Objective To investigate the application value of ultrasound measurement of optic nerve sheath diameter （ONSD） in the assessment of brain death. Methods A total of 124 subjects were enrolled and divided into brain death group with 34 patients， deep coma group with 28 patients， and healthy control group with 62 individuals， and ultrasound measurement of ONSD was performed for all three groups. A Spearman correlation analysis was used to investigate the correlation of brain death with ONSD and baseline characteristics. Univariate and multivariate Logistic regression analyses were used to identify the independent predictive value of ONSD for brain death. The receiver operating characteristic （ROC） curve was plotted to determine the optimal cut-off value of ONSD and evaluate its diagnostic efficacy. Results The Spearman correlation analysis showed a significant positive correlation between brain death and ONSD （r=0.825，P<0.001）. The multivariate Logistic regression analysis confirmed that ONSD was an independent predictive factor for brain death （odds ratio=70.874， P<0.05，Nagelkerke R²=0.739， Hosmer-Lemeshow test P=0.786）.ONSD had an area under the ROC curve （AUC） of 0.939（95%CI 88.3‒99.4） in the brain death group and the deep coma group， with an optimal cut-off value of 6.005 mm， a sensitivity of 97.1%，a specificity of 78.6%， a positive predictive value of 84.6%， and a negative predictive value of 95.7%. Conclusion Ultrasound measurement of ONSD has an important clinical application value in the assessment of brain death.

Objective The supine-to-standing transcranial Doppler（TCD） technique is suitable for evaluating cardiovascular autonomic dysfunction， and this study aims to assess its performance in predicting adverse outcomes in diabetic patients with or without orthostatic hypotension （OH）. Methods The patients with type 2 diabetes mellitus who were admitted to Department of Endocrinology and Department of Neurology in The Second Affiliated Hospital of Hainan Medical University from August 2020 to May 2023 were enrolled as subjects. Basic clinical data were collected， and supine-to-standing TCD was performed to monitor and record the changes in blood pressure， heart rate， and cerebral hemodynamics in both supine and standing positions. The patients were followed for 2-4 years to record medication， orthostatic intolerance score， and adverse events. The two-independent-samples t test was used for comparison of normally distributed continuous variables between groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous variables between groups； the chi-square test was used for comparison of categorical variables between groups. The binary logistic regression analysis was used to investigate the association between the results of supine-to-standing TCD and adverse outcomes. Results A total of 118 patients （96 male patients and 22 female patients） were enrolled， among whom there were 28 patients with OH （23.7%） and 90 patients without OH（76.3%）. During follow-up， 19 patients （16.1%） experienced adverse outcomes （including syncope， falls， and death）.TCD showed that impaired “W” wave recovery in cerebral blood flow in the standing position was an independent risk factor for adverse outcomes in diabetic patients （OR=3.536， 95% CI 1.136-11.006， P=0.029）. Conclusion Vascular reflex failure and paradoxical cerebral vasoconstriction may be the mechanisms for impaired cerebral blood flow recovery in the standing position. TCD testing has an important role in detecting cerebrovascular abnormalities and cerebral hemodynamic changes， especially in diabetic patients with OH， and it has good performance in predicting adverse outcomes.

Severe carotid artery stenosis is an independent risk factor for stroke， and carotid endarterectomy （CEA） can effectively prevent ischemic stroke by alleviating such stenosis. However， CEA carries certain risks of adverse events， including perioperative death， ischemic stroke， and hyperperfusion injury， and these adverse events not only compromise perioperative safety but also diminish the efficacy of the procedure in preventing cerebral ischemic events. A multimodal imaging-based comprehensive management mode （i.e.， preoperative assessment with carotid ultrasound， transcranial Doppler （TCD）， and CT angiography， intraoperative monitoring with TCD and cerebral oximetry， and standardized postoperative follow-up with carotid ultrasound and TCD） can significantly reduce perioperative mortality and the incidence rate of stroke and avoid hypoperfusion， hyperperfusion syndrome， and arterial restenosis or occlusion， thereby enhancing the perioperative safety of CEA.

