Morten Ingvar Lossius

• Kyte, Eli B.; Helmstaedter, Christoph; Skogan, Annette Holth; Lossius, Morten Ingvar & Alfstad, Kristin Åshild (2026). How far-reaching is the impact of temporal lobe epilepsy surgery on quality of life 10–44 years after the operation? Epilepsy & Behavior. ISSN 1525-5050. 185. doi: 10.1016/j.yebeh.2026.111272. Full text in Research Archive
• Giorgis, Valentina De; Bernardina, Bernando Dalla; Brambilla, Isabella; Helmstaedter, Christoph; Kotulska, Katarzyna & Lagae, Lieven [Show all 14 contributors for this article] (2026). Beyond seizures: proceedings of the ERN EpiCARE working group 18 on developmental and epileptic encephalopathies. Epilepsy & Behavior. ISSN 1525-5050. 182. doi: 10.1016/j.yebeh.2026.111112. Full text in Research Archive Show summary

  Developmental and Epileptic Encephalopathies (DEEs) are rare, severe neurodevelopmental disorders characterized not only by refractory seizures but also by complex cognitive, behavioral, psychiatric, and psychosocial manifestations that profoundly affect long-term outcomes. Traditional seizure-centered endpoints capture only part of the disease burden and may fail to reflect priorities identified by patients and caregivers. This manuscript represents a conference proceedings paper developed within the ERN EpiCARE Working Group 18 (“Beyond Seizures”), integrating a structured narrative synthesis of current literature with thematic discussions held during the 2025 ERN EpiCARE Congress in Ålesund. Contributions from domain experts were harmonized through iterative review to identify shared priorities, unmet needs, and future directions in DEE care. The aim was not to develop formal consensus statements, but rather to identify shared priorities, unmet needs, and future directions in DEE care. Key domains addressed include neurodevelopmental trajectories, patient-centered outcomes, sleep disturbances, stigma, antiseizure medication effects beyond seizure control, neuropsychological rehabilitation, and transition to adult care. Across these areas, emerging evidence supports the integration of developmental, functional, and quality-of-life measures alongside seizure outcomes in both clinical practice and research. While advances in genetics and targeted therapies are reshaping the therapeutic landscape, substantial gaps remain in longitudinal data, standardized assessment strategies, and equitable access to multidisciplinary care. A coordinated, patient-centered, and lifespan-oriented approach is necessary to ensure that novel interventions meaningfully improve developmental and functional outcomes for individuals with DEEs and their families.

• Kyte, Eli B.; Skogan, Annette Holth; Ivanovic, Jugoslav; Heminghyt, Einar; Lossius, Morten Ingvar & Helmstaedter, Christoph [Show all 7 contributors for this article] (2026). Well preserved versus severely impaired memory 10-44 years after temporal lobe epilepsy surgery: “How did the patients get there?”. Seizure. ISSN 1059-1311. 137, p. 143–151. doi: 10.1016/j.seizure.2026.03.008. Full text in Research Archive
• Hauger, Lisa Evju; Helmstaedter, Christoph; Lossius, Morten Ingvar; Alfstad, Kristin Åshild; Molteberg, Ellen & Torgersen, Halvor S. [Show all 7 contributors for this article] (2026). Executive dysfunction and employment in epilepsy. Epilepsia. ISSN 0013-9580. doi: 10.1002/epi.70165. Full text in Research Archive
• Helmstaedter, Christoph; Alfstad, Kristin Åshild; Dahl-Hansen, Eline; Henning, Oliver Johannes; Landmark, Cecilie Johannessen & Kälviäinen, Reetta [Show all 15 contributors for this article] (2026). Proceedings from ERN EpiCARE “BEYOND SEIZURES” meeting, Aalesund, Norway, May the 27th. Advancing holistic care for rare and complex epilepsies in adults. Epilepsy & Behavior. ISSN 1525-5050. 178. doi: 10.1016/j.yebeh.2025.110879. Full text in Research Archive
• Wilms, Line Kønig; Lossius, Morten Ingvar; Annala, Kaapo; Abdel-Khalik, Jonas; Fanter, Lena & Elomaa, Kaisa [Show all 7 contributors for this article] (2025). Seizure classification using a multimodal seizure monitoring system (Nelli) in Dravet and Lennox–Gastaut syndromes: A non-randomized, single-center feasibility study. Epilepsia. ISSN 0013-9580. 67(1), p. 164–174. doi: 10.1111/epi.18640. Full text in Research Archive
• Vikin, Truls; Chin, Richard F.; Lossius, Morten Ingvar; Hofoss, Dag; Brandlistuen, Ragnhild Eek & Aaberg, Kari Modalsli (2025). Syndromic and etiological classification predicts seizure freedom in childhood and youth onset epilepsy: A population-based study from the Norwegian Mother, Father, and Child Cohort Study. Epilepsia. ISSN 0013-9580. doi: 10.1111/epi.18672. Full text in Research Archive
• Kostov, Konstantin Hrisimirov; Kostov, Hrisimir; Larsson, Pål Gunnar; Henning, Oliver Johannes; Egge, Arild & Lossius, Morten Ingvar [Show all 7 contributors for this article] (2025). Turning up the current – optimizing stimulation parameters with vagus nerve stimulation in a nationwide Norwegian cohort (The NOR-current study). Brain Stimulation. ISSN 1935-861X. 18(4), p. 1219–1219. doi: 10.1016/j.brs.2025.06.016. Full text in Research Archive Show summary

  Background Despite widespread use of vagus nerve stimulation (VNS), evidence regarding optimal stimulation titration and dosing remains limited. Significant inter-practice variability and deviation from guidelines, results in sub-optimal dosing. Objective Identify optimal stimulation parameters and establish target dosing for VNS therapy in epilepsy. Methods We linked long-term outcomes with dosing parameters in 415 patients from a VNS registry (median follow-up = 79.0 months). A generalized linear mixed model (GLMM) assessed relationships between stimulation parameters (Output Current (OC), Frequency, Pulse Width (PW), Duty cycle [DC]) and very good clinical response (≥75 % seizure frequency reduction from baseline). Results Output current was the strongest predictor of seizure reduction (p = 0.001). Increasing OC by 1 mA more than doubled the probability of ≥75 % seizure reduction, peaking at 2.70 mA. Greatest likelihood of ≥50 % seizure reduction was at 2.1 mA. Post-hoc analysis supported GLMM findings, showing significantly more patients (46.3 %) receiving >2.0 mA OC achieved ≥75 % seizure reduction compared with 30.7 % (p = 0.01) among patients using lower OC. Although changes in DC were not significantly associated with seizure reduction, post-hoc analysis suggested benefits from other duty cycles. Standard 250 μs PW and 20 Hz frequency were associated with best effect. Longer follow-up improved seizure control (p < 0.001); intellectual disability negatively impacted response (p = 0.005). Seizure-free patients had significantly lower total charge (122.4 vs. 250.1 mC, p = 0.014) than patients with persistent seizures. Conclusion Output current should be the primary focus when titrating VNS patients to optimal dose. We suggest a target range of 1.5–2.25 mA with 250 μs PW and 20 Hz frequency. Higher OC should be attempted if tolerated.

• Karterud, Hilde Nordahl; Tschamper, Merete Kristin Bustetun; Bækkelund, Siv; Henning, Oliver Johannes & Lossius, Morten Ingvar (2025). What contributes to recovery in the long term? Young people's experiences with psychogenic non-epileptic seizures (PNES). Epilepsy & Behavior. ISSN 1525-5050. 164. doi: 10.1016/j.yebeh.2025.110281. Full text in Research Archive
• Villagran, Antonia; Hessen, Erik; Torgersen, Halvor; Alfstad, Kristin Åshild; Duncan, Roderick & Hauger, Lisa Evju [Show all 7 contributors for this article] (2025). Negative impact of self-reported executive problems in patients with functional/dissociative seizures: Results from a prospective long-term observational study. Seizure. ISSN 1059-1311. 125, p. 44–49. doi: 10.1016/j.seizure.2025.01.010. Full text in Research Archive
• Vikin, Truls; Lossius, Morten Ingvar; Brandlistuen, Ragnhild Eek; Chin, Richard F. & Aaberg, Kari Modalsli (2025). Incidence of childhood and youth epilepsy: A population-based prospective cohort study utilizing current International League Against Epilepsy classifications for seizures, syndromes, and etiologies. Epilepsia. ISSN 0013-9580. 66(3), p. 776–789. doi: 10.1111/epi.18238. Full text in Research Archive Show summary

  Objective This study was undertaken to describe incidence and distribution of seizures, etiologies, and epilepsy syndromes in the general child and youth population, using the current International League Against Epilepsy (ILAE) classifications. Methods The study platform is the Norwegian Mother, Father, and Child Cohort Study (MoBa). Epilepsy cases were identified through registry linkages facilitated by Norway's universal health care system and mandatory reporting to the Norwegian Patient Registry. A standardized protocol guided medical record review, leading to validation of diagnoses and classification of seizures, epilepsy types, syndromes, and etiologies based on the latest ILAE criteria. Results MoBa included 111 365 participants aged 12–21 years by the end of follow-up on December 31, 2020. We identified 1053 children and youth with epilepsy (CYE). A defined epilepsy syndrome and/or identified etiology was found in 76% of CYE in this population-based study. Seizure types exhibited variation by age at onset. Focal epilepsies were predominant, occurring in 61% of CYE, whereas generalized epilepsies were identified in 24% of CYE. Standard clinical assessment identified etiology in 30% of CYE and in 55% with onset age < 2 years. Structural and identified genetic etiologies constituted 21% and 10%, respectively. Including presumed genetic and rare etiologies, 53% exhibited known etiology. A defined ILAE epilepsy syndrome was found in 53% of CYE. The cumulative incidence per 1000 children of the following ILAE epilepsy syndrome groups were as follows: self-limited epilepsies, 2.25; idiopathic generalized epilepsies, 1.75; and developmental and/or epileptic encephalopathies, 2.62. Significance Using the new ILAE classifications, this population-based childhood study provides incidences of seizures, epilepsies, and epilepsy syndromes. Half of epilepsy cases are classified as an ILAE epilepsy syndrome with its prognostic and therapeutic implications, but a substantial proportion of cases still have unknown etiology.

