{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T10:19:37Z","timestamp":1787998777269,"version":"build-2784847793"},"reference-count":49,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["SNSF 163398"],"award-info":[{"award-number":["SNSF 163398"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Seizure recurrence in new onset epilepsy (NOE) can result from various factors. Although drug ineffectiveness is frequently investigated, other causes\u2014such as nonadherence, inadequate treatment, nonepileptic events (e.g., functional\/dissociative), or acute symptomatic seizures\u2014also impact patient outcomes. This retrospective, longitudinal single\u2010center study evaluated relapse causes over a 5\u2010year period in a cohort of NOE patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed the NOE registry of Geneva University Hospital, including adult patients diagnosed between 2005 and 2019. Of 740 consecutive patients, 330 with more than 5\u2009years of follow\u2010up were included in the analysis. Relapses after antiseizure medication (ASM) initiation were classified into seven categories: poor adherence, inadequate treatment, ineffective treatment, acute symptomatic seizures, nonepileptic seizures, multiple, and unknown causes. Mixed\u2010effects logistic regression and post hoc analyses were used to assess temporal trends.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 202 of 330 patients (61%) experienced at least one relapse; 181 occurred after ASM initiation. Of these, 32% (57\/181) were due to treatment ineffectiveness, whereas 68% were attributable to other causes. Inadequate treatment was the most frequent cause in year 1 (37%) but declined to 10% by year 5 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Poor adherence remained stable (27%\u201338%). The proportion of drug ineffectiveness as a cause of relapse increased over time (22% in year 1 to 41% in year 5). Drug\u2010resistant epilepsy (DRE) was diagnosed in 7% of the entire cohort. Generalized tonic\u2013clonic (GTC) seizures at relapse were associated with poor adherence, whereas non\u2010GTC seizures were linked to ineffectiveness (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>In our cohort, most early relapses in NOE were due to modifiable factors. Systematic identification of relapse causes can prevent misclassification of DRE and reduce unnecessary treatment escalation. The high proportion of patients lost to follow\u2010up is a relevant limitation of this study; however, a substantial selection bias is unlikely.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70298","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T13:21:17Z","timestamp":1781184077000},"page":"4183-4193","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Seizure relapse in new onset epilepsy: It is not always drug resistance"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4893-1062","authenticated-orcid":false,"given":"Cecilia","family":"Catania","sequence":"first","affiliation":[{"name":"Department of Clinical Neurosciences, EEG &amp; Epilepsy Unit University Hospitals of Geneva  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Menetre","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, EEG &amp; Epilepsy Unit University Hospitals of Geneva  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4540-1428","authenticated-orcid":false,"given":"Aikaterini","family":"Fitsiori","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Neuroradiology Unit  Berne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix Tobias","family":"Kurz","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Neuroradiology Unit  Berne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1940-2232","authenticated-orcid":false,"given":"Gabriela","family":"Moreno Legast","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, EEG &amp; Epilepsy Unit University Hospitals of Geneva  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serge","family":"Vulliemoz","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, EEG &amp; Epilepsy Unit University Hospitals of Geneva  Geneva Switzerland"},{"name":"CIBM Center for Biomedical Imaging  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Genoud","sequence":"additional","affiliation":[{"name":"Emergency Department University Hospitals of Geneva  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"M\u00e9gevand","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, EEG &amp; Epilepsy Unit University Hospitals of Geneva  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Wiest","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Neuroradiology, University Hospital  Berne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabienne","family":"Picard","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, EEG &amp; Epilepsy Unit University Hospitals of Geneva  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6035-6581","authenticated-orcid":false,"given":"Sandor","family":"Beniczky","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurophysiology Copenhagen University Hospital  Copenhagen Denmark"},{"name":"Department of Clinical Neurophysiology Danish Epilepsy Centre  Dianalund Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margitta","family":"Seeck","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, EEG &amp; Epilepsy Unit University Hospitals of Geneva  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.4065\/71.6.576"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2024.107457"},{"key":"e_1_2_12_4_1","doi-asserted-by":"crossref","unstructured":"BrodieMJ BarrySJE BamagousGA NorrieJD KwanP.Patterns of treatment response in newly diagnosed 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