective treatment for migraine due to missed diagnosis or misdiagnosis. In order to improve the ability for identification and precise treatment of epilepsy comorbid with migraine among clinicians， this article elaborates on the possible mechanism of epilepsy comorbid with migraine and discusses the concept， identification， and diagnosis and treatment regimens for epilepsy comorbid with migraine by considering the temporal association between headache symptoms and epileptic seizures， with reference to the classification of epilepsy comorbid with migraine and related diagnostic criteria in Chinese expert consensus （2019） and the ICHD-3-2018 guidelines issued by the International Headache Society.

Objective To investigate the association between dietary inflammation and the risk of epilepsy （EP） based on dietary inflammatory index （DII）， and to provide a scientific basis for the prevention and treatment of EP in terms of dietary intervention.Methods Related data of the adults aged ≥20 years were obtained from the National Health and Nutrition Examination Survey （NHANES） from January 2013 to March 2020. A multivariate logistic regression model was used to investigate the association between DII and the risk of EP， and a restricted cubic spline （RCS） regression analysis was used to perform the linearity test and explore the quantitative relationship between DII score and the risk of EP. The subgroup and interaction analyses were used to evaluate the stability of the association between DII and EP across different subgroups.Results A total of 15565 respondents were included in this study， among whom 131 were diagnosed with EP. In the fully adjusted multivariate logistic regression model， DII， as a continuous variable， was positively associated with the risk of EP [odds ratio （OR）=1.12， 95% confidence interval （CI） 1.02-1.24， P=0.021]. After the tertile categorization of DII， the fully adjusted model showed that the high pro-inflammatory group had a significantly higher risk of EP than the low pro-inflammatory group （OR=1.63， 95% CI 1.02-2.6， P=0.039）. In the RCS linearity test， DII was positively associated with the risk of EP （non-linearity： P=0.342）. The stratified analysis showed that the relationship between DII and the risk of EP remained stable， with no significant interactions observed between subgroups.Conclusion There is a positive correlation between DII and the risk of EP among American adults， and for every unit increase in DII， the risk of EP is increased by 12%.

Epilepsy is one of the common diseases of the nervous system， which is characterized by repeated epileptic seizures caused by abnormal discharge of brain neurons. Brivaracetam is an analogue of the third-generation antiepileptic drug levetiracetam and exerts a therapeutic effect by binding to synaptic vesicular protein 2A. This article reviews the disease of epilepsy and the mechanism of action， pharmacokinetic characteristics， clinical efficacy， safety， and adverse reactions of brivaracetam in epilepsy， in order to provide a better choice of drugs for the treatment of epilepsy.

Acute symptomatic seizures secondary to autoimmune encephalitis refers to seizures that occur during the active stage of immune-mediated encephalitis， and autoimmune-related epilepsy refers to disorders with an immune etiology and a long-term predisposition to unprovoked seizures. Both diseases often have poor response to antiepileptic drugs， and early identification of immune etiology and initiation of immunotherapy may help patients achieve a good prognosis. However， there are no guidelines for the use of drugs in patients with different types of symptomatic seizures， and there is also a lack of diagnostic criteria and treatment principles for autoimmune-related epilepsy. This article reviews and discusses the two diseases from the aspects of possible pathogenesis， clinical manifestations， and recommended treatment methods， so as to provide a theoretical basis for diagnosis and treatment and help to determine future research directions.

Objective To investigate the electroencephalographic characteristics of patients with temporal lobe epilepsy （TLE） with bitemporal interictal epileptiform discharges （IEDs） and their association with surgical outcome.Methods We retrospectively collected the clinical data of patients with TLE with IEDs who underwent surgical treatment at our epilepsy center from January 2013 to December 2019. The surgical outcomes of patients with different interictal and ictal electroencephalographic characteristics were compared.Results A total of 159 patients with TLE were included in this study. The frequency of IEDs showed no laterality in 42.1% （67/159） of the patients， dominance on the surgical side in 48.4% （77/159），and dominance on the contralateral side in 9.4% （15/159）. Seizures were recorded in 73.0% （116/159） during preoperative electroencephalogram monitoring， which originated from the temporal lobe on the surgical side in 56.0% （65/116），the ipsilateral hemisphere in 5.2%（6/116），the contralateral temporal lobe in 5.2% （6/116）， and on an undetermined side in 33.6% （39/116）. Twenty-nine patients were lost to follow-up after surgery， and the remaining patients were followed up for a mean length of （64.0±20.6）months （26-101 months）， with 66.2% （86/130） of them in Engel class I and 33.8% （44/130） in Engel class II-IV. There were no significant differences in surgical outcome between patients with different types of IEDs （P=0.794） and those with different seizure origins（P=0.299）.Conclusion Patients with TLE with bitemporal IEDs can achieve effective control over seizures in a long term after surgery with comprehensive preoperative evaluation. IED characteristics and seizure origins are not associated with surgical outcome， and ictal electroencephalography is not necessary for preoperative evaluation.

The “R-on-T” phenomenon is a phenotype of electrocardiogram （EEG） caused by the premature contraction of the ventricle during the ventricular vulnerable period of the previous cardiac cycle， which often leads to malignant arrhythmia. This article reports a case of epilepsy in which the patient underwent the resection of lesions in the right temporal lobe and selective hippocampal amygdala resection and was found to have sharp and slow waves on EEG during the hyperventilation test， which were similar to the “R-on-T” homologous phenomenon； meanwhile， this article also discusses the possible mechanism of this phenomenon， in order to reveal the homology between neurophysiology and cardiac electrophysiology and further expand the theoretical learning of electrophysiology and the diagnosis thinking of electrophysiology.