• Etholm, Lars; Ivanovic, Jugoslav; Larsen, Vilde Stangebye; Sneve, Markus Handal; Lossius, Morten Ingvar & Alfstad, Kristin Åshild (2024). Localizing value of disturbances of self-integration, depersonalization, and forced thinking: A systematic review. Epileptic disorders. ISSN 1294-9361. p. 1–15. doi: 10.1002/epd2.20317. Full text in Research Archive Show summary

  We performed a systematic review of the localizational value of disturbances of self-integration, depersonalization and forced thinking in focal epilepsy with the aim to summarize the state-of-the-art anatomo-clinical correlations in the field and help guide interpretation of ictal semiology within the framework of pre-surgical evaluation. The review was performed using a PRISMA- and QUADAS2-based approach. Three separate PubMed and EMBASE searches were undertaken using the keywords self-integration, depersonalization and forced thinking, along with synonyms, in combination with terms to identify epileptogenic zone as defined by surgical outcome, MRI-findings or intracranially recorded EEG. Studies published in peer-reviewed journals with an abstract available, limited to English, French, German, Spanish, or Italian were included for review. Abstracts from scientific meetings were included if precise data on semiology in addition to either localization or surgical outcome was presented. Cases were regarded as eligible if data informing on anatomo-clinical correlations were sufficient to allow determination of an epileptogenic zone and evaluate its level of confidence. For disturbances of self-integration, the search identified 18 publications containing 23 eligible cases, with 10 additional cases identified in the literature. For depersonalization, a single case from a two patient study fulfilled inclusion criteria. For forced thinking, the search identified two publications containing four eligible cases, with six additional cases identified through literature searches. The retrieved cases suggest that disturbances of self-integration often reflect an epileptogenic zone centered around the temporoparietal region, where neighboring areas in the parietal lobe, the posterior insula, and likely depending on the type of disturbance also the adjoining occipital lobe, the anterior and middle cingulum, premotor and supplementary motor in addition to medial temporal structures could be involved. When present, lateralized symptomatology reflects a contralateral focus. Depersonalization, as a localizing ictal phenomenon was quite elusive. Forced thinking either pointed to premotor frontal or temporal epileptogenic zones. Currently, outlined epileptogenic zones of ictal disturbances of self-integration and forced thinking are quite widespread and should be regarded with a low-to-moderate degree of reliability. A focus on such rarer ictal phenomena, in combination with improved imaging techniques and increased use of SEEG, will hopefully lead to an accumulation of cases with better defined epileptogenic zones.

• Kostov, Konstantin Hrisimirov; Kostov, Hrisimir; Larsson, Pål Gunnar; Henning, Oliver Johannes; Aaberg, Kari Modalsli & Egge, Arild [Show all 8 contributors for this article] (2024). Norwegian population-based study of effectiveness of vagus nerve stimulation in patients with developmental and epileptic encephalopathies. Epilepsia Open. doi: 10.1002/epi4.12908. Full text in Research Archive Show summary

  Objective Evaluate the long-term efficacy of vagus nerve stimulation (VNS) in patients with developmental and epileptic encephalopathies (DEE) compared with epilepsy patients without intellectual disability (ID). Methods Long-term outcomes from a Norwegian VNS quality registry are reported in 105 patients with DEEs (Lennox–Gastaut syndrome [LGS] n = 62; Dravet n = 16; Rett n = 9; other syndromes n = 18) were compared with 212 epilepsy patients without ID, with median follow-up of 88 and 72 months, respectively. Total seizure reduction was evaluated at 6, 12, 24, 36, and 60 months. Effect on different seizure types was evaluated at baseline and last observation carried forward (LOCF). Results Median monthly seizure frequency at LOCF was reduced by 42.2% (p < 0.001) in patients with DEE and by 55.8% (p < 0.001) in patients without ID. In DEE patients, ≥50% seizure reduction at 6 and 24 months were 17.1% and 37.1%, respectively, and 33.5% and 48.6% for patients without ID. Seizure reduction ≥75% at 60 months occurred in 14.3% of DEE patients and 23.1% of patients without ID. Highest median reduction was for atonic seizures, most notably 64.6% for LGS patients. A better effect was seen at 2 years among DEE patients with unchanged medication compared with those with changed medication (54.5% vs. 35.6% responders, p = 0.078). More DEE patients were reported to have greater improvement in ictal or postictal severity (43.8% vs. 28.3%, p = 0.006) and alertness (62.9% vs. 31.6%, p < 0.001) than patients without ID. For both groups, use of the magnet reduced seizure severity. Hoarseness was the most common adverse effect in both groups. In addition, DEE patients were frequently reported to have sleep disturbance, general discomfort, or abdominal problems. Significance Our data indicate that VNS is very effective for atonic seizures. Patients without ID had best overall seizure reduction, however, patients with DEE had higher retention rates probably due to other positive effects.

• Wrede, Randi von; Witt, Juri-Alexander; Jessen, Nina; Lossius, Morten Ingvar; Moskau-Hartmann, Susanna & Helmstaedter, Christoph (2024). Screening for depression in patients with epilepsy: What are the benefits for physicians and patients in the real-life setting. Epilepsia. ISSN 0013-9580. doi: 10.1111/epi.18089. Full text in Research Archive
• Karterud, Hilde Nordahl; Nakken, Karl Otto; Lossius, Morten Ingvar; Tschamper, Merete Kristin; INGEBRIGTSEN, TRINE & Henning, Oliver Johannes (2024). Young people diagnosed with psychogenic nonepileptic seizures (PNES) years ago − How are they now? Epilepsy & Behavior. ISSN 1525-5050. 157. doi: 10.1016/j.yebeh.2024.109874. Full text in Research Archive
• Rubboli, Guido; Bø, Margrete Halvorsen; Alfstad, Kristin Åshild; Armand Larsen, Sidsel; Jacobsen, Mads Due Holm & Vlachou, Maria [Show all 12 contributors for this article] (2024). Clinical utility of ultra long-term subcutaneous electroencephalographic monitoring in drug-resistant epilepsies: a “real world” pilot study. Epilepsia. ISSN 0013-9580. doi: 10.1111/epi.18121. Full text in Research Archive
• Nakken, Karl Otto; Sætre, Erik; Hlauschek, Gernot; Farmen, Anette Huuse & Lossius, Morten Ingvar (2024). Epilepsi oppstått etter hjerneslag. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 144(9). doi: 10.4045/tidsskr.24.0103. Full text in Research Archive Show summary

  Epilepsi som følge av hjerneslag er i dag den epilepsiformen som øker mest. Risikoen for utvikling av epilepsi er større etter hemoragiske enn etter iskemiske slag. Fordi korte fokale epileptiske anfall hos slagpasienter ofte blir mistolket og ubehandlet, gir vi her en kort klinisk oversikt over temaet. Riktig diagnostikk og behandling er viktig fordi gjentatte epileptiske anfall kan redusere livskvaliteten og hemme rehabiliteringen.

• Rusten, Frida Knutstad; Nakken, Karl Otto; Lossius, Morten Ingvar & Henning, Oliver Johannes (2024). A call for better information about epilepsy: The next of kin perspective. Seizure. ISSN 1059-1311. 125, p. 10–15. doi: 10.1016/j.seizure.2024.12.012. Full text in Research Archive
• Hlauschek, Gernot; Nicolo, John-Paul; Sinclair, Benjamin; Law, Meng; Yasuda, Clarissa L. & Cendes, Fernando [Show all 9 contributors for this article] (2023). Role of the glymphatic system and perivascular spaces as a potential biomarker for post-stroke epilepsy. Epilepsia Open. p. 1–17. doi: 10.1002/epi4.12877. Full text in Research Archive Show summary

  Stroke is one of the most common causes of acquired epilepsy, which can also result in disability and increased mortality rates particularly in elderly patients. No preventive treatment for post-stroke epilepsy is currently available. Development of such treatments has been greatly limited by the lack of biomarkers to reliably identify high-risk patients. The glymphatic system, including perivascular spaces (PVS), is the brain's waste clearance system, and enlargement or asymmetry of PVS (ePVS) is hypothesized to play a significant role in the pathogenesis of several neurological conditions. In this article, we discuss potential mechanisms for the role of perivascular spaces in the development of post-stroke epilepsy. Using advanced MR-imaging techniques, it has been shown that there is asymmetry and impairment of glymphatic function in the setting of ischemic stroke. Furthermore, studies have described a dysfunction of PVS in patients with different focal and generalized epilepsy syndromes. It is thought that inflammatory processes involving PVS and the blood–brain barrier, impairment of waste clearance, and sustained hypertension affecting the glymphatic system during a seizure may play a crucial role in epileptogenesis post-stroke. We hypothesize that impairment of the glymphatic system and asymmetry and dynamics of ePVS in the course of a stroke contribute to the development of PSE. Automated ePVS detection in stroke patients might thus assist in the identification of high-risk patients for post-stroke epilepsy trials.

• Hauger, Lisa Evju; Lossius, Morten Ingvar; Aaberg, Kari Modalsli; Helmstaedter, Christoph; Lossius, Johanne & Skogan, Annette Holth (2023). Screening of attention and executive functions in pediatric patients at a tertiary epilepsy center. European journal of paediatric neurology. ISSN 1090-3798. 46, p. 35–41. doi: 10.1016/j.ejpn.2023.06.006. Full text in Research Archive
• Villagran, Antonia; Lund, Caroline; Duncan, Roderick & Lossius, Morten Ingvar (2023). Adverse life events in patients with functional seizures: Assessment in clinical practice and association with long-term outcome. Epilepsy & Behavior. ISSN 1525-5050. 148, p. 1–7. doi: 10.1016/j.yebeh.2023.109456. Full text in Research Archive Show summary

  Background A history of adverse life events (ALE) is a risk factor for functional seizures (FS). Their influence on long-term outcome remains unclear. International guidelines recommend assessing ALE in patients presenting with associated disorders. It is not clear to what extent patients evaluated for FS are regularly asked about ALE. Objectives We hypothesised that the presence of ALE would relate to worse outcome at follow-up and, that the rate of detection of ALE in clinical work-up would be inferior to that based on self-report questionnaires. Methods 53 patients with FS from the National Centre for Epilepsy in Norway, aged 16–62 years were included. Symptom severity, health-related quality of life (HRQoL), and antecedent ALE were assessed at baseline. Medical records were examined for disclosure of ALE. At a mean of 70.45 (SD 29.0, range 22–130) months after inclusion, participants were inquired about FS status, FS-related health care utilization and HRQoL. Findings: A history of emotional abuse documented in the medical record was an independent risk factor for worse HRQoL at follow-up. Prevalence of ALE documented in medical records was lower compared with rates measured by a self-report questionnaire. Conclusions These findings indicate an association between antecedent ALE and HRQoL years after diagnosis. A substantial proportion of the adverse life events by a self-report questionnaire had not been documented in the clinical records. Clinical implications The supplemental use of a self-report questionnaire in the diagnostic work-up of patients with FS may be valuable for detecting ALE.

