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Long and complex shadow childhood epilepsy casts over educational achievement

Journal of Neurology, Neurosurgery & Psychiatry - Online First Published 18 Aug 2026 Relevancy: 34%

Register studies (Wimberly et al ) reveal the long-lasting educational disadvantage of childhood epilepsy but unexpected sex differences indicate that the mechanisms require cautious interpretation. Commentary The Danish national cohort study of educational achievement in childhood-onset epilepsy, published in this edition, is an impressive and important contribution to the literature. Its scale is striking: more than 1.19 million individuals were included, of whom 11 760 developed epilepsy before the age of 15 years, with follow-up extending into adulthood. The linkage of multiple registers allows the authors to describe, at the population level, a pattern that clinicians, families and teachers have long recognised: children with epilepsy are at substantially increased risk of educational disadvantage. In this study, childhood-onset epilepsy was associated with higher odds of not completing primary school, lower grades in final mathematics and language examinations and markedly reduced attainment of higher educational qualifications by the age of 35 years. Only 9.3% of individuals...

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Epilepsy and education: a nationwide cohort study

Journal of Neurology, Neurosurgery & Psychiatry - Online First Published 18 Aug 2026 Relevancy: 39%

Background Childhood-onset epilepsy has been linked to poor school performance but limited evidence exists for long-term educational achievement. We examined educational achievement from adolescence into adulthood in individuals with childhood-onset epilepsy compared with the general population. Methods In this nationwide population-based cohort study using Danish registers, we included 1 195 138 individuals born between 1987 and 2005 and followed through 2023. Epilepsy before age 15 years was identified from hospital diagnoses and antiseizure medication prescriptions (n=11 758). Individuals with epilepsy were matched on sex and age to reference individuals without epilepsy, with additional propensity score matching on perinatal and parental factors. Outcomes included completion of primary school, ninth grade mean grades and attainment of higher educational levels. Adjusted ORs (aORs), mean grade differences and adjusted incidence rate ratios were estimated using multivariable regression models. Educational trajectories were assessed from age 15 to 35 years. Results Compared with reference individuals, those with epilepsy had higher odds of not completing primary school (aOR 3.0, 95% CI 2.8 to 3.1) and lower grades in mathematics (–0.9, 95% CI –0.9 to –0.8) and language (–0.6, 95% CI –0.6 to –0.5). Educational attainment rates were reduced by 50%–56% across all higher levels, and only 9.3% of individuals with epilepsy attained the highest educational level versus 19.5% of matched reference individuals by age 35 years. Conclusions Childhood-onset epilepsy was associated with significantly lower primary school completion rates, grades and long-term educational attainment. Targeted assessment of academic capacity, interventions and support are needed to optimise outcomes for young people with epilepsy.

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When Nausea and Vomiting Are Something Else Entirely, It's Not Gastroparesis: A Report of Two Cases

PubMed - functional neurological disorder AND differential diagnosis Published 16 Aug 2026 Relevancy: 75%

Gastroparesis, a chronic motility disorder, is a diagnosis of exclusion that necessitates careful evaluation for structural and surgically correctable causes. Although the medical differential diagnosis emphasizes functional etiologies, anatomic abnormalities are often under-recognized despite guideline recommendations for thorough endoscopic and structural assessment. Symptoms such as nausea, vomiting, early satiety, and delayed gastric emptying may be indistinguishable from true motility...

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Isolated orofacial dystonia and facial pain as the inaugural manifestation of anti-NMDAR encephalitis: a case report and literature review

PubMed - autoimmune encephalitis AND misdiagnosis Published 14 Aug 2026 Relevancy: 86%

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis typically presents with psychiatric symptoms, seizures, and cognitive dysfunction. Movement disorders, when present, usually coexist with these features. We report a rare case of anti-NMDAR encephalitis in a 30-year-old female who presented with isolated left temporomandibular joint (TMJ) dystonia, jaw tremor, and facial pain as the sole manifestations for seven months, without clinically significant psychiatric, cognitive, or seizure...

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