Objective To investigate the severity of white matter lesions （WML） in patients with right-to-left shunt （RLS）-positive migraine. Methods A total of 415 patients with RLS-positive migraine who were consecutively admitted to Department of Neurology， The First Affiliated Hospital of Soochow University， from January 2022 to January 2025 were enrolled， and all these patients met the diagnostic criteria in The International Classification of Headache Disorders， 3 rd edition. RLS was diagnosed based on contrast-enhanced transcranial Doppler and contrast-enhanced transesophageal echocardiography， and the type and grade of RLS were assessed. After a series of statistical analyses was conducted， the factors with P<0.05 in the univariate logistic regression analysis were included in the multivariate binary logistic regression analysis to investigate the risk factors for the onset and severity of WML， with P<0.05 indicating statistical significance. Results The analysis of the baseline data of patients with different grades of WML showed that the grade of WML increased with age in the patients with RLS-positive migraine （P<0.05）. Comparison of multimodal ultrasound findings between the patients with different grades of WML showed that there were significant differences between the patients with different grades of WML in the factors such as large RLS， potential RLS， prolonged PFO tunnel， higher PFO at the right atrial side in resting state and after Valsalva maneuver， higher PFO at the left atrial side after Valsalva maneuver， early appearance of shunt， and longer duration of shunt （P<0.05）. For the establishment of a predictive model， large RLS shunt （P=0.037）， higher PFO at the right atrial side after Valsalva maneuver （P=0.018）， and longer duration of shunt （P<0.001） were independent risk factors for the onset of WML in patients with RLS-positive migraine， and further research showed that prolonged PFO tunnel （P<0.001） was a risk factor for the onset of moderate-to-severe WML in patients with RLS-positive migraine. Conclusion The predictive model established based on the ultrasound factors including large RLS shunt and prolonged PFO tunnel can be used as an imaging method to screen for WML， especially moderate-to-severe WML， which provides a theoretical basis for subsequent treatment.

Objective There are currently limited studies on the hemodynamics of posterior cerebral artery （PCA） compensation in patients with severe stenosis or occlusion of the internal carotid artery （ICA）， and this study aims to investigate the application value of transcranial Doppler （TCD） in assessing PCA compensation after severe stenosis or occlusion of the unilateral extracranial ICA. Methods A retrospective analysis was performed for 107 patients who were hospitalized in Encephalopathy Center， Guangdong Provincial Hospital of Traditional Chinese Medicine， from January 2022 to February 2025 and met the diagnostic criteria for severe stenosis or occlusion of the unilateral extracranial ICA， and all patients underwent both digital subtraction angiography （DSA） and TCD. The patients were divided into groups based on PCA compensation on DSA， and TCD quantitative parameters were analyzed. The receiver operating characteristic （ROC） curve was plotted to investigate the value of TCD in assessing graded compensation of the PCA. Results Among the 107 patients， there were 75 patients （70.1%） in the compensation group and 32 patients （29.9%） in the non-compensation group. The optimal cut-off value of TCD in assessing PCA compensation was a mean velocity of ≥65 cm/s at the PCA P1 segment， with an area under the ROC curve（AUC） of 0.869（95% CI 0.785‒0.953）， a sensitivity of 78.7%， a specificity of 84.4%， and a Youden index of 0.630. Compared with the non-compensation group， the compensation group had significant increases in peak systolic velocity， end-diastolic velocity， and mean velocity （P<0.01） and a significant reduction in pulsatility index （P<0.05）. As for the graded compensation of the PCA， the patients with posterior communicating artery （PCoA） compensation alone accounted for 57.3% （43/75）， those with leptomeningeal collateral compensation of the PCA alone accounted for 16.0%（12/75）， and those with both patterns of compensation accounted for 36.7% （20/75）.An end-diastolic velocity of ≥48 cm/s at the PCA P1 segment was the optimal cut-off value for assessing PCoA compensation， with an AUC of 0.813 （95%CI 0.726‒0.900）， a sensitivity of 76.2%， a specificity of 79.5%， and a Youden index of 0.557； a mean velocity of ≥60 cm/s at the PCA P2 segment was the optimal cut-off value for assessing leptomeningeal collateral compensation of the PCA， with an AUC of 0.824 （95%CI 0.723‒0.925）， a sensitivity of 71.5%， a specificity of 90.7%， and a Youden index of 0.625. Conclusion This study conducts a hemodynamic stratification analysis on compensation patterns of the PCA in patients with severe stenosis or occlusion of the unilateral extracranial ICA. Quantitative blood flow indicators at the PCA-P1 and PCA-P2 segments are highly consistent with DSA in assessing PCA compensation and can reliably evaluate the compensation status of the PCoA and the leptomeningeal collaterals.