• Terman, Samuel W.; Slinger, Geertruida; Koek, Adriana; Skvarce, Jeremy; Springer, Mellanie V. & Ziobro, Julie M. [Show all 13 contributors for this article] (2023). Variation in seizure risk increases from antiseizure medication withdrawal among patients with well-controlled epilepsy: A pooled analysis. Epilepsia Open. p. 333–334. doi: 10.1002/epi4.12880. Full text in Research Archive Show summary

  Abstract Objective Guidelines suggest considering antiseizure medication (ASM) discontinuation in seizure‐free patients with epilepsy. Past work has poorly explored how discontinuation effects vary between patients. We evaluated (1) what factors modify the influence of discontinuation on seizure risk; and (2) the range of seizure risk increase due to discontinuation across low‐ versus high‐risk patients. Methods We pooled three datasets including seizure‐free patients who did and did not discontinue ASMs. We conducted time‐to‐first‐seizure analyses. First, we evaluated what individual patient factors modified the relative effect of ASM discontinuation on seizure risk via interaction terms. Then, we assessed the distribution of 2‐year risk increase as predicted by our adjusted logistic regressions. Results We included 1626 patients, of whom 678 (42%) planned to discontinue all ASMs. The mean predicted 2‐year seizure risk was 43% [95% confidence interval (CI) 39%–46%] for discontinuation versus 21% (95% CI 19%–24%) for continuation. The mean 2‐year absolute seizure risk increase was 21% (95% CI 18%–26%). No individual interaction term was significant after correcting for multiple comparisons. The median [interquartile range (IQR)] risk increase across patients was 19% (IQR 14%–24%; range 7%–37%). Results were unchanged when restricting analyses to only the two RCTs. Significance No single patient factor significantly modified the influence of discontinuation on seizure risk, although we captured how absolute risk increases change for patients that are at low versus high risk. Patients should likely continue ASMs if even a 7% 2‐year increase in the chance of any more seizures would be too much and should likely discontinue ASMs if even a 37% risk increase would be too little. In between these extremes, individualized risk calculation and a careful understanding of patient preferences are critical. Future work will further develop a two‐armed individualized seizure risk calculator and contextualize seizure risk thresholds below which to consider discontinuation. Plain Language Summary Understanding how much antiseizure medications (ASMs) decrease seizure risk is an important part of determining which patients with epilepsy should be treated, especially for patients who have not had a seizure in a while. We found that there was a wide range in the amount that ASM discontinuation increases seizure risk—between 7% and 37%. We found that no single patient factor modified that amount. Understanding what a patient's seizure risk might be if they discontinued versus continued ASM treatment is critical to making informed decisions about whether the benefit of treatment outweighs the downsides.

• Kloster, Ane G.; Opheim, Giske; Alfstad, Kristin Åshild; Larsen, Karen B.; Niehusmann, Pitt & Holm, Emil [Show all 16 contributors for this article] (2023). Postprocessing of MRIs Using FreeSurfer in Epilepsy Surgery Patients Provides an Excellent Imaging Marker of Hippocampal Sclerosis but Fails to Separate Subtypes. Acta Neurologica Scandinavica. ISSN 0001-6314. 2023, p. 1–10. doi: 10.1155/2023/2366355. Full text in Research Archive Show summary

  Objective. Histopathological examinations will diminish as minimally invasive epilepsy surgery increasingly replaces open surgery. The objective of this study was to test if visual and computer-aided quantitative analyses of presurgical high-quality 3 Tesla MRIs complying with the International League Against Epilepsy (ILAE) Neuroimaging Task Force recommendations can inform on histopathological diagnosis. Methods. Ninety-two patients from Copenhagen and Oslo University Hospitals fulfilled patient-, imaging-, and histopathological inclusion criteria: 69 patients were diagnosed with hippocampal sclerosis (HS) ILAE type 1 or 2, and 23 patients had normal appearing hippocampi or other histopathology than HS (no-HS). MRIs from 52 healthy controls (HC) were included. Image processing was performed in FreeSurfer v.6.0 with the built-in cross-sectional hippocampal subfield segmentation tool and multimodal MRI input. Volume outputs were used to calculate volume asymmetry ratios (VARs) for whole hippocampus (WH) and subfields. Results. HS patients had significantly larger WH VARs compared to no-HS patients and HC, with a sensitivity = 0:93 and specificity = 1:0 for histopathological HS diagnosis. Visual MRI assessment yielded a sensitivity = 0:90 and specificity = 0:96 for histopathological HS diagnosis. CA1 and CA4 VARs and the number of seizure-free patients were not significantly different in HS ILAE type 1 compared to type 2 patients. Significance. FreeSurfer analyses of presurgical MRIs are excellent at separating patients histopathologically diagnosed with HS from patients with other pathology or normal appearing hippocampi. Using the FreeSurfer hippocampal subfield segmentation tool did not allow for separating HS ILAE subtypes.

• Kverneland, Magnhild; Nakken, Karl Otto; Hofoss, Dag; Skogan, Annette Holth; Iversen, Per Ole & Selmer, Kaja Kristine [Show all 7 contributors for this article] (2023). Health-related quality of life in adults with drug-resistant focal epilepsy treated with modified Atkins diet in a randomized clinical trial. Epilepsia. ISSN 0013-9580. 64(5). doi: 10.1111/epi.17585. Full text in Research Archive Show summary

  Abstract Ketogenic diet, a high‐fat, low‐carbohydrate diet, is an established treatment for patients with severe epilepsy. We have previously reported a moderate reduction in seizure frequency after treatment with a modified Atkins diet. This study aimed to see whether dietary therapy impacts patients' health‐related quality of life (HRQOL). In a randomized controlled design, we compared the change in self‐reported HRQOL among adults with difficult‐to‐treat epilepsy after a 12‐week diet intervention. Thirty‐nine patients with drug‐resistant focal epilepsy (age = 16–65 years) were randomized to eat a modified Atkins diet with maximum 16 g of carbohydrate per day (diet group, n  = 19) or to continue eating habitual diet (control group, n  = 20). No changes to the other epilepsy treatments were allowed. Patient‐reported HRQOL was assessed with the Quality of Life in Epilepsy Inventory‐89 (QOLIE‐89). The diet group experienced a statistically significant improvement in mean total score of QOLIE‐89 of 10 points compared to controls ( p  = .002). Moreover, although not statistically significant when using a cutoff of 50% seizure reduction, our data suggest an association between diet‐induced reduction in seizure frequency and improvement in HRQOL. The improvement in HRQOL was not associated with diet‐induced weight reduction.

• Hlauschek, Gernot; Lossius, Morten Ingvar; Schwartz, Daniel L; Silbert, Lisa C; Hicks, Amelia J & Ponsford, Jennie L [Show all 13 contributors for this article] (2023). Reduced total number of enlarged perivascular spaces in post-traumatic epilepsy patients with unilateral lesions – a feasibility study. Seizure. ISSN 1059-1311. 113, p. 1–5. doi: 10.1016/j.seizure.2023.10.006. Full text in Research Archive Show summary

  Background We investigated the value of automated enlarged perivascular spaces (ePVS) quantification to distinguish chronic traumatic brain injury (TBI) patients with post-traumatic epilepsy (PTE+) from chronic TBI patients without PTE (PTE−) in a feasibility study. Methods Patients with and without PTE were recruited and underwent an MRI post-TBI. Multimodal auto identification of ePVS algorithm was applied to T1-weighted MRIs to segment ePVS. The total number of ePVS was calculated and corrected for white matter volume, and an asymmetry index (AI) derived. Results PTE was diagnosed in 7 out of the 99 participants (male=69) after a median time of less than one year since injury (range 10-22). Brain lesions were observed in all 7 PTE+ cases (unilateral=4, 57%; bilateral=3, 43%) as compared to 40 PTE− cases (total 44%; unilateral=17, 42%; bilateral=23, 58%). There was a significant difference between PTE+ (M=1.21e−4, IQR [8.89e−5]) and PTE− cases (M=2.79e−4, IQR [6.25e−5]) in total corrected numbers of ePVS in patients with unilateral lesions (p=0.024). No differences in AI, trauma severity and lesion volume were seen between groups. Conclusion This study has shown that automated quantification of ePVS is feasible and provided initial evidence that individuals with PTE with unilateral lesions may have fewer ePVS compared to TBI patients without epilepsy. Further studies with larger sample sizes should be conducted to determine the value of ePVS quantification as a PTE-biomarker.

• Terman, Samuel W.; Wang, Chang; Wang, Lu; Braun, Kees P. J.; Otte, Willem M. & Slinger, Geertruida [Show all 11 contributors for this article] (2022). Reappraisal of the Medical Research Council Antiepileptic Drug Withdrawal Study: Contamination-adjusted and dose-response re-analysis. Epilepsia. ISSN 0013-9580. 63(7), p. 1724–1735. doi: 10.1111/epi.17273. Full text in Research Archive Show summary

  Objective The 1991 Medical Research Council (MRC) Study compared seizure relapse for seizure-free patients randomized to withdraw vs continue of antiseizure medications (ASMs). We re-analyzed this trial to account for crossover between arms using contamination-adjusted intention to treat (CA ITT) methods, to explore dose-response curves, and to validate predictions against external data. ITT assesses the effect of being randomized to withdraw, as-treated analysis assesses the confounded effect of withdrawing, but CA ITT assesses the unconfounded effect of actually withdrawing. Methods CA ITT involves two stages. First, we used randomized arm to predict whether patients withdrew their ASM (logistic) or total daily ASM dose (linear). Second, we used those values to predict seizure occurrence (logistic). Results The trial randomized 503 patients to withdraw and 501 patients to continue ASMs. We found that 316 of 376 patients (88%) who were randomized to withdraw decreased their dose at every pre-seizure visit, compared with 35 of 424 (8%) who were randomized to continue (p < .01). Adjusted odds ratios of a 2-year seizure for those who withdrew vs those who did not was 1.3 (95% confidence interval [CI] 0.9–1.9) in the as-treated analysis, 2.5 (95% CI 1.9–3.4) comparing those randomized to withdraw vs continue for ITT, and 3.1 (95% CI 2.1–4.5) for CA ITT. Probabilities (withdrawal vs continue) were 28% vs 24% (as-treated), 40% vs 22% (ITT), and 43% vs 21% (CA ITT). Differences between ITT and CA ITT were greater when varying the predictor (reaching zero ASMs) or outcome (1-year seizures). As-treated dose-response curves demonstrated little to no effects, but larger effects in CA ITT analysis. MRC data overpredicted risk in Lossius data, with moderate discrimination (areas under the curve ~0.70). Significance CA ITT results (the effect of actually withdrawing ASMs on seizures) were slightly greater than ITT effects (the effect of recommend withdrawing ASMs on seizures). How these findings affect clinical practice must be individualized.

• Villagran, Antonia; Lund, Caroline; Duncan, Roderick & Lossius, Morten Ingvar (2022). The effect of attachment style on long-term outcomes in psychogenic nonepileptic seizures: Results from a prospective study. Epilepsy & Behavior. ISSN 1525-5050. 135, p. 1–6. doi: 10.1016/j.yebeh.2022.108890. Full text in Research Archive Show summary

  Introduction Insecure and fearful attachment styles have been reported in psychogenic nonepileptic seizures (PNES). We have investigated associations between long-term clinical outcome in PNES, parenting and attachment styles and demographic, clinical, and neuropsychiatric factors. Material and methods Patients aged at least 16 years and with documented PNES, according to criteria from the International League Against Epilepsy, were prospectively recruited to this study. They were assessed at baseline to determine clinical characteristics, experience of attachment and perceptions of experienced parenting styles, trauma history, dissociation, and health-related quality of life. At a mean of 70.45 (SD 29.0, range 22–130) months after inclusion, participants were contacted by telephone and asked about their current medical status and psychiatric/psychological interventions. Results Of 53 patients included in the study, 51 (96 %) provided follow-up data. Most (84.9 %) patients were female, and the mean age of PNES onset was 25.6 years. At follow‐up, 20 patients (39 %) were free of PNES. Those patients that had achieved PNES freedom at follow-up had lower levels of attachment anxiety (p = 0.01) and reported to have experienced their fathers as less controlling (p = 0.02) and their mothers as more caring (p = 0.04) at baseline compared with those patients still suffering from PNES. Seizure freedom at follow-up was predicted by male gender, younger age at PNES onset, and less attachment anxiety. Conclusion In our cohort from a tertiary epilepsy center the long-term prognosis of PNES is poor. Attachment anxiety is a risk factor for persistent PNES. It may be of therapeutic relevance to assess attachment patterns in patients with PNES.

