{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T08:42:29Z","timestamp":1792226549797,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Chapeau de gendarme (CdG) is a subtle but clinically relevant semiology that has been scarcely studied in children. Previous studies have primarily focused on its localizing value in small, surgical cohorts. This study aimed to systematically characterize frequency and clinical features of CdG across the pediatric age spectrum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed video\u2010electroencephalography (EEG) monitoring of 264 children with epilepsy (0\u201317\u2009years). Up to 10 seizures per type were reviewed per patient. CdG was defined as a symmetrical downward contraction of both mouth corners and chin contraction lasting \u22655\u2009s. CdG characteristics, co\u2010occurring semiologies, and EEG patterns were assessed and compared to the cohort without CdG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CdG was identified in 28 of 264 patients (10.6%), corresponding to 73 seizures. The median age at first observed CdG was 12.3\u2009years (range 1.3\u201316.8), with a trend toward increasing frequency in older children. All but one case occurred in focal epilepsies, which were significantly more frequent in the CdG cohort than in those without CdG (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.009). CdG appeared early in the seizure course (\u22645\u2009s in 61.6%) and more often during sleep (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Hyperkinetic behavior occurred significantly more often in CdG seizures (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Progression to bilateral tonic\u2013clonic seizures was recorded in 20.5% of CdG seizures (17.9% of patients with CdG) and occurred more frequently in the CdG cohort than in patients without CdG (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). The first ictal scalp EEG pattern most frequently involved the frontal lobe (57.7%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>CdG occurred in a notable proportion of pediatric patients across the entire age range, with a descriptive tendency toward higher occurrence in older children. These findings provide an essential foundation for future investigations exploring developmental and network mechanisms underlying this semiology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70396","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T16:36:02Z","timestamp":1784824562000},"page":"5301-5311","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Characterizing chapeau de gendarme in pediatric epilepsy through systematic video\u2010\n                    <scp>EEG<\/scp>\n                    evaluation"],"prefix":"10.1002","volume":"67","author":[{"given":"Hanna Barbara","family":"Brinkmann","sequence":"first","affiliation":[{"name":"Department of Neuropediatrics and Muscle Disorders, Center for Pediatrics, Medical Center, Faculty of Medicine University of Freiburg  Freiburg im Breisgau Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Neuropediatrics and Muscle Disorders, Center for Pediatrics, Medical Center, Faculty of Medicine University of Freiburg  Freiburg im Breisgau Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Sch\u00f6nberger","sequence":"additional","affiliation":[{"name":"Department of Neuropediatrics and Muscle Disorders, Center for Pediatrics, Medical Center, Faculty of Medicine University of Freiburg  Freiburg im Breisgau Germany"},{"name":"Epilepsy Center, Medical Center, Member of the European Reference Network for Rare and Complex Epilepsies EpiCARE, Faculty of Medicine University of Freiburg University of Freiburg  Freiburg im Breisgau Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Neuropediatrics and Muscle Disorders, Center for Pediatrics, Medical Center, Faculty of Medicine University of Freiburg  Freiburg im Breisgau Germany"},{"name":"Hotchkiss Brain Institute and Alberta Children's Hospital Research Institute University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2780-6560","authenticated-orcid":false,"given":"Victoria","family":"San Antonio\u2010Arce","sequence":"additional","affiliation":[{"name":"Epilepsy Center, Medical Center, Member of the European Reference Network for Rare and Complex Epilepsies EpiCARE, Faculty of Medicine University of Freiburg University of Freiburg  Freiburg im Breisgau Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1601-5384","authenticated-orcid":false,"given":"Kerstin Alexandra","family":"Klotz","sequence":"additional","affiliation":[{"name":"Department of Neuropediatrics and Muscle Disorders, Center for Pediatrics, Medical Center, Faculty of Medicine University of Freiburg  Freiburg im Breisgau Germany"},{"name":"Department of Neuropediatrics, Member of the European Reference Network for Rare and Complex Epilepsies EpiCARE, University Hospital Bonn University Bonn  Bonn 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