Container metaphor and the cognitive conventionalization of residential naming: a diachronic corpus study of the [X + Li] construction in Chinese.

Epilepsy represents one of the most prevalent neurological conditions in Germany, affecting approximately 1% of the population. Despite the availability of numerous newer therapeutic options, approximately 30 to 40% of patients have a drug-resistant epilepsy (). For this cohort, specialized evaluation at a tertiary epilepsy center is the established standard of care to explore surgical or advanced pharmacological interventions. However, historical data suggests that many patients face significant delays before accessing these centers, often remaining in secondary care for years despite persisting seizures (). In the German healthcare system, the outpatient sector serves as the primary gateway for longitudinal epilepsy management. Care is structured through a delegated model in which office-based neurologists and general practitioners provide the majority of long-term treatment, while hospital-based specialists contribute expertise in cases of drug-resistant epilepsy. The successful implementation of evidence-based guidelines therefore depends on effective coordination across sectors, particularly for therapies requiring prolonged titration, rational polytherapy, and close monitoring of drug interactions. When this coordination is inconsistent, maintaining guideline-concordant care in routine practice becomes more challenging, especially for patients with therapy-resistant or multi-morbid profiles. In this context, patient outcomes are shaped not only by the availability of pharmacological options, but also by the continuity and integration of the care framework (). We integrated external morbidity data from the BARMER Institute for Health Systems Research (bifg, 2023) to provide a closer look at patient care in epilepsy on a regional level. These data reveal that the Federal State of Saxony occupies a unique position in the German healthcare landscape. While the national average prevalence for epilepsy is 12.87 per 1,000 inhabitants, Saxony reports a significantly higher rate of 17.07 per 1,000 and ranks among the federal states with the highest epilepsy associated morbidity burdens. In addition to the elevated prevalence, BARMER 2023 data indicate that Saxony is also characterized by a higher-than-average medication burden per affected person, reflected in increased Defined Daily Dose (DDD) exposure and a greater diversity of prescribed active substances compared to the national mean. The elevations above the federal baseline makes the identification of structural treatment gaps a matter of significant public health urgency and suggest that epilepsy care in Saxony has not only one of the highest medication burdens but is also pharmacologically complex at the patient level This complexity is highly relevant to clinical outcomes, as the International League Against Epilepsy (ILAE), defines drug resistant epilepsy as the failure of two appropriately chosen and tolerated ASMs ().