• Henning, Oliver Johannes; Alfstad, Kristin Åshild; Landmark, Cecilie Johannessen; Helmstadter, Cristoph; Lossius, Morten Ingvar & Skogan, Annette Holth (2022). Use of screening tools to assess comorbidities and adverse events in patients with epilepsy. A European Reference Network for Rare and Complex Epilepsies (EpiCARE) survey. Seizure. ISSN 1059-1311. 101, p. 237–243. doi: 10.1016/j.seizure.2022.09.008. Full text in Research Archive Show summary

  Purpose As comorbidities can affect treatment decisions, quality of life, and prognosis in epilepsy, it is important that they are detected and addressed as soon as possible. Screening tools can help by rapidly assessing various additional challenges in epilepsy. Methods To map the use and perceived benefit of different screening instruments for quality of life, psychiatric comorbidity, and cognition, along with side effects from anti-seizure medication in Europe, we sent an online questionnaire to dedicated epilepsy centres departments within the European Reference Network for Rare and Complex Epilepsies (EpiCARE). Results Among the 40 hospitals in the EpiCARE network, we received responses from 25 (63%), with 28 individual respondents. Most respondents reported using screening for quality of life (86%) and psychiatric comorbidity (82%), but relatively few (14%) screen for sexual problems. Many (47) different tools were used for evaluation of cognitive dysfunction, but just a few (5) different tools were used to screen for adverse events. The optimization of individual patient care was one main reason given for using screening tools (58%-100% - depending on purpose of tool), another was research (50% - 88% - depending on purpose of tool). A major benefit of using screening tools perceived by the respondents is the detection of “hidden” comorbidity (67% - 90% - depending on purpose of tool). Conclusion In the absence of a broad consensus regarding use of screening tools, practices vary considerably among epilepsy centres. Greater emphasis should be directed towards harmonizing use of screening tools. Future research should address how screening results influence treatment choices, and how these might affect clinical care.

• Svendsen, Torleiv; Brodtkorb, Eylert; Linge, Hanna Lande; Burns, Margrete Larsen; Johannessen, Svein Ivar & Nakken, Karl Otto [Show all 8 contributors for this article] (2022). Efficacy, tolerability and pharmacokinetic variability of brivaracetam in adults with difficult-to-treat epilepsy. Epilepsy Research. ISSN 0920-1211. 183, p. 1–6. doi: 10.1016/j.eplepsyres.2022.106946. Full text in Research Archive Show summary

  Purpose: Brivaracetam (BRV) is one of our latest antiseizure medications (ASMs). It is an analogue of levetiracetam with limited real-life experience. The purpose of this study was to evaluate clinical experience with BRV with focus on efficacy, tolerability and pharmacokinetic variability among adult patients with difficult-to-treat epilepsy. Methods: We retrospectively collected clinical and laboratory data from patients aged > 18 years who initiated treatment with BRV during 2016-2019 and were followed for > one year or cessation of BRV. Results: The study cohort consisted of 120 adults with drug-resistant epilepsy. Serum concentrations of BRV were available in 72 patients. After one-year follow-up, the retention rate of BRV was 52%. Fifty-seven patients (48%) were responders (>50 reduction of seizure frequency), of whom six became seizure free. Adverse effects were reported in 78 patients (65%); 37 (31%) experienced psychiatric problems like increased irritability, anxiety and depressive symptoms. The mean daily BRV dose was 159 mg (SD 80 mg) and the mean serum concentration 5.4 μmol/L (SD 4.1 μmol/L). In 24 patients, BRV replaced levetiracetam. Pharmacokinetic variability between patients was considerable; 14-fold variation in concentration/dose (C/D)-ratios. Concomitant use of enzyme-inducing ASMs decreased the C/D-ratio by 48%. There were no significant differences in serum concentrations between responders vs. non-responders, or those who experienced adverse effects or not. Conclusion: After > 1 year of treatment with BRV, we found a responder rate of 48% in adult patients with difficult-to-treat epilepsy. The drug was largely well tolerated, but one third experienced psychiatric adverse effects. The combination of clinical and pharmacokinetic data provides insight into factors contributing to efficacy and tolerability of new ASMs. Keywords: Antiseizure medications; Efficacy; Epilepsy; Therapeutic drug monitoring; Tolerability. Copyright © 2022 Elsevier B.V. All rights reserved.

• Sabers, Anne; Aumüller-Wagner, Sophia; Christensen, Lars Rune; Henning, Oliver Johannes; Kostov, Konstantin Hrisimirov & Lossius, Morten Ingvar [Show all 11 contributors for this article] (2021). Feasibility of transcutaneous auricular vagus nerve stimulation in treatment of drug resistant epilepsy: A multicenter prospective study. Epilepsy Research. ISSN 0920-1211. 177. doi: 10.1016/j.eplepsyres.2021.106776. Full text in Research Archive
• Henning, Oliver Johannes; Buer, Charlotte; Nakken, Karl Otto & Lossius, Morten I. (2021). People with epilepsy still feel stigmatized. Acta Neurologica Scandinavica. ISSN 0001-6314. 144(3), p. 312–316. doi: 10.1111/ane.13449. Full text in Research Archive Show summary

  Objectives Those affected with epilepsy have long been subject to stigmatization. This may have manifold negative effects, for example social isolation, low self-esteem, reduced quality of life and worsening of seizures. In Norway educational programs have been arranged at the National Centre for Epilepsy, aiming at reducing stigma and shame associated with epilepsy, and thereby increase the quality of life for those affected and their families. Thus, we wanted to explore the extent of self-reported perceived stigma and experienced discrimination in a Norwegian cohort with epilepsy. Materials and Methods We conducted a web-based questionnaire survey in Norway. Participants were asked to provide background and epilepsy-related information. In addition, they were encouraged to answer questions regarding felt stigmatization in different situations and to rate stigma according to the Jacoby stigma scale. Results Of 1182 respondents, 56% reported to have felt being stigmatized, and 35% reported to have experienced discrimination solely on the ground of the disease. 70% of respondents reported at least one type of perceived or experienced stigma. After controlling for gender, age, perceived depression and seizure freedom, reports of experienced stigmatization was a statistically significant independent predictor for reduced quality of life. Conclusions A considerable proportion of people with epilepsy in Norway feel stigmatized and/or subject to discrimination, which negatively affects their quality of life.

• Villagran, Antonia; Eldøen, Guttorm; Duncan, Roderick; Aaberg, Kari Modalsli; Hofoss, Dag & Lossius, Morten (2021). Incidence and prevalence of psychogenic nonepileptic seizures in a Norwegian county: A 10-year population-based study. Epilepsia. ISSN 0013-9580. 62(7), p. 1528–1535. doi: 10.1111/epi.16949. Full text in Research Archive Show summary

  Objective: This study was undertaken to measure the incidence and prevalence of active psychogenic nonepileptic seizures (PNES) in a Norwegian county.Methods: Using the Norwegian patient registry, we identified patients in Møre and Romsdal County in Norway diagnosed with F44.5 (conversion disorder with seizures or convulsions) or R56.8 (convulsions, not elsewhere classified) in the period January 2010 to January 2020. A review of the patients' medical records and an assessment of diagnostic validity were performed. PNES were diagnosed according to the rec-ommendations by the International League Against Epilepsy Nonepileptic Seizures Task Force. Point prevalence of PNES on January 1, 2020 and incidence rates for the period 2010– 2019 were determined.Results: Based on PNES within the past 5 years, we found a PNES prevalence of 23.8/100 000 (95% confidence interval [CI] = 17.9– 29.6), including all lev-els of diagnostic certainty. For the highest level of diagnostic certainty (video- electroencephalographically confirmed), the prevalence was 10.6/100 000 (95% CI = 6.7– 14.5). The highest prevalence was found in the age group 15– 19 years, at 59.5/100 000 (95% CI = 22.6– 96.3). The mean annual incidence rate between 2010 and 2019 was 3.1/100 000/year (95% CI = 2.4– 3.7).Significance: We report for the first time a population- based estimate of the preva-lence of PNES. Our findings suggest that the prevalence of PNES is within the range of estimates from non- population- based data. We found a strikingly high prevalence of PNES in the 15– 19- year age group.KEYWORDSadolescents, diagnostic coding, epidemiology, psychogenic nonepileptic seizures

• Kostov, Konstantin Hrisimirov; Kostov, Hrisimir; Larsson, Pål Gunnar; Henning, Oliver Johannes; Eckmann, Christian Alexander Cornelius & Lossius, Morten Ingvar [Show all 7 contributors for this article] (2021). Norwegian population-based study of long-term effects, safety, and predictors of response of vagus nerve stimulation treatment in drug-resistant epilepsy: The NORPulse study. Epilepsia. ISSN 0013-9580. doi: 10.1111/epi.17152. Full text in Research Archive Show summary

  Objective This study was undertaken to evaluate the efficacy of vagus nerve stimulation (VNS) over time, and to determine which patient groups derive the most benefit. Methods Long-term outcomes are reported in 436 epilepsy patients from a VNS quality registry (52.8% adults, 47.2% children), with a median follow-up of 75 months. Patients were stratified according to evolution of response into constant responders, fluctuating responders, and nonresponders. The effect was evaluated at 6, 12, 24, 36, and 60 months. Multivariate regression analysis was used to identify predictors of response. Results The cumulative probability of ≥50% seizure reduction was 60%; however, 15% of patients showed a fluctuating course. Of those becoming responders, 89.5% (230/257) did so within 2 years. A steady increase in effect was observed among constant responders, with 48.7% (19/39) of those becoming seizure-free and 29.3% (39/133) with ≥75% seizure reduction achieving these effects within 2–5 years. Some effect (25%–<50%) at 6 months was a positive predictor of becoming a responder (odds ratio [OR] = 10.18, p < .0001) and having ≥75% reduction at 2 years (OR = 3.34, p = .03). Patients without intellectual disability had ORs of 3.34 and 3.11 of having ≥75% reduction at 2 and 5 years, respectively, and an OR of 6.22 of being seizure-free at last observation. Patients with unchanged antiseizure medication over the observation period showed better responder rates at 2 (63.0% vs. 43.1%, p = .002) and 5 years (63.4% vs. 46.3%, p = .031) than patients whose antiseizure medication was modified. Responder rates were higher for posttraumatic (70.6%, p = .048) and poststroke epilepsies (75.0%, p = .05) than other etiologies (46.5%). Significance Our data indicate that the effect of VNS increases over time and that there are important clinical decision points at 6 and 24 months for evaluating and adjusting the treatment. There should be better selection of candidates, as certain patient groups and epilepsy etiologies respond more favorably.