Case-based teaching is a teaching model that integrates theoretical knowledge with clinical practice， and it is widely used in medical education and plays an important role in standardized residency training. Taking preoperative vascular ultrasound evaluation for carotid endarterectomy （CEA） as an example， this article explores the application of the case-based teaching method in cultivating clinical thinking ability among trainees receiving standardized residency training for ultrasound. Through an analysis of typical cases， trainees engage in the whole process of clinical practice under the guidance of instructors， from medical history collection and imaging interpretation to identification of key intraoperative issues. The teaching process emphasizes the characteristics of vascular ultrasound， such as the combination of vascular structure and hemodynamics， integrated cerebrovascular and cervical assessment， and precise evaluation of collateral circulation. The case-based teaching method not only deepens the understanding of diseases among trainees， but also fosters their ability to think independently and solve clinical problems， facilitating the transition from theory to practice and ensuring precise diagnosis and treatment. This article summarizes the implementation steps and effectiveness of the case-based teaching method， in order to provide a reference for ultrasound residency training.

Artificial intelligence （AI） technologies， especially machine learning algorithms， have achieved remarkable advances in medical image analysis in recent years. As a noninvasive， real-time， and cost-effective imaging modality， vascular ultrasound is one of the most active areas for the application of AI technologies in medicine. This article reviews the latest research advances in the application of AI in vascular ultrasound image recognition， automatic segmentation， diagnostic assistance， and risk prediction in 2021—2025， covering the aspects of transcranial Doppler， carotid artery， abdominal aortic aneurysms， aortic dissection， peripheral artery disease， arteriovenous fistula， venous thrombosis， and the inferior vena cava. This article highlights the key technological innovations， clinical value， and research challenges of AI within these areas.

Objective To apply bedside ultrasound for real-time monitoring of intracranial conditions in patients with severe traumatic brain injury experiencing acute encephalocele during large craniotomy， and to investigate the clinical value of intraoperative bedside ultrasound in the diagnosis and prognostic evaluation of acute encephalocele. Methods A retrospective analysis was performed for 32 adult patients with severe traumatic brain injury， and according to whether intraoperative ultrasound was performed， they were divided into ultrasound group with 17 patients and CT group with 15 patients. The two groups were compared in terms of time of operation， accuracy， mortality rate， and postoperative Glasgow Outcome Scale （GOS） score. The chi-square test was used for comparison of categorical data between groups， and the independent samples t-test was used for comparison of continuous data between groups. Results Both ultrasound and CT could provide an accurate basis for diagnosis， with no significant difference in diagnostic accuracy； however， compared with the CT group， the ultrasound group had significantly shorter time of operation and diagnostic time. Based on GOS score and grading results at 6 months after surgery， the patients undergoing ultrasound examination had a significantly better prognosis than those undergoing CT examination. Conclusion Intraoperative ultrasound for patients with severe traumatic brain injury enables rapid and accurate identification of etiology， facilitates dynamic intracranial monitoring， and shortens the time for rescue， showing an important clinical significance in improving prognosis and reducing mortality rate. Therefore， it holds promise for clinical application.

Objective We sought to investigate the clinical characteristics and echocardiographic changes of cryptogenic perforator infarction（PI） patient with patent foramen ovale（PFO）. Methods From Jan 2015 to Dec 2023， patients diagnosed with cryptogenic stroke were retrospectively included in our study. All patients received transthoracic echocardiography（TTE） and transcranial Doppler（TCD）.PFO was diagnosed by the bubble test of TCD. Comparisons of clinical features and TTE findings were performed firstly in PI patients， between PFO and non-PFO， and then in patients with PFO， between PI and cortical infarction（CI）. Results A total of 251 patients were retrospectively analyzed. PFO was detected in 104 patients，of those，40.4%（42/104） had pure PI（PFO-PI） and 59.6%（62/104） had CI（PFO-CI）. In patients without PFO，30.6%（45/147） had pure PI（non-PFO-PI）.Compared with non-PFO-PI， PFO-PI associated with a higher proportion of vertebrobasilar circulation infarctions（VCI）（47.6% vs 17.8%， P=0.003）， lower mean value of left ventricle end-diastolic diameters（LVEDd）（47.3 mm vs 49.8 mm， P=0.037） and lower peak E-wave velocity（62.6 cm/s vs 70.8 cm/s，P=0.015）.In PFO patients， PFO-PI was detected with a lower mean value of aorta root diameters（32.5 mm，P=0.011） and lower mean value of LVEDd（47.3 mm，P=0.045） than PFO-CI（34.5 mm and 49.4 mm， respectively）. Conclusion Higher proportion of VCI was found in PFO-PI. Lower LVEDd， lower Em and without aortic root dilatation were three echocardiographic features associated with PFO-PI in cryogenic PI patients.

