Objective This study aimed to investigate the status of sleep disorders and comorbidity profiles in patients with newly diagnosed epilepsy, to inform early intervention strategies. Methods This single-center retrospective study enrolled 24 newly diagnosed epilepsy patients and 28 healthy controls from the Department of Neurology, The First Affiliated Hospital of Soochow University, between April and October 2025. Sleep quality, daytime sleepiness, mood, and cognitive function were assessed using the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, Beck Anxiety Inventory, Beck Depression Inventory-II, and Mini-Mental State Examination, respectively. Intergroup comparisons were conducted for all measures. Results The incidence of sleep disturbance (PSQI>5) was 79.2% in the epilepsy group, significantly higher than the 46.4% observed in the control group, with a statistically significant difference (P<0.05). The epilepsy group demonstrated significantly higher PSQI component scores than the control group in domains of sleep continuity, sleep disturbances, and daytime dysfunction (all P<0.05), reflecting issues with nocturnal sleep fragmentation and daytime impairment. We observed no statistically significant differences between the groups in anxiety, depression, daytime sleepiness, or cognitive function (all P>0.05). Conclusion Newly diagnosed and drug-naive epilepsy patients exhibit significant sleep disturbances, characterized by poor sleep continuity, disrupted sleep architecture, and daytime dysfunction, which appear independent of mood comorbidities.
Seizure clusters, a severe form of epilepsy requiring urgent intervention, are challenging to manage in out-of-hospital settings due to limitations of traditional benzodiazepine administration routes. Diazepam nasal spray (DZP-NS), a novel intranasal formulation, achieves rapid absorption through the nasal mucosa, bypassing first-pass metabolism, with bioavailability comparable to rectal gel and faster onset. Clinical studies demonstrate its high efficacy in treating seizure clusters and prolonged seizures (≥5 minutes), with an initial control rate of 87.4% and low second-dose utilization (12.6%). No severe adverse reactions, such as cardiorespiratory depression, were observed. Long-term use (12 months) showed no tolerance development, significantly extending seizure intervals (SEIVAL) (from 12.2 to 25.7 days) and improving quality of life scores, particularly in "epilepsy-related concerns" and "social functioning" domains. The non-invasive delivery method was favored by over 80% of patients and healthcare providers for its convenience compared to rectal administration. Subgroup analyses confirmed consistent safety and efficacy across genders, ages, concomitant medications (including cannabidiol), and patients with allergy histories. In conclusion, DZP-NS provides an efficient, safe, and socially accepted out-of-hospital rescue therapy for seizure clusters, positioning it as a potential cornerstone in standardized epilepsy emergency care.
Objective To preliminarily analyse the phenomenon of the first seizure in patients with epilepsy while driving a motor vehicle, and discuss its harms and possible coping strategies. Methods The first seizure while driving a motor vehicle was investigated among epilepsy patients who attended the First Affiliated Hospital of Soochow University from June 2020 to March 2023. Results A total of five patients had their first seizure while driving a motor vehicle, all causing traffic accidents. One patient had a generalized tonic-clonic seizure with a first epileptic seizure, two had focal seizures with impaired consciousness that progressed to generalized seizures, and two had focal seizures with impaired awareness. One of the patients caused a fatal traffic accident, leading to the death of another person who riding the electric bicycle. In this case, the patient's driving license was revoked. The other four patients continued to drive after the first seizure. One patient terminated driving 5 months after the diagnosis of epilepsy. Two patients drove less since then, and one patient continued driving as before. Two patients experienced seizures again while driving, and one of them coincidentally had his second seizure while driving. Conclusions The first seizure while driving may not be uncommon, reflecting the severity of epilepsy and driving, in which traffic accidents can be fatal. People with epilepsy are currently prohibited from driving in China. After the first seizure, patients should immediately stop driving and go to see an epileptologist, avoiding further endangering themselves and the public.