• Heminghyt, Einar; Herrman, Helle; Skogan, Annette Holth; Konglund, Ane; Egge, Arild & Lossius, Morten Ingvar [Show all 8 contributors for this article] (2021). Cognitive change after DBS in refractory epilepsy: A randomized-controlled trial. Acta Neurologica Scandinavica. ISSN 0001-6314. p. 1–8. doi: 10.1111/ane.13539. Full text in Research Archive Show summary

  Objectives Deep brain stimulation of the anterior thalamic nucleus (ANT-DBS) reduces seizure frequency in patients with refractory epilepsy. There are, however, few studies on treatment-related changes in cognitive functions. The main objective of this study was to investigate cognitive changes in patients receiving ANT-DBS. We also explored whether possible effects were related to stimulation duration and whether change in seizure frequency was associated with cognitive changes. Materials and methods Bilateral ANT electrodes were implanted in 18 patients with refractory epilepsy, aged 18–52 years. Immediately after implantation, patients were randomized to stimulation ON (n = 8) or OFF (n = 10) for the first 6 months (blinded phase). During the following 6-month open phase, both groups received stimulation. Neuropsychological assessments were conducted before implantation (T1), at the end of the blinded period (T2), and 1 year after implantation (T3). Results Groupwise comparisons across the three time points revealed changes in performance in two of 22 cognitive test scores: motor speed and sustained attention. We found no significant group differences in cognitive change from T1 to T2. Patients reported fewer symptoms of executive dysfunction after 12 months of stimulation. Patients showing significant improvement in seizure frequency had better performance in a measure of verbal learning. Conclusion Our results indicate that ANT-DBS has very limited effects on cognitive functioning, as measured by formal tests after 6- or 12-month stimulation. ANT-DBS may have a positive influence on executive function. Our findings provide limited support for an association between change in seizure frequency and cognitive functioning.

• Lossius, Ida Marie Bakke; Svendsen, Torleiv; Sødal, Hild Flatmark; Kjeldstadli, Kari Grandaunet; Lossius, Morten Ingvar & Nakken, Karl Otto [Show all 7 contributors for this article] (2021). Effect and tolerability of perampanel in patients with drug-resistant epilepsy. Epilepsy & Behavior. ISSN 1525-5050. 119. doi: 10.1016/j.yebeh.2021.107965. Full text in Research Archive Show summary

  Objective: Perampanel is one of the most recently approved antiseizure medications. The aim of the present study was to assess clinical efficacy and tolerability, in combination with pharmacokinetic variability, of perampanel treatment in patients at a tertiary referral center for epilepsy. Methods: We performed a retrospective observational study of patients given perampanel as adjunctive treatment in the period January 2013 - February 2019 at the National Center for Epilepsy at Oslo University Hospital, Norway. Results: Clinical data were available for 175 mainly adult patients with drug-resistant epilepsy with mean treatment duration of 16.1 months. We found that 23% (40 patients) were responders (i.e., achieving more than 50% reduction in seizure frequency), four of whom became seizure free, 29% (51 patients) experienced a modest effect, whereas for 29% (50 patients) perampanel had no seizure-reducing effect. A paradoxical effect, with seizure aggravation, was reported in 9% (15 patients). The responder rate was significantly higher in those with slow vs. fast dosage titration. Logistic regression analysis showed better efficacy among those with generalized vs. those with focal epilepsy. Adverse effects were reported by 135 patients (77%), ranging from mild (34%), to moderate (41%) and severe (2%). In 55 patients (41%), these adverse effects resulted in discontinuation of treatment with perampanel. The most frequent adverse effects were psychiatric symptoms (34%), dizziness (31%), and sleepiness (26%). Of the 31 patients for whom serum concentration measurements were available, the mean daily perampanel dose was 6.3 mg (SD 3.0), with a mean serum concentration at steady state of 1.03 μmol/L (range: 0.15-3.59 μmol/L). There were pronounced differences between patients, as demonstrated by a 12-fold variability in the range of concentration/dose (C/D)-ratios (0.06 to 0.69 μmol/L/mg), where enzyme inducers contributed. Conclusion: Our results demonstrate that perampanel had a modest seizure-reducing effect in this very treatment-resistant patient group. Predictors of treatment success were generalized epilepsy and slow dosage titration. In patients without a history of psychiatric problems, clinicians could consider increasing dose of perampanel beyond 6 mg daily, taking co-medication and serum concentrations into account. Keywords: Antiseizure medications drugs; Serum concentrations; Therapeutic drug monitoring. Copyright © 2021 Elsevier Inc. All rights reserved.

• Markuola, Sofia; Limpias, Andreas; Rubboli, Guido; Duncan, John; Velis, Demetrios & Schultze-Bonhage, Andreas [Show all 33 contributors for this article] (2020). A European Questionnaire survey on epilepsy monitoring units`current practice for postoperative psychogenic nonepileptic seizures`detection. Epilepsy & Behavior. ISSN 1525-5050. 112. doi: 10.1016/j.yebeh.2020.107355. Full text in Research Archive
• Markhus, Rune; Henning, Oliver Johannes; Molteberg, Ellen; Hecimovic, Hrvoje; Ujvari, akos & hirsch, edouard [Show all 30 contributors for this article] (2020). EEG in fitness to drive evaluations in people with epilepsy-Considerable variations across Europe. Seizure. ISSN 1059-1311. 79, p. 56–56. doi: 10.1016/j.seizure.2020.04.013. Full text in Research Archive
• Zaidan, Sabreen; Nakken, Karl Otto; Lillestølen, Kari Mette; Alvestad, Silje & Lossius, Morten (2020). Assisted reproductive treatment in women with epilepsy. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. doi: 10.4045/tidsskr.19.0253. Full text in Research Archive
• Henning, Oliver Johannes; Medalen, Tone Eline; Nakken, Karl Otto & Lossius, Morten (2020). How often do doctors discuss drug withdrawal with their seizure-free patients with epilepsy? Epilepsy & Behavior. ISSN 1525-5050. 108, p. 1–3. doi: 10.1016/j.yebeh.2020.107095. Full text in Research Archive Show summary

  Among patients with epilepsy, almost 70% become seizure-free with the current antiseizure drugs (ASDs) within 20 years following seizure onset. Of those who have been seizure-free for many years, around 70% remain seizure-free after withdrawal of ASDs. The purpose of this study was to determine the extent to which seizure-free patients with epilepsy in Norway discuss drug discontinuation with their physician. An online questionnaire was used; among the respondents were 186 adult patients who had been seizure-free for at least five years and were still using ASDs. Of these, 60 patients (32%) reported that they had discussed the question of drug withdrawal with their treating physician. Those patients who reported being involved in treatment decisions were more likely to have discussed ASD withdrawal. In conclusion, it is our opinion that discontinuation of drug treatment in patients with long-term seizure freedom is discussed far too seldom and that many patients may be living with an unnecessary drug burden.

• Henning, Oliver Johannes; Landmark, Cecilie Johannessen; Træen, Bente; Svendsen, Torleiv; Farmen, Anette Huuse & Nakken, Karl Otto [Show all 7 contributors for this article] (2019). Sexual function in people with epilepsy: Similarities and differences with the general population. Epilepsia. ISSN 0013-9580. 60(9), p. 1984–1992. doi: 10.1111/epi.16311. Full text in Research Archive Show summary

  OBJECTIVE: The potential impact of epilepsy on sexual function is important for patient welfare, but often neglected. This study explored the occurrences of different sexual problems in patients with both well-controlled and mostly refractory epilepsy, and compared these with equivalent information from the general population. METHODS: Between 2015 and 2017, a total of 221 adult inpatients and outpatients, mostly with intractable epilepsy, at the National Centre for Epilepsy in Norway, and 78 outpatients with well-controlled epilepsy at Lillehammer hospital participated in a questionnaire survey on sexual function. Information on the individual patient's epilepsy was collected. The results were compared with equivalent data on sexual function from 1671 adult Norwegians in the general population. RESULTS: Patients with epilepsy reported a significantly higher frequency of problems with orgasm, dyspareunia, erectile dysfunction, and feelings of sexual deviance. However, reduced sexual desire, premature ejaculation/climax, and vaginal dryness occurred at similar frequencies in the general population. After controlling for gender, we found no significant association between sexual problems and seizure control or use of enzyme-inducing antiepileptic drugs. In both genders, feelings of sexual deviance were associated with lower quality of life. Fewer patients with epilepsy were satisfied with their sex lives. The perception of sex as an important part of daily life was similar among women with epilepsy and women from the general population, whereas significantly fewer men with epilepsy than men in the general population reported that sex was an important part of their daily lives. Women with mostly refractory epilepsy reported asking for help with their sexual problems significantly more often than women in the other groups. SIGNIFICANCE: Some sexual problems occur significantly more often in patients with epilepsy than in the general population and feelings of sexual deviancy occur more frequently. No epilepsy-related factors could be identified as specific predictors. © 2019 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International League Against Epilepsy. KEYWORDS: comorbidity; epilepsy; quality of life; sexual dysfunction; sexual problems

• Svendsen, Torleiv; Brodtkorb, Eylert; Baftiu, Arton; Lossius, Morten; Nakken, Karl Otto & Johannessen, Svein Ivar [Show all 7 contributors for this article] (2019). Clinical experience combined with therapeutic drug monitoring of lacosamide. Acta Neurologica Scandinavica. ISSN 0001-6314. 00, p. 1–8. doi: 10.1111/ane.13206. Full text in Research Archive Show summary

  Objective: Lacosamide (LCM) is an antiepileptic drug (AED) with insufficient clinical experience in patients with intellectual disability (ID). They often have more severe epilepsy with comorbidities. The objective was to evaluate the efficacy and tolerabil-ity of lacosamide (LCM) in patients with refractory epilepsy with and without ID in a real-life setting, taking drug monitoring (TDM) data into account therapeutic.Methods: Retrospectively, we identified 344 patients using LCM from the TDM service covering the majority of the country, at the National Center for Epilepsy in Norway (2013-2018). Clinical and TDM data were available for 132 patients.Results: Forty-four of the 132 patients (33%) had ID. The retention rate was signifi-cantly higher in the ID vs the non-ID group after 1 year (84% vs 68%, P < .05). By combining clinical and TDM data, we demonstrated that 37/38 responding patients had serum concentrations above the lower limit of the reference range (>10 μmol/L), and 16/17 with lower concentrations were non-responders. Mean serum concentra-tion/dose ratios were similar in both groups, 0.06 and 0.07 μmol/L/mg. There were no significant differences regarding efficacy and tolerability. The risk of LCM with-drawal was significantly higher when LCM was added to sodium channel blockers, even if the latter was discontinued.Significance: Lacosamide was generally well tolerated in patients with drug-resistant epilepsy, where one third had ID, and in these patients the retention rate was higher. The combination of clinical and TDM data could possibly facilitate LCM therapy in these vulnerable patients.

