{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:58:46Z","timestamp":1785412726751,"version":"3.56.0"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T00:00:00Z","timestamp":1735516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To analyze the clinical characteristics, etiology, drug treatment, and related factors of patients with young adult\u2010onset epilepsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study included patients with epilepsy aged between 18 and 44\u2009years and aimed to analyze the clinical characteristics of epilepsy in young people and their response to antiseizure medication (ASM) over a 24\u2010year period (February 1999 and March 2023).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 4227 patients experienced epilepsy onset between 18 and 44\u2009years of age. The median age of onset was 26\u2009years (interquartile range [IQR]: 21\u201333), and the median duration from the first seizure to starting treatment was 3\u2009months (IQR: 1.0\u20136.0). Structural etiology was the most common cause of epilepsy, accounting for 43.2% (1827\/4227) of cases, of which head trauma and a history of craniotomy accounted for 64.9% (1186\/1827). However, these two causes did not necessarily result in prompt medication or poor epilepsy control. Co\u2010morbid cognitive decline was more prevalent than headache and anxiety\/depression. Multifactorial regression analysis showed that the factors associated with poor seizure control included longer seizure duration (odds ratio [OR] 1.85; 95% confidence interval [CI] 1.58\u20102.16; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), electroencephalography (EEG) epileptic discharge (OR 1.37; 95% CI 1.17\u20131.67; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), focal seizure (OR 1.69; 95% CI 1.38\u20132.07; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and seizure clusters (OR 3.35; 95% CI 2.70\u20134.15; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Initiating treatment after two seizures (OR, 1.18; 95% CI 0.98\u20131.15; <jats:italic>p<\/jats:italic>\u2009=\u2009.08) or 6\u2009months after the first seizure (OR 0.84; 95% CI 0.67\u20131.03; <jats:italic>p<\/jats:italic>\u2009=\u2009.09) did not worsen effectiveness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Young adult\u2010onset epilepsy was frequently caused by head trauma or craniotomies. Co\u2010morbid cognitive decline was more prevalent than headache and anxiety\/depression. The median time from the first seizure to follow\u2010up treatment was 3\u2009months (IQR: 1.0\u20136.0). Initiating treatment after two seizures did not necessarily indicate poor drug effectiveness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>In this article, we observed that young adult\u2010onset epilepsy was mainly caused by head trauma and craniotomy; co\u2010morbid cognitive decline was more common. The median duration from first seizure to initiation of treatment for young\u2010onset epilepsy was 3\u2009months, and more than one\u2010third of patients experienced more than two seizures prior to treatment, but this factor had no effect on the drug effectiveness.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.13126","type":"journal-article","created":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T14:18:31Z","timestamp":1735568311000},"page":"298-306","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical characteristics, etiology, and treatment of young adult\u2010onset epilepsy: A 24\u2010year retrospective study"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2395-7986","authenticated-orcid":false,"given":"Xu","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Neurology The First Medical Center of Chinese PLA General Hospital  Beijing 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