Stroke is one of the most common and serious neurological complications associated with extracorporeal membrane oxygenation （ECMO） therapy， and close monitoring， early recognition， and timely intervention can reduce the incidence rate of stroke and the mortality rate of patients. Transcranial Doppler （TCD） and transcranial color Doppler ultrasonography （TCCD） have emerged as the preferred modalities for monitoring cerebral blood flow in ECMO patients due to their bedside applicability， ability to provide real-time dynamic assessments， and noninvasive safety. This article summarizes the spectral characteristics of cerebral blood flow in patients undergoing various ECMO modalities and elaborates on the latest research advances and clinical significance of TCD/TCCD in predicting stroke events， monitoring cerebral microembolic signals， reflecting the change in intracranial pressure， confirming brain death， and providing prognostic evaluation.

Objective To investigate the safety and efficacy of remote ischemic conditioning （RIC） in the treatment of patients with acute ischemic stroke undergoing mechanical thrombectomy. Methods This was a single-center randomized parallel-controlled clinical study. A total of 40 patients with anterior circulation large-vessel occlusive ischemic stroke who were admitted to Baoji High-Tech Hospital within 24 hours after onset and underwent emergency mechanical thrombectomy from July 2023 to July 2024 were enrolled and randomly assigned to the experimental group and the control group at a ratio of 1∶1. The patients in the experimental group received standardized RIC treatment （cuff pressure 200 mmHg）， while those in the control group received sham RIC intervention （cuff pressure 60 mmHg）， and the course of treatment was 7 days for both groups. The two groups were compared in terms of baseline information， safety assessment indicators （including hemorrhagic transformation， symptomatic intracranial hemorrhage， and adverse events）， and efficacy evaluation indicators [including NIHSS score， Barthel index， and mRS score after 7 days of treatment， as well as the proportion of patients with good prognosis （an mRS score of 0-2） and excellent prognosis （an mRS score of 0-1） at follow-up on day 90]. Results A total of 39 patients were finally included in the analysis， with 19 in the experimental group and 20 in the control group. At follow-up on day 90， 3 patients were lost to follow-up， and 18 patients in each group were included in the analysis. There were no significant differences between the two groups in all baseline data （P0.05） except sex （P=0.048）. The safety analysis showed that during hospitalization， there were no deaths in either group， and there were no significant differences in hemorrhagic transformation， symptomatic intracranial hemorrhage， and adverse events between the two groups （P0.05）. One patient in the control group and 2 patients in the experimental group died at follow-up on day 90， with no significant difference between the two groups（P0.999）. The efficacy analysis showed that after 7 days of treatment， there were no significant differences in NIHSS score， Barthel index， and mRS score between the two groups （P0.05）. At follow-up on day 90 after surgery， 10 patients in the experimental group and 9 patients in the control group had a good prognosis （55.6% vs 50.0%， P0.99）， and 10 patients in the experimental group and 6 patients in the control group had an excellent prognosis （55.6% vs 33.3%， P=0.315）. Conclusion RIC has good safety and efficacy in the treatment of patients with acute ischemic stroke after mechanical thrombectomy， with a tendency to improve 90-day functional prognosis.

Objective To investigate the practical efficacy of precise pulmonary rehabilitation strategy based on lung ultrasound（LUS） in patients with stroke-associated pneumonia （SAP）. Methods A total of 86 SAP patients who attended Xiangtan Central Hospital from January 2023 to January 2025 were enrolled and randomly divided into control group and experimental group， with 43 patients in each group. The patients in the control group received conventional SAP rehabilitation regimen， while those in the experimental group received LUS-based precise pulmonary rehabilitation strategy； the course of intervention was 14 days for both groups. The two groups were compared in terms of pulmonary function， pulmonary infection， inflammatory factors， and quality of life before intervention and after 7 and 14 days of intervention， and adverse reactions were recorded for both groups. Results Significant time， group， and interaction effects were observed in pulmonary function between the two groups， indicating that the experimental group had a significantly better improvement in pulmonary function than the control group， which became more significant over time （P0.001）. Compared with the control group， the experimental group had significantly lower rate of pulmonary infection and levels of inflammatory factors （P0.001）， a significantly higher quality of life （P0.001）， and a significantly lower overall incidence rate of adverse reactions （P0.05）. Conclusion For patients with SAP， the precise pulmonary rehabilitation strategy based on LUS can improve lung function and inflammatory indicators， alleviate pulmonary infection， enhance quality of life， and reduce the risk of adverse reactions. Therefore， it holds promise for clinical application.