• Henning, Oliver Johannes; Landmark, Cecilie Johannessen; Nakken, Karl Otto & Lossius, Morten (2019). Nonadherence to treatment regimens in epilepsy from the patient's perspective and predisposing factors: Differences between intentional and unintentional lack of adherence. Epilepsia. ISSN 0013-9580. 60(5), p. e58–e62. doi: 10.1111/epi.14734. Full text in Research Archive Show summary

  Nonadherence to recommended antiepileptic drug (AED) treatment regimens can result in seizure relapse with increased health risks. Nonadherence can be unintentional (eg, patients forget to take a dose), or intentional, when patients consciously decide not to follow the agreed AED treatment regimen. We aimed to determine the extent to which Norwegian patients with epilepsy (PWEs) report taking their AED differently from prescribed, either intentionally or unintentionally, and to identify risk factors for either form of nonadherence. Of 1182 PWEs who completed an online survey presented on the website of the Norwegian Epilepsy Association, 40% reported that they sometimes or often forget to take their AED as scheduled, and about 30% reported that they consciously chose not to follow the AED treatment plan agreed upon with their physician. Independent variables significantly associated with unintentional nonadherence include the following: feeling depressed, being younger than the mean age, and having memory problems. Independent factors significantly associated with intentional nonadherence include the following: feeling depressed, male gender, and perceptions of stigmatization. To improve the treatment of PWEs, it is important to distinguish between intentional and unintentional nonadherence to AED treatment regimens, as different risk factors and reasons associated with nonadherence to AED treatment regimens might require different interventions.

• Henning, Oliver Johannes; Landmark, Cecilie Johannessen; Henning, David; Nakken, Karl Otto & Lossius, Morten (2019). Challenges in epilepsy – the perspective of Norwegian epilepsy patients. Acta Neurologica Scandinavica. ISSN 0001-6314. 140(1), p. 40–47. doi: 10.1111/ane.13098. Full text in Research Archive Show summary

  Objectives: For most people with epilepsy (PWE), problems that are not directly related to seizures may constitute major challenges in everyday life. The purpose of this study was to determine the extent of these challenges and any risk factors for their occurrence among PWE in Norway, based on the patients’ own perspective. Materials and Methods: We used a web‐based survey to ask PWE visiting the homepage of the Norwegian Epilepsy Association about different everyday challenges. A link to the survey was accessible via the members’ homepage for a 4‐month period during 2017. Results: One thousand one hundred eighty‐two PWE responded to the questionnaire. Although more than 40% of the cohort reported that they had been seizure free for at least 1 year, the majority reported that tiredness (71%), memory problems (70%), concentration problems (68%), headache or vertigo (51%), and feeling depressed (59%) continued to represent challenges. In addition, fear of being alone, sexual problems or difficulties in social settings were reported by about one‐third of the patients. Reporting having these challenges was significantly associated with female gender, polytherapy, experiencing seizures during the previous 12 months and feeling blue or depressed. Conclusions: The results of this study, reflecting a self‐selected Norwegian population, provide insights into the challenges not directly associated with seizures that impact on the quality of life of PWE. The impacts of such challenges may be underestimated as components of the entire burden of epilepsy.

• Henning, Oliver Johannes; Lossius, Morten; Lima, Maren Haugen; Mevåg, Morten Andreas; Villagran, Antonia & Nakken, Karl Otto [Show all 7 contributors for this article] (2019). Refractory epilepsy and nonadherence to drug treatment. Epilepsia Open. 4(4), p. 618–623. doi: 10.1002/epi4.12367. Full text in Research Archive Show summary

  In patients with epilepsy, nonadherence to agreed antiepileptic drug (AED) treatment may result in seizure relapse, and at worst sudden unexpected death. The aim of this study was to examine the extent of both unintentional and intentional nonadherence among Norwegian patients with refractory epilepsy and try to identify possible risk factors. At the National Centre for Epilepsy in Norway, 333 consecutive adult in‐ and outpatients with refractory epilepsy participated in an anonymous survey about adherence to drug treatment. Twenty‐two percentages admitted that they sometimes or often forgot to take their drugs as scheduled, and 19% reported that they, rarely, sometimes or often intentionally did not follow the AED treatment plan agreed upon with their physician. Young age and depression were significantly correlated with unintentional nonadherence. Intentional nonadherence was associated with young age (36 years or younger). We found nonadherence not to be associated with any specific AED. In conclusion, about one‐fifth of patients with refractory epilepsy admitted that they did not adhere to the agreed drug treatment plan, either intentionally or unintentionally. Measures to reduce nonadherence in this patient group may improve seizure control and should be tailored to address both unintentional and intentional lack of adherence.

• Henning, Oliver Johannes; Alfstad, Kristin Åshild; Nakken, Karl Otto & Lossius, Morten (2019). A call for better information about epilepsy: The patients? perspective?An online survey. Seizure. ISSN 1059-1311. 69, p. 173–179. doi: 10.1016/j.seizure.2019.04.015. Full text in Research Archive
• Henning, Oliver Johannes; Nakken, Karl Otto & Lossius, Morten (2018). People with epilepsy and their relatives want more information about risks of injuries and premature death. Epilepsy & Behavior. ISSN 1525-5050. 82, p. 6–10. doi: 10.1016/j.yebeh.2018.02.023. Full text in Research Archive
• Hessen, Erik; Alfstad, Kristin Åshild; Torgersen, Halvor & Lossius, Morten (2018). Tested and reported executive problems in children and youth epilepsy. Brain and Behavior. 8(5). doi: 10.1002/brb3.971. Full text in Research Archive Show summary

  Objectives Executive problems in children and youth with epilepsy influence their ability to handle important aspects of daily life activities. The present study sought to explore factors associated with executive problems for patients with epilepsy in this age group. Methods The cohort consisted of 97 consecutive patients at the National Centre for Epilepsy in Norway, aged 10–19 years, with focal or genetic generalized epilepsy. All underwent tests of executive functions (D‐KEFS), the Behavior Rating Inventory for Executive Function (BRIEF), and screening for psychiatric symptoms, using the Strengths and Difficulties Questionnaire (SDQ). Results Parent‐reported cognitive executive dysfunction (BRIEF, Metacognitive Index) was the strongest independent predictor for tested executive dysfunction and vice versa. Furthermore, male gender correlated strongest with parent‐reported behavioral regulation problems (BRIEF, Behavioral Regulation Index) along with borderline/pathological score on the SDQ and parent‐reported cognitive executive dysfunction. Conclusions A strong association between parent‐reported cognitive executive dysfunction and tested executive dysfunction was found. Male gender correlated strongest with parent‐reported behavioral regulation problems. The latter was probably related to a higher frequency of symptoms associated with psychopathology among the boys than the girls. The frequency of executive deficits according to the different modes of measurement varied from 16% to 43%, suggesting that they capture different aspects of behavior under the executive umbrella.

• Baud, Maxime O.; Perneger, Thomas; Rácz, Attila; Pensel, Max C.; Elger, Christian E. & Rydenhag, Bertil [Show all 40 contributors for this article] (2018). European trends in epilepsy surgery. Neurology. ISSN 0028-3878. 91(2), p. e96–e106. doi: 10.1212/WNL.0000000000005776. Full text in Research Archive
• Farmen, Anette Huuse; Grundt, Jacob Holter; Nakling, Ole Jakob; Mowinckel, Petter; Nakken, Karl Otto & Lossius, Morten (2018). Increased rate of acute caesarean sections in women with epilepsy: results from the Oppland Perinatal Database in Norway. European Journal of Neurology. ISSN 1351-5101. 26(4), p. 1–7. doi: 10.1111/ene.13865. Full text in Research Archive Show summary

  BACKGROUND AND PURPOSE: Studies in women with epilepsy (WWE) regarding pregnancy and labour complications have disclosed contradictory results. Our purpose was to investigate whether WWE have a higher risk of acute caesarean section (CS) or pregnancy complications than women without epilepsy or women with other chronic diseases and, if we found a higher risk, to explore potential explanations. METHODS: The study used prospectively registered obstetric data from the Oppland Perinatal Database in the period 2001-2011, containing information on 18 244 births, including 110 singleton pregnancies in mothers with validated epilepsy. Data regarding epilepsy were collected retrospectively from medical records. RESULTS: Epilepsy was a significant risk factor for acute CS, breech presentation and low birth weight in offspring [odds ratio (OR), 1.93, 95% confidence interval (CI), 1.2-3.1; OR, 2.29, 95% CI, 1.2-4.6 and OR, 2.10, 95% CI, 1.0-4.2, respectively]. In multivariate logistic regression analysis, antiepileptic drug exposure was an independent risk factor for acute CS (OR, 2.00; 95% CI, 1.06-3.77) and polytherapy was a significant risk factor for breech presentation (OR, 5.37; 95% CI, 1.13-25.57). Seizure frequency during pregnancy had no influence on the complication rate. CONCLUSIONS: We found that WWE using antiepileptic drugs during pregnancy had increased rates of acute CS, breech presentation and low birth weight, and that seizure frequency during pregnancy did not influence the complication rate.

• Landmark, Cecilie Johannessen; Farmen, Anette Huuse; Burns, Margrete Larsen; Baftiu, Arton; Lossius, Morten & Johannessen, Svein Ivar [Show all 7 contributors for this article] (2018). Pharmacokinetic variability of valproate in pregnancy-implications for the use of therapeutic drug monitoring. Epilepsy Research. ISSN 0920-1211. 141, p. 31–37. doi: 10.1016/j.eplepsyres.2018.02.004. Full text in Research Archive
• Aaberg, Kari Modalsli; Bakken, Inger Johanne; Lossius, Morten; Søraas, Camilla Lund; Tallur, Kamath K. & Stoltenberg, Camilla [Show all 8 contributors for this article] (2018). Short-term seizure outcomes in childhood epilepsy. Pediatrics. ISSN 0031-4005. 141(6). doi: 10.1542/peds.2017-4016. Full text in Research Archive
• Kolstad, Eivind; Bjørk, Marte Helene; Gilhus, Nils Erik; Alfstad, Kristin Åshild; Clench-Aas, Jocelyne & Lossius, Morten (2017). Young people with epilepsy have an increased risk of eating disorder and poor quality diet. Epilepsia Open. 3(1), p. 40–45. doi: 10.1002/epi4.12089. Full text in Research Archive Show summary

  Objective: To investigate whether adolescents with epilepsy are at increased risk of having self‐reported eating disorder symptoms and poor quality diet compared to young people from the general population. Methods: We used data from the Health Profile for Children and Youth in Akershus Study, a cross‐sectional population‐based study based on a voluntary self‐reported questionnaire. There were 19,995 participants (response rate 85%) aged 13–19 years; 247 (1.2%) reported a lifetime diagnosis of epilepsy. Odds ratios (OR) and 95% confidence intervals (CI) for eating disorders, unhealthy diet, dieting, satisfaction with looks, and participation in sports were estimated by using a logistic regression model. All estimates were adjusted for single parents and poor family economy. Results: Children and adolescents with epilepsy had more eating disorders than their peers (OR 1.8, CI 1.0–3.0, p = 0.03). They were less satisfied with their own appearance (OR 0.7, CI 0.5–0.9, p = 0.02), and they eat more unhealthily (OR 1.7, CI 1.3–2.2, p = 0.001). Males with epilepsy were more likely to have been dieting (OR 3.1, CI 1.2–7.9, p = 0.02) and less satisfied with their own appearance (OR 0.4, CI 0.3–0.7, p < 0.001). Females with epilepsy were more likely to eat unhealthily (OR 1.7, CI 1.1–2.5, p = 0.01). Significance: Adolescents with epilepsy are at increased risk of having eating disorder symptoms. They eat less healthily and are less satisfied with their looks. Health workers should be aware of this and bring diet and lifestyle into the dialogue with young people with epilepsy.

