Evidence map›Paper›PMID 41542891›Full record

ArticleEpilepsia open2026

Predictors of etiology and drug resistance in children with new-onset focal seizures.

Byoung Chan Lee, Russell C Dale, Elizabeth H Barnes, Shekeeb S Mohammad, Sachin Gupta, Chong Wong, Deepak Gill, Kavitha Kothur

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Epilepsia open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Byoung Chan LeeThe Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-0099-0617
Russell C DaleThe Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia.
Elizabeth H BarnesNHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Shekeeb S MohammadThe Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia.
Sachin GuptaTY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
Chong WongDepartment of Neurology, Westmead Hospital, Sydney, New South Wales, Australia.
Deepak GillThe Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-6219-9479
Kavitha KothurThe Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-0109-8877

Funding

National Health and Medical Research Council 2017279
6 · The paper itself

Abstract

objectiveTo examine the clinical features of new-onset focal seizures in children and investigate clinical associations and predictors of underlying etiology and drug resistance.

methodsData were gathered from The Children's Hospital at Westmead admissions for patients aged 1 month to 18 years who presented with new-onset focal seizures between 2018 and 2022 (n = 140). Seizure characteristics, etiology, clinical comorbidities, investigations, and antiseizure medications were analyzed. Clinical associations between etiologies and comorbidities/treatment outcomes were investigated using nonparametric tests and hierarchical cluster analysis. Multivariable logistic regression was performed to identify predictors of drug resistance.

resultsThe median age of seizure onset was 4.7 years (IQR 1.9-8.1). The etiologies included unknown (n = 53, 39%) followed by structural (n = 36, 26%), self-limited childhood focal epilepsy (n = 21, 15%), genetic (n = 12, 9%), inflammatory (n = 12, 9%), and metabolic (n = 3, 2%). The explosive seizure-onset seizures (p = 0.04), focal neurological abnormalities (p = 0.04), younger age at seizure onset (p = 0.01), abnormal neuroimaging findings (p < 0.001), and drug resistance (p < 0.001) were associated with known etiology. Regression analysis showed the drug resistance risk increased with the presence of known genetic (OR 6.7; 95% CI 1.6-31.8), structural (OR 6.4; 95% CI 2.3-19.5), and inflammatory (OR 4.6; 95% CI 1.0-21.2) etiologies. SIGNIFICANCE: Our study examines the important associations and predictors of etiology and drug resistance in children with new-onset focal seizures. The significance of known etiologies as risk factors for drug resistance promotes the need for improved monitoring and etiology-driven treatment. PLAIN LANGUAGE SUMMARY: This study looked at children who had focal seizures for the first time. In many cases, the cause was unknown, but a large portion was linked to structural brain changes, childhood epilepsies that usually resolve, or genetic, inflammatory, and metabolic conditions. Children with a known cause, especially genetic, structural, or inflammatory, were more likely to have seizures that did not improve with anti-seizure medications. Identifying the cause early can help doctors choose better treatments and provide closer monitoring for patients.

Indexed as

AnticonvulsantsDrug ResistanceDrug Resistant EpilepsyEpilepsies, PartialSeizuresAdolescentAge of OnsetChildChild, PreschoolFemaleHumansInfantMaleRisk FactorsAnticonvulsantsdrug resistanceetiologyexplosive onsetfocal seizurenew onset

Identifiers

PMID41542891
PMCPMC12903812

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.