Epilepsy & Behavior is introducing an editorial policy encouraging authors to move away from the use of the term "intelligence" in neuropsychological discussions of epilepsy. This recommendation is informed by the historical association of intelligence testing with eugenicist practices directed toward people with epilepsy, as well as by advances in contemporary cognitive science demonstrating that cognition is multidimensional and domain specific and that no universally accepted scientific definition of intelligence exists. Modern frameworks provide more clinically useful characterization of memory, language, executive functioning, attention, and processing speed than global IQ constructs. In clinical settings, domain specific language may also reduce unintended stigma by emphasizing measurable cognitive performance rather than fixed biological attributes. Building on prior calls within neuropsychology to retire IQ terminology and paralleling successful terminology reforms in epilepsy internationally, Epilepsy & Behavior calls for the use of more precise terminology, including cognitive composites, domain specific cognitive descriptors, and other empirically defined measures of cognitive performance rather than labels implying a unitary construct of intelligence.

Epilepsy is a common neurological disorder in the United States that disproportionately affects African Americans. Religious and spiritual practices are important coping mechanisms that may influence health beliefs and healthcare decisions, yet their influence on epilepsy outcomes in this population remains understudied. This narrative review examines how religious and spiritual practices contribute to health decision making behaviors among African Americans living with epilepsy. A literature search was conducted using PubMed, Google Scholar, Connected Papers, and the New York University Library system, focusing on religiosity and spirituality in chronic illness, epilepsy outcomes, racial disparities, stigma in faith-based settings, and church-based health interventions. Across the reviewed literature, findings showed that religiosity and spirituality were associated with coping, finding purpose, social support, and quality of life. In epilepsy-specific studies, positive religious and spiritual coping associated with better well-being, lower anxiety and depressive symptoms, and higher quality of life, while negative religious coping was associated with poorer psychosocial outcomes. Direct evidence among African Americans with epilepsy was limited; however, available findings suggest that Black patients relied more on religion, emotional support, positive reframing, and denial as coping strategies compared to White patients. Overall, this review highlights the need to better understand how African Americans with epilepsy use religious and spiritual frameworks to manage living with a chronic neurological condition.

Convulsive status epilepticus (CSE) is a time-sensitive neurological emergency in which delayed treatment may contribute to pharmacoresistance and poor outcomes. Evidence comparing third-line antiseizure medications in children remains limited. Objective To compare intravenous lacosamide and phenytoin in pediatric refractory CSE and to determine whether treatment timing predicts seizure cessation. Methods This prospective observational cohort study included 100 children aged 1 month-16 years with refractory CSE treated with intravenous lacosamide (n = 46) or phenytoin (n = 54) after failure of benzodiazepines and levetiracetam. The primary objective was to evaluate the effect of treatment delay on seizure cessation. Secondary outcomes included treatment response, electroencephalographic findings, cardiac safety, and predictors of treatment failure. Results Seizure cessation was achieved in 56% of patients and did not differ significantly between lacosamide and phenytoin (60.9% vs. 51.9%, p = 0.365). Treatment delay was the strongest independent predictor of failure; each additional hour from seizure onset to treatment initiation increased the odds of failure by 11% (adjusted OR 1.11, 95% CI 1.03-1.19; p = 0.005). Greater baseline antiseizure medication burden was also independently associated with treatment failure (adjusted OR 2.10, 95% CI 1.05-4.17; p = 0.035). Persistent epileptiform activity on 24-hour EEG was significantly associated with poor outcome (p < 0.001). Both medications were well tolerated. Conclusions Lacosamide and phenytoin demonstrated comparable efficacy and safety. Treatment timing, rather than drug selection, was the principal determinant of seizure cessation, emphasizing the importance of rapid escalation of therapy in pediatric refractory CSE.