Objective To investigate the risk factors and seizure types of secondary seizures in elderly patients with acute ischemic stroke(AIS),and to screen the effective indicators for predicting Post-stroke seizures(PSS). Methods Elderly patients who were hospitalized in Henan Provincial People's Hospital from January 2019 to June 2020 and diagnosed with AIS for the first time were consecutively collected. The patients were followed up for 1 year and divided into the observation group and the control group according to whether they developed secondary PSS,and the patients in the observation group were divided into subgroups according to the time of secondary PSS. The demographic and clinical characteristics of the patients were recorded,and the National Institutes of Health Stroke Scale(NIHSS) score and Modified Rankin Scale(mRS) score were used to assess stroke severity and outcome at discharge,respectively. Univariate and multivariate Logistic regression analyses were used to identify the independent risk factors for PSS. Results (1)Comparison of general information:There were statistically significant differences in gender,lesion location,hemorrhagic transformation(HT),NIHSS score ≥11,hypertension,cardiac cerebral embolism(CE) and baseline NIHSS score between the observation group and the control group(P<0.05). (2)Results of Multivariate Logistic regression analysis:Cortical infarction(OR=1.702,95%CI 1.172-2.471,P=0.005),HT(OR=2.384,95%CI 1.605-3.434,P<0.001) and NIHSS scores ≥11(OR=1.723,95%CI 1.188-2.500,P=0.004) were independent risk factors for PSS,and the differences were statistically significant. (3)Comparison of early-onset seizures(ES) and late-onset seizures(LS):Focal progression to bilateral tonic-clonic seizures(46.8%) was the most common seizure type in this group and the most common seizure type in the LS group(50.4%). The most common seizure type in ES group was focal seizure(47.8%). In addition,the proportion of negative emotions(65.2%) and mRS Score[2(3,4)]in ES group were higher than those in LS group[37.4%,2(2,3)],and the differences were statistically significant. Conclusion Cortical infarction,HT and NIHSS score ≥11 were independent risk factors for PSS. Focal progression to bilateral tonic-clonic seizures is the most common seizure type and is a common seizure type of LS,The common seizure type of early seizures is focal seizures,which are associated with negative mood and a worse prognosis.

Objective To investigate the long-term surgical outcome and safety of resective surgical treatment in patients with post-traumatic epilepsy(PTE). Methods Patients with PTE who underwent resective surgery from January 2014 to December 2020 at our center were consecutively included,and their demographic characteristics and clinical data were retrospectively analyzed. Univariate analysis and multifactor Logistic regression analysis were used to identify potential predictors of postoperative outcome,and surgery-related complications were documented and followed-up. Results A total of 104 patients with PTE were included. The postoperative outcomes were graded by Engel class:60.6%(63/104) as Engel class Ⅰ and 39.4%(41/104) as Engel class Ⅱ-Ⅳ with a mean follow-up of(68.7±23.2) months(20-103 months). Univariate analysis showed that age at the time of surgery and surgical side were associated with postoperative outcome,while multivariate analysis showed that only surgical side was an independent predictor of postoperative outcome(OR=2.944,95%CI 1.283-6.753,P=0.011),with 2.9 times the seizure-free(Engel class Ⅰ) rate when the surgical side was right-sided compared with left-sided. 29.8%(31/104) of patients had varying degrees of surgery-related complications,including 20 cases of subcutaneous or subdural effusion;3 cases of cerebral edema;2 cases of cerebral hemorrhage;1 case of hydrocephalus combined with incisional infection;and 5 cases of neurological deficits,4 of which recovered completely during the follow-up period. Conclusion PTE patients treated with resective surgery after comprehensive preoperative evaluation had good long-term surgical outcomes and safety,and good postoperative outcomes were predicted when the surgical side was right-sided.

Objective To investigate the correlation of slow wave on quantitative electroencephalography(QEEG) with cognitive dysfunction. Methods A total of 80 patients with temporal lobe epilepsy who attended The Affiliated Hospital of Chifeng University from January to October 2022 were collected. All patients underwent Montreal Cognitive Assessment(MoCA) and QEEG monitoring to calculate δ wave power and(δ+θ)/(α+β) ratio(DTABR),and statistical analyses were performed. Results There were 40 patients in the temporal lobe epilepsy+cognitive dysfunction group,among whom there were 23 male patients(57.5%) and 17 female patients(42.5%),with a mean age of(48.15±14.85)years,a mean duration of education of 9.43±2.5 years,and a mean duration of medication of 8.35±4.55 years;there were 40 patients in the control group,among whom there were 21 male patients(52.5%) and 19 female patients(47.5%),with a mean age of 50.83±15.58 years,a mean duration of education of 9.45±2.45 years,and a mean duration of medication of 9.23±5.14 years. There were no significant differences in age,sex,education level,and medication years between the cognitive dysfunction group and the normal control group(P>0.05),and there was a significant difference in MoCA score between the cognitive dysfunction group and the normal control group [21±7(5-25) points vs 27±2(26-29) points,Z=-7.738,P<0.05]. The cognitive dysfunction group had significantly higher δ wave power and DTABR than the normal control group(P<0.05). In the patients with temporal lobe epilepsy,cognitive function parameters were correlated with electric power and DTABR on QEEG;cognitive function parameters were negatively correlated with δ wave power and DTABR(P<0.05),while δ wave power was positively correlated with DTABR(P<0.05). Conclusion There is a correlation between slow wave and DTABR on QEEG in patients with temporal lobe epilepsy,suggesting that DTABR can be used as an electric power indicator for cognitive function screening in patients with temporal lobe epilepsy.