Objective To investigate the hemodynamic features of left innominate vein （LIV） compression and their association with clinical manifestations， and to assess the diagnostic value of ultrasound. Methods A total of 32 patients with LIV compression and 67 healthy controls （HCs） were enrolled， and according to the symmetry of the diameters of bilateral transverse sinuses， sigmoid sinuses， and internal jugular veins （IJV）， the HCs were divided into symmetric group with 32 individuals and asymmetric group with 35 individuals. All subjects underwent CTV/MRV and ultrasound examination to measure the diameter， velocity， and flow volume of IJV and vertebral vein， and the differences between groups were analyzed. The receiver operating characteristic （ROC） curve was plotted to assess diagnostic efficacy. Results The patients with LIV compression mainly had the neurological symptoms such as cerebral tinnitus， dizziness， and tinnitus. Compared with the HCs， the patients with LIV compression had a significantly lower total flow volume of IJV and vertebral vein on the ipsilateral side [（406.42±177.05）ml/min vs （742.55±276.41）ml/min， P0.001）]， and the parameters of the ipsilateral side were lower than those of the contralateral side. There was no significant difference in the flow volume of IJV between the contralateral side of patients with LIV compression and the dominant side of the HCs in the asymmetric group. Total flow volume had an area under the ROC curve of 0.849 in predicting LIV compression， with a sensitivity of 77.60%， a specificity of 78.10%， and a cut-off value of 525.73 ml/min. Conclusion This study systematically reveals the blood flow characteristics of the bilateral IJV-vertebral vein system in patients with LIV compression，i.e.，LIV compression leads to a reduction in flow on the ipsilateral side and a compensatory increase on the contralateral side，and the asymmetry of bilateral blood flow may be the cause of the symptoms such as cerebral tinnitus and tinnitus.Ultrasound can be used to measure the total flow volume of IJV and vertebral vein， and it can effectively identify this disease and thus has a good value in screening.

Objective To systematically evaluate the efficacy and safety of Xingnaojing Injection （XNJ） in the treatment of post-stroke disorders of consciousness （PSDOC）. Methods PubMed， Embase， the Cochrane Library， Web of Science， VIP， CNKI， Wanfang Data， and SinoMed were searched for related randomized controlled trials （RCT） published up to July 2025. RevMan 5.4 and Stata 16.0 were used for data extraction and analysis. Results A total of 48 RCT were included， with 4 570 patients in total. The RCT included had relatively low overall risk of bias. The meta-analysis showed that compared with conventional treatment alone， XNJ combined with conventional treatment significantly improved the Glasgow Coma Scale （GCS） score of patients with PSDOC （mean difference=2.62， 95% confidence interval： 2.37-2.86， I²=66%， P0.000 01）. The subgroup analyses showed that XNJ administered at three dosages （20 ml， 30 ml， 40 ml） and for different treatment durations （1 week， 2 weeks， 4 weeks） could effectively improve the GCS score of patients， and it also showed efficacy in patients with hemorrhagic/ischemic stroke and disorders of consciousness. Nine RCT reported the adverse reactions including nausea， rash， and mild dizziness during the trial， which were resolved after the infusion rate was slowed down. Conclusion XNJ is a safe and effective therapy for improving consciousness in patients with PSDOC.

Acute cerebral infarction predominantly occurs in middle-aged and elderly individuals with multiple underlying diseases， and it is often accompanied by atherosclerosis or heart diseases. It has a low incidence rate in children and adolescents， who tend to have atypical symptoms in the early stage， leading to misdiagnosis or missed diagnosis. With the continuous development of imaging technology， the diagnosis of cerebral infarction has become more precise， which helps to further clarify the etiology of cerebral infarction and identify an increasing number of patients with different subtypes of cerebral infarction in clinical practice. This article reports a rare case of a pediatric patient with acute cerebral infarction caused by primary central nervous system vasculitis， which led to neurological dysfunction， in order to improve the awareness of cerebral infarction in children among clinicians.