• Vogt, Viola Lara; Äikiä, Marja; Barrio, Antonio del; Boon, Paul; Borbély, Csaba & Bran, Ema [Show all 56 contributors for this article] (2017). Current standards of neuropsychological assessment in epilepsy surgery centers across Europe. Epilepsia. ISSN 0013-9580. 58(3), p. 343–355. doi: 10.1111/epi.13646. Full text in Research Archive
• Aaberg, Kari Modalsli; Gunnes, Nina; Bakken, Inger Johanne; Søraas, Camilla Lund; Berntsen, Alexander & Magnus, Per [Show all 10 contributors for this article] (2017). Incidence and prevalence of childhood epilepsy: A nationwide cohort study. Pediatrics. ISSN 0031-4005. 139(5). doi: 10.1542/peds.2016-3908. Full text in Research Archive Show summary

  BACKGROUND AND OBJECTIVES: Epilepsy affects 0.5% to 1% of children and is the most frequent chronic neurologic condition in childhood. Incidence rates appear to be declining in high-income countries. The validity of epilepsy diagnoses from different data sources varies, and contemporary population-based incidence studies are needed. METHODS: The study was based on the Norwegian Mother and Child Cohort Study. Potential epilepsy cases were identified through registry linkages and parental questionnaires. Cases were validated through medical record reviews and telephone interviews of parents. RESULTS: The study population included 112 744 children aged 3 to 13 years (mean 7.4 years) at end of registry follow-up (December 31, 2012). Of these, 896 had registry recordings and/or questionnaire reports of epilepsy. After validation, 587 (66%) met the criteria for an epilepsy diagnosis. The incidence rate of epilepsy was 144 per 100 000 person-years in the first year of life and 58 per 100 000 for ages 1 to 10 years. The cumulative incidence of epilepsy was 0.66% at age 10 years, with 0.62% having active epilepsy. The 309 children (34%) with erroneous reports of epilepsy from the registry and/or the questionnaires had mostly been evaluated for nonepileptic paroxysmal events, or they had undergone electroencephalography examinations because of other developmental or neurocognitive difficulties. CONCLUSIONS: Approximately 1 out of 150 children is diagnosed with epilepsy during the first 10 years of life, with the highest incidence rate observed during infancy. Validation of epilepsy diagnoses in administrative data and cohort studies is crucial because reported diagnoses may not meet diagnostic criteria for epilepsy.

• Landmark, Cecilie Johannessen; Burns, Margrete Larsen; Baftiu, Arton; Farmen, Anette Huuse; Lossius, Morten & Johannessen, Svein Ivar [Show all 7 contributors for this article] (2017). Pharmacokinetic variability of valproate in women of childbearing age. Epilepsia. ISSN 0013-9580. 58(10), p. 142–146. doi: 10.1111/epi.13872. Full text in Research Archive
• Aaberg, Kari Modalsli; Surén, Pål; Søraas, Camilla Lund; Bakken, Inger Johanne; Lossius, Morten & Stoltenberg, Camilla [Show all 7 contributors for this article] (2017). Seizures, syndromes, and etiologies in childhood epilepsy: The International League Against Epilepsy 1981, 1989, and 2017 classifications used in a population-based cohort. Epilepsia. ISSN 0013-9580. 58(11), p. 1880–1891. doi: 10.1111/epi.13913. Full text in Research Archive
• Hansen, Berit Marina Hjelde; Alfstad, Kristin Åshild; Roy, Betty Van; Henning, Oliver Johannes & Lossius, Morten (2016). Sleep problems in children and adolescents with epilepsy: Associations with psychiatric comorbidity. Epilepsy & Behavior. ISSN 1525-5050. 62, p. 14–19. doi: 10.1016/j.yebeh.2016.06.015. Full text in Research Archive
• Svendsen, Torleiv; Alfstad, Kristin Åshild; Lossius, Morten Ingvar & Nakken, Karl Otto (2016). Langtidsbivirkninger av antiepileptika. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 136(4), p. 324–327. doi: 10.4045/tidsskr.15.0220. Full text in Research Archive
• Lossius, Morten Ingvar; Villagran, Antonia; Karterud, Hilde; Henning, Oliver Johannes & Nakken, Karl Otto (2016). Psykogene ikke-epileptiske anfall hos barn. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 136(23-24), p. 1993–1995. doi: 10.4045/tidsskr.16.0312. Full text in Research Archive
• Alfstad, Kristin Åshild; Torgersen, Halvor; Roy, Betty Van; Hessen, Erik; Hansen, Berit Marina Hjelde & Henning, Oliver Johannes [Show all 10 contributors for this article] (2016). Psychiatric comorbidity in children and youth with epilepsy: An association with executive dysfunction? Epilepsy & Behavior. ISSN 1525-5050. 56, p. 88–94. doi: 10.1016/j.yebeh.2016.01.007. Full text in Research Archive
• Aurlien, Dag; Rath-Olsen, Trude; Taubøll, Erik; Gjerstad, Leif; Lossius, Morten & Nakken, Karl Otto (2016). Plutselig, uventet epilepsirelatert død. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 136(2), p. 131–135. doi: 10.4045/tidsskr.14.0640. Full text in Research Archive
• Henning, Oliver Johannes; Nakken, Karl Otto; Træen, Bente; Mowinckel, Petter & Lossius, Morten (2016). Sexual problems in people with refractory epilepsy. Epilepsy & Behavior. ISSN 1525-5050. 64, p. 174–179. doi: 10.1016/j.yebeh.2016.08.015. Full text in Research Archive
• Lossius, Morten; Nakken, Karl Otto; Mowinckel, Petter; Taubøll, Erik & Gjerstad, Leif (2016). Favorable change of lipid profile after carbamazepine withdrawal. Acta Neurologica Scandinavica. ISSN 0001-6314. 134(3), p. 219–223. doi: 10.1111/ane.12534. Full text in Research Archive Show summary

  Objective Patients treated with carbamazepine (CBZ) have increased serum levels of total cholesterol (TC), high-density lipoproteins (HDL), and low-density lipoproteins (LDL). We aimed to investigate whether these changes of serum lipids are reversible after CBZ withdrawal. Material and methods We used a prospective, randomized double-blinded design. A total of 160 patients who had been seizure free on anti-epileptic drug monotherapy for more than 2 years were included and randomized to withdrawal or not. The intervention was completed by 150 (80 females, 53%) patients. Serum samples from before and 4 months after completed withdrawal or no withdrawal were obtained from 130 patients (63 females, 48%). Of these, 84 were treated with CBZ, 28 with valproate, nine with phenytoin, four with phenobarbital, and five with lamotrigine. Of the patients who had been treated with CBZ, 47 were randomized to the withdrawal group, and 37 were randomized to the non-withdrawal group. Results Among the CBZ-treated patients, a significant decrease in serum levels of TC, LDL, and apolipoprotein B (ApoB) were found in the withdrawal group compared with the non-withdrawal group. Mean differences in change were as follows: TC 0.68 mmol/l (P = 0.005, CL – 1.15 to −0.21); LDL – 0.67 mmol/l (P = 0.001, CL – 1.03 to −0.29); ApoB – 0.13 g/l (P = 0.02, CL – 0.23 to −0.03). No significant changes in HDL, apolipoprotein A, and C-reactive protein were detected. Conclusion Our results indicate that CBZ may have unfavorable effects on serum levels of TC, LDL, and ApoB. However, these changes seem to be reversible even after years of treatment.

• Farmen, Anette Huuse; Grundt, Jacob Holter; Tomson, Torbjørn; Nakken, Karl Otto; Nakling, Ole Jakob & Mowinckel, Petter [Show all 8 contributors for this article] (2016). Age-specific birth rates in women with epilepsy: a population-based study. Brain and Behavior. 6(8). doi: 10.1002/brb3.492. Full text in Research Archive
• Aaberg, Kari Modalsli; Bakken, Inger Johanne; Lossius, Morten; Søraas, Camilla Lund; Håberg, Siri Eldevik & Stoltenberg, Camilla [Show all 8 contributors for this article] (2016). Comorbidity and Childhood Epilepsy: A Nationwide Registry Study. Pediatrics. ISSN 0031-4005. 138(3). doi: 10.1542/peds.2016-0921. Full text in Research Archive
• Mouthaan, Brian E; Rados, Matea; Barsi, Peter; Boon, Paul; Carmichael, David W & Carrette, Evelien [Show all 55 contributors for this article] (2016). Current use of imaging and electromagnetic source localization procedures in epilepsy surgery centers across Europe. Epilepsia. ISSN 0013-9580. 57(5), p. 770–776. doi: 10.1111/epi.13347. Full text in Research Archive
• Kobulashvili, Teia; Höfler, Julia; Dobesberger, Judith; Ernst, Florian; Ryvlin, Philippe & Cross, J Helen [Show all 31 contributors for this article] (2016). Current practices in long-term video-EEG monitoring services: A survey among partners of the E-PILEPSY pilot network of reference for refractory epilepsy and epilepsy surgery. Seizure. ISSN 1059-1311. 38, p. 38–45. doi: 10.1016/j.seizure.2016.03.009. Full text in Research Archive
• Lossius, Morten; Alfstad, Kristin Åshild; Roy, Betty Van; Mowinckel, Petter; Clench-Aas, Jocelyne & Gjerstad, Leif [Show all 7 contributors for this article] (2016). Early sexual debut in Norwegian youth with epilepsy: A population-based study. Epilepsy & Behavior. ISSN 1525-5050. 56, p. 1–4. doi: 10.1016/j.yebeh.2015.12.014. Full text in Research Archive
• Kolstad, Eivind; Gilhus, Nils Erik; Veiby, Gyri; Reiter, Simone B. C. Frizell; Lossius, Morten & Bjørk, Marte Helene (2015). Epilepsy and eating disorders during pregnancy: Prevalence, complications and birth outcome. Seizure. ISSN 1059-1311. 28, p. 81–84. doi: 10.1016/j.seizure.2015.02.014. Full text in Research Archive
• Farmen, Anette Huuse; Grundt, Jacob Holter; Tomson, Torbjörn; Nakken, Karl Otto; Nakling, Ole Jakob & Mowinckel, Petter [Show all 7 contributors for this article] (2015). Intrauterine growth retardation in foetuses of women with epilepsy. Seizure. ISSN 1059-1311. 28, p. 76–80. doi: 10.1016/j.seizure.2015.02.026. Full text in Research Archive Show summary

  Various factors may affect intrauterine foetal growth, amongst which conditions such as epilepsy and the use of anti-epileptic drugs (AED) may play a role. This study investigated intrauterine growth of foetuses in women with epilepsy, as compared with controls, and explored whether intrauterine growth was affected by prenatal exposure to AED. Method Data were obtained from prospectively registered data regarding pregnancy and prenatal and perinatal factors in women in Oppland County in Norway. The final analysis included information from 166 mothers with epilepsy and 287 children. The control group consisted of 40,553 pregnancies in women without epilepsy registered in the same database. Results There was a significantly higher risk of the ponderal index being below the 10th percentile and infants being small for gestational age (SGA) in the epilepsy group; exposure to AED increased the risk. The frequency of SGA and low ponderal index was highest in Lamotrigine exposed infants. In the AED group, head circumference was significantly smaller among Carbamazepine exposed. Conclusion Impaired intrauterine growth of foetuses in women with epilepsy was identified. The frequency of SGA and low ponderal index was highest in Lamotrigine exposed infants. The epilepsy group had a higher risk profile for having smaller babies, in being younger at age, lower in body weight and more frequent smokers. However despite these differences, the effects of epilepsy and AED exposure were significant. The ponderal index may be a useful supplement to more established measures assessing intrauterine growth in epilepsy.

• Realfsen, Martha Seim; Bø, Siri M. Hylleraas; Lossius, Morten & Nakken, Karl Otto (2015). Førstegangs generalisert tonisk-klonisk krampeanfall. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 135(14), p. 1256–1258. doi: 10.4045/tidsskr.14.0654. Full text in Research Archive
• Hessen, Erik; Lossius, Morten & Gjerstad, Leif (2013). Repeated neuropsychological assessment in well-controlled epilepsy. Acta Neurologica Scandinavica. ISSN 0001-6314. 127(1), p. 53–60. doi: 10.1111/j.1600-0404.2012.01682.x. Full text in Research Archive
• Nakken, Karl Otto; Sætre, Erik; Markhus, Rune & Lossius, Morten (2013). Epilepsi hos eldre. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 133(5), p. 528–531. doi: 10.4045/tidsskr.12.0781. Full text in Research Archive
• Bremer, Anna; Lossius, Morten & Nakken, Karl Otto (2012). Dravet syndrome - considerable delay in making the diagnosis. Acta Neurologica Scandinavica. ISSN 0001-6314. 125(5), p. 359–362. doi: 10.1111/j.1600-0404.2011.01609.x. Full text in Research Archive
• Lund, Caroline; Anna, Bremer; Lossius, Morten; Selmer, Kaja Kristine; Brodtkorb, Eylert & Nakken, Karl Otto (2012). Dravets syndrom som årsak til epilepsi og utviklingshemning. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 132(1), p. 44–47. doi: 10.4045/tidsskr.11.0539. Full text in Research Archive
• Alfstad, Kristin Åshild; Clench-Aas, Jocelyne; Roy, Betty Van; Mowinckel, P; Gjerstad, Leif & Lossius, Morten (2011). Psychiatric symptoms in Norwegian children with epilepsy aged 8-13 years: Effects of age and gender? Epilepsia. ISSN 0013-9580. 52(7), p. 1231–1238. doi: 10.1111/j.1528-1167.2011.03042.x. Full text in Research Archive
• Alfstad, Kristin Åshild; Clench-Aas, Jocelyne; Roy, Betty Van; Mowinckel, Petter; Gjerstad, Leif & Lossius, Morten (2011). Gender differences in risk-taking behaviour in youth with epilepsy: a Norwegian population-based study. Acta Neurologica Scandinavica. ISSN 0001-6314. 124, p. 12–17. doi: 10.1111/j.1600-0404.2011.01537.x. Full text in Research Archive
• Alfstad, Kristin Åshild; Lossius, Morten; Røste, Geir Ketil; Mowinckel, Petter; Scheie, David & Borota, Olivera Casar [Show all 8 contributors for this article] (2011). Acute postoperative seizures after epilepsy surgery - a long-term outcome predictor? Acta Neurologica Scandinavica. ISSN 0001-6314. 123(1), p. 48–53. doi: 10.1111/j.1600-0404.2010.01343.x. Full text in Research Archive
• Hessen, Erik; Lossius, Morten & Gjerstad, Leif (2011). Improvement in verbal memory after withdrawal of carbamazepine and valproate in patients with well-controlled epilepsy: a randomized, double-blind study. Acta Neurologica Scandinavica. ISSN 0001-6314. 123(6), p. 385–389. doi: 10.1111/j.1600-0404.2010.01452.x. Full text in Research Archive
• Nakken, Karl Otto & Lossius, Morten (2011). Buccal midazolam or rectal diazepam for treatment of residential adult patients with serial seizures or status epilepticus. Acta Neurologica Scandinavica. ISSN 0001-6314. 124(2), p. 99–103. doi: 10.1111/j.1600-0404.2010.01474.x. Full text in Research Archive
• Lossius, Morten; Taubøll, Erik; Mowinckel, Petter & Gjerstad, Leif (2009). Reversible effects of antiepileptic drugs on thyroid hormones in men and women with epilepsy: A prospective randomized double-blind withdrawal study. Epilepsy & Behavior. ISSN 1525-5050. 16(1), p. 64–68. doi: 10.1016/j.yebeh.2009.07.014. Full text in Research Archive
• Farmen, Anette Huuse; Lossius, Morten & Nakken, Karl Otto (2009). Flerumettede fettsyrer og epilepsi. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 129(1), p. 26–28. Full text in Research Archive

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• Myren, Sverre; Lossius, Morten Ingvar & Maridal, Ann-Kristin Haram (2025). Funksjonell nevrologisk liding: Symptoma utan synlege teikn. [Internet]. helse-mr.no. Full text in Research Archive
• Henning, Oliver Johannes; Nakken, Karl Otto & Lossius, Morten Ingvar (2022). All patients with epilepsy, whether at high or low risk of SUDEP, should have access to individually tailored SUDEP information. Epilepsy & Behavior. ISSN 1525-5050. 127. doi: 10.1016/j.yebeh.2021.108418. Full text in Research Archive
• Villagran, Antonia; Duncan, Roderick; Hofoss, Dag & Lossius, Morten Ingvar (2021). Response: The true prevalence of psychogenic nonepileptic seizures is much higher than this. Epilepsia. ISSN 0013-9580. 62(11), p. 2877–2877. doi: 10.1111/epi.17054. Full text in Research Archive
• lossius, ida marie; Sødal, Hild Flatmark; Nakken, Karl Otto; Svendsen, Torleiv; Lossius, Morten & Landmark, Cecilie Johannessen (2019). Kliniske erfaringer med perampanel – et nytt antiepileptisk legemiddel. Full text in Research Archive
• Alvestad, Silje; Bjørnvold, Marit; Molteberg, Ellen; Lossius, Morten & Landmark, Cecilie Johannessen (2019). Valproat fortsatt viktig for kvinner med generalisert epilepsi. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 139(7), p. 1–2. doi: 10.4045/tidsskr.19.0220. Full text in Research Archive
• Svendsen, Torleiv; Lossius, Morten; Nakken, Karl Otto; Baftiu, Arton; Johannessen, Svein Ivar & Landmark, Cecilie Johannessen (2018). Efficacy and tolerability of brivaracetam in patients with refractory epilepsy. An open prospective follow-up study. Full text in Research Archive
• Hansen, Berit M Hjelde; Alfstad, Kristin Åshild; Roy, Betty Van; Henning, Oliver Johannes & Lossius, Morten (2017). Subjectively reported sleep problems in children and youth with epilepsy- associated with objective measures of sleep? Full text in Research Archive
• Landmark, Cecilie Johannessen; Farmen, Anette Huuse; Burns, Margrete Larsen; Baftiu, Arton; Lossius, Morten & Johannessen, Svein Ivar [Show all 7 contributors for this article] (2017). Farmakokinetisk variasjon med valproat hos gravide kvinner. Full text in Research Archive
• lossius, ida marie; Landmark, Cecilie Johannessen & Lossius, Morten (2017). Tapering of antiepileptic drugs and liver function. Full text in Research Archive
• Svendsen, Torleiv; Brodtkorb, Eylert; Lossius, Morten; Nakken, Karl Otto; Baftiu, Arton & Johannessen, Svein Ivar [Show all 7 contributors for this article] (2017). Efficacy and tolerability of lacosamide as add-on treatment in patients with refractory epilepsy and intellectual disability. Full text in Research Archive
• Landmark, Cecilie Johannessen; Farmen, Anette Huuse; Burns, Margrete Larsen; Baftiu, Arton; Lossius, Morten & Johannessen, Svein Ivar [Show all 7 contributors for this article] (2017). Pharmacokinetic variability of valproate in women with epilepsy during pregnancy. Full text in Research Archive
• Landmark, Cecilie Johannessen; Farmen, Anette Huuse; Burns, Margrete Larsen; Baftiu, Arton; Lossius, Morten & Johannessen, Svein Ivar [Show all 7 contributors for this article] (2016). Pharmacokinetic variability of valproate in women of childbearing age and during pregnancy. Full text in Research Archive
• Realfsen, Martha Seim; Bø, Siri M. Hylleraas; Lossius, Morten & Nakken, Karl Otto (2015). Re: Førstegangs generalisert tonisk-klonisk krampeanfall. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 135(22), p. 2025–2026. doi: 10.4045/tidsskr.15.1194. Full text in Research Archive
• Hansen, Berit Marina Hjelde; Alfstad, Kristin Åshild; Roy, Betty Van & Lossius, Morten (2013). Self- and parent- reported sleep problems in children and youths with epilepsy. Full text in Research Archive
• Lossius, Morten; Clench-Aas, Jocelyne; Alfstad, KÅ & Gjerstad, Leif (2011). ATTITUDE TOWARD SCHOOL AND SCHOOLWORK IN NORWEGIAN YOUTH WITH EPILEPSY A POPULATION BASED STUDY-THE AKERSHUS HEALTH PROFILE STUDY. Epilepsia. ISSN 0013-9580. 52, p. 139–139. Full text in Research Archive
• Nakken, Karl Otto & Lossius, Morten (2011). BUCCAL MIDAZOLAM OR RECTAL DIAZEPAM FOR ONGOING SEIZURES - WHAT IS BEST? Epilepsia. ISSN 0013-9580. 52, p. 75–75. Full text in Research Archive
• Lossius, Morten (2010). Skader etter krampeanfall. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 130(11), p. 1155–1155. Full text in Research Archive
• Lossius, Morten; Erik, T; Mowinckel, P & Gjerstad, Leif (2009). REVERSIBLE EFFECTS OF ANTIEPILEPTIC DRUGS ON THYROID HORMONES IN MEN AND WOMEN WITH EPILEPSY - A PROSPECTIVE RANDOMIZED DOUBLE-BLIND WITHDRAWAL STUDY. Epilepsia. ISSN 0013-9580. 50, p. 146–146. Full text in Research Archive

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