Objective To investigate the research hotspots， development trends， and potential challenges in the field of stroke and exosomes based on bibliometric and visual analyses， and to provide scientific evidence for basic research and clinical translation. Methods The Web of Science database was used to obtain related articles published up to 2024， and CiteSpace and other tools were used to perform visual analyses from various aspects such as publication trends， collaboration networks， co-occurrence and clustering of keywords， and literature burst analysis. Results A total of 1 153 articles were included. The analysis showed an overall increasing trend in the number of publications per year. The institution with the highest number of publications was Henry Ford Health System， the author with the highest number of publications was Professor Chopp， and the journal with the highest number of articles Int J Mol Sci. High-frequency keywords included "extracellular vesicles" "ischemic stroke" and "stroke"， forming 12 research clusters， with neural repair and barrier protection as the key research directions. Conclusion The research on stroke and exosomes has been increasing year by year， with rapid development in recent years and the formation of an interdisciplinary pattern. Future studies should focus on the molecular mechanisms mediated by exosomes and their clinical application in stroke treatment， so as to promote the development of precision medicine and provide new therapeutic approaches.

Occipital lobe epilepsy （OLE） accounts for 5%-10% of all focal epilepsy cases. Ictal clinical symptoms mainly include visual and ocular movements， with common and specific elementary visual hallucinations. Electroencephalography has certain limitations， and a well-localized unifocal rhythmic ictal discharge during seizure is infrequent on ictal EEG. Detailed preoperative evaluation， especially the evaluation of symptoms and intracranial EEG monitoring， can help to obtain good outcomes after surgical treatment.

This study summarizes the prognosis of epilepsy and related influencing factors in patients with different conditions of epilepsy （after first seizure， refractory epilepsy， and after surgical treatment）. The risk of recurrence was 40%-50% after the first unprovoked seizure， with the risk factors including childhood， history of brain injury， electroencephalographic abnormalities， abnormal brain imaging， and nocturnal seizures. Although immediate medication after the first seizure can reduce the risk of short-term recurrence， there was no significant difference in long-term （over 3 years） seizure-free rate between the delayed treatment （till the second seizure） group and the immediate treatment group. About one-third of patients may progress to intractable epilepsy and have a poor prognosis after anti-seizure medication therapy. Surgical treatment is currently an important treatment regimen to improve the prognosis of patients with intractable epilepsy， and it can significantly improve the prognosis of such patients， with a particularly notable effect in pediatric patients. Preoperative assessment techniques， such as structural connectivity analysis based on diffusion MRI， machine learning models incorporating clinical variables， and computational models based on interictal EEG， can help to predict the optimal resection site， thereby improving the postoperative outcomes of patients. Finally， the integration of big data and omics technology is expected to achieve precise and individualized prognosis prediction and clinical decision-making， promoting the precise long-term management of epilepsy and improving the prognosis of patients.

Post-stroke epilepsy （PSE） is one of the most common complications of stroke and represents a leading cause of secondary epilepsy in adults. Its development follows a well-defined temporal sequence， progressing through stroke onset， latent phase remodeling， and eventual seizure manifestation. PSE is classified into early- and late-onset types based on the timing of seizures. The former is associated with acute injury， while the latter involves chronic reorganization of neural networks. During the latent phase， the brain exhibits pathological changes such as disrupted synaptic plasticity， inflammatory activation， oxidative stress accumulation， and blood-brain barrier disruption， offering a critical window for therapeutic intervention. However， conventional antiseizure medications， which primarily inhibit abnormal neuronal discharges， are insufficient to reverse the underlying pathogenesis and show limited preventive efficacy. Against this backdrop， the concept of disease-modifying treatment （DMT） has gained traction. DMT underscores mechanistic， targeted， and early-stage interventions that prioritize core processes such as inflammation， synaptic remodeling， ferroptosis， and miRNA regulation. Due to its predictability and ease of modeling， PSE serves as an ideal platform for DMT research. Emerging strategies encompass small-molecule drugs， stem cell transplantation， epigenetic modulation， and neuromodulation， some of which have shown promising results in animal models. This review systematically summarizes the pathogenesis of PSE and recent advances in DMT approaches， providing a theoretical foundation and practical guidance for clinical interventions.

Temporal lobe epilepsy is the most common type of focal medically intractable epilepsy. Seizures with involvement of the basal temporal region are extremely rare， and there is still a lack of understanding of their characteristics. The basal temporal region is divided into the olfactory cortex （including the perirhinal cortex and the entorhinal cortex）， the parahippocampal gyrus， and the fusiform gyrus. The ictal symptoms of basal temporal lobe epilepsy include naming dysfunction， comprehension deficit， spontaneous speech， vocal automatism， and dé jà vu. Anterior temporal lobectomy is recommended due to extensive epileptogenic areas.