Preview

Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Some clinical and diagnostic features of patients with new-onset epilepsy in the presence of chronic cerebrovascular disease

https://doi.org/10.14412/2074-2711-2015-3-28-34

Full Text:

Abstract

Objective: to investigate the specific features of epilepsy that manifests itself in the presence of chronic cerebrovascular disease.

Patients and methods. A total of 304 patients (a study group of 174 patients with new-onset seizures developing in the presence of cerebrovascular disease and a control group of 130 patients with cerebrovascular disease and no seizures) were examined. They underwent clinical neurological examination, electroencephalography (EEG), ultrasonic duplex scanning of extra- and intracranial arteries with functional tests, and visualization of brain structures.

Results. Focal seizures were prevalent in the patients with cerebrovascular disease and epilepsy. It was found that there was a preponderance of left-sided localization of EEG foci of abnormal activity and a tendency to more commonly detect subcritical and critical stenoses in the left carotid bed in the patients with epileptic seizures. Diminished perfusion reserves in the posterior circulation system were more frequently observed in the patients with seizures in the presence of cardiovascular diseases. Moreover, the patients with seizures displayed a more profound degree of brain ischemia with the frequent cortical and subcortical localization of dyscirculatory foci. Thus, a study of perfusion reserves, localization of vascular foci, and degree of occlusive changes in the wall of brachiocephalic vessels allows identification of risk factors for epilepsy in the patients with cerebrovascular disease and promotes the prediction of the course of the disease.

About the Authors

D. R. Khasanova
Interregional Clinical and Diagnostic Center, Kazan State Medical University
Russian Federation
12a, Karbyshev St., Kazan 420101, Republic of Tatarstan


T. V. Danilova
Interregional Clinical and Diagnostic Center, Kazan State Medical University
Russian Federation
12a, Karbyshev St., Kazan 420101, Republic of Tatarstan


Z. K. Latypova
Interregional Clinical and Diagnostic Center, Kazan State Medical University
Russian Federation
12a, Karbyshev St., Kazan 420101, Republic of Tatarstan


References

1. Власов ПН, Шахабасова ЗС, Филатова НВ. Эпилепсия, впервые возникшая у пожилого пациента: диагностика, дифференциальная диагностика, терапия. Фарматека. 2010;(7):40-7. [Vlasov PN, Shakhabasova ZS, Filatova NV. Epilepsy, which first arose in an elderly patient: diagnosis, differential diagnosis, therapy. Farmateka. 2010;(7):40-7. (In Russ.)].

2. Карлов ВА. Эпилепсия. Москва: Медицина; 1990. 336 с. [Karlov VA. Epilepsiya [Epilepsy]. Moscow: Meditsina; 1990. 336 p.]

3. Квасов ВТ, Абдулина ОВ. Эпилепсия у пожилых. Клиническая геронтология. 2005;(8):31-6. [Kvasov VT, Abdulina OV. Epilepsy in elderly patients. Klinicheskaya gerontologiya. 2005;(8):31-6. (In Russ.)].

4. Hauser WA. Recent developments in the epidemiology of epilepsy. Acta Neurol Scand Suppl. 1995;162:17-21.

5. Гехт АБ, Лебедева АВ, Рулева ЗС и др. Эпилепсия у больных инсультом. Российский медицинский журнал. 2000;(2):14-7. [Gekht AB, Lebedeva AV, Ruleva ZS, et al. Epilepsy in patients with stroke. Rossiiskii meditsinskii zhurnal. 2000;(2):14-7. (In Russ.)].

6. Гехт АБ. Эпилепсия у пожилых. Журнал неврологии и психиатрии им. С.С. Корсакова. 2005;(11):66-7. [Gekht AB. Epilepsy in elderly patients. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2005;(11):66-7. (In Russ.)].

7. Генералов ВО, Федин АИ, Садыков ТР и др. Клинико-энцефалографический анализ парциальных вторично-генерализованных приступов. Эпилепсия: приложение к Журналу неврологии и психиатрии им. С.С. Корсакова. 2009;(11):65-8. [Generalov VO, Fedin AI, Sadykov TR, et al. Clinical and encephalographic analysis of partial secondary generalised seizures. Epilepsiya: prilozhenie k Zhurnalu nevrologii i psikhiatrii im. S.S. Korsakova. 2009;(11):65-8. (In Russ.)].

8. Bryniarska D, Zakrzewska E. Etiological spectrum of symptomatic epilepsy in adults. Przegl Lek. 2001;58(9):839-42.

9. Knake S, Rochon J, Fleischer S, et al. Status epilepticus after stroke in associated with increased long-term fatality. Epilepsia. 2006 Dec;47(12):2020-6.

10. Sander JW. The epidemiology of epilepsy revisited. Curr Opin Neurol. 2003 Apr;16(2):165-70.

11. Anisya-Vasanth AV, Satishchandra P, Nagaraja D, et al. Spectrum of epilepsy in tuberous sclerosis. Neurol India. 2004 Jun;52(2):210-2.

12. Fazekas F, Chawluk JB, Alavi A, et al. MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJR Am J Roentgenol. 1987 Aug;149(2):351-6.

13. Kapeller P, Barber R, Vermeulen RJ, et al. Visual Rating of Age-Related White Matter Changes on Magnetic Resonance Imaging: Scale Comparison, Interrater Agreement, and Correlations With Quantitative Measurements. Stroke. 2003 Feb;34(2):441-5.

14. Wahlund LO, Barkhof F, Fazekas F, et al. A New Rating Scale for Age-Related White Matter Changes Applicable to MRI and CT. Stroke. 2001 Jun;32(6):1318-22.

15. Белова ЮА, Котов СВ, Рудакова ИГ. Парциальная эпилепсия у больных пожилого возраста. Клиническая геронтология. 2010;(9-10):11-2. [Belova YuA, Kotov SV, Rudakova IG. Partial epilepsy in elderly patients. Klinicheskaya gerontologiya. 2010;(9-10):11-2. (In Russ.)].

16. Котов АС, Рудакова ИГ, Белова ЮА, Котов СВ. Затылочная эпилепсия у взрослых. Журнал неврологии и психиатрии им. С.С. Корсакова. 2009;(7):4-8. [Kotov AS, Rudakova IG, Belova YuA, Kotov SV. Occipital epilepsy in adults. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2009;(7):4-8. (In Russ.)].

17. Меликян ЭГ. Эпилепсия у больных пожилого возраста. Aвтореф. дис. канд. мед. наук . Москва; 2004. 23 с. [Melikyan EG. Epilepsy in elderly patients. autoref. diss. cand. med. sci . Moscow; 2004. 23 p.]

18. Сорокина НД, Селицкий ГВ, Косицын НС, Свинов ММ. Нейробиологические аспекты ишемии мозга и постинсультной эпилепсии. Журнал высшей нервной деятельности. 2002;52(6):656-64. [Sorokina ND, Selitskii GV, Kositsyn NS, Svinov MM. Neurobiological aspects of brain ischemia and post-stroke epilepsy. Zhurnal vysshei nervnoi deyatel'nosti. 2002;52(6):656-64. (In Russ.)].

19. Arboix A, Garcia-Eroles L, Massons JB, et al. Predictive factors of early seizures after acute cerebrovascular disease. Stroke. 1997 Aug;28(8):1590-4.

20. Kraus JA, Berlit P. Cerebral embolism and epileptic seizures – the role of the embolic source. Acta Neurol Scand. 1998 Mar;97(3):154-9.

21. Rumbach L, Sablot D, Berger E, et al. Status epilepticus in stroke. Report on a hospital-based stroke cohort. Neurology. 2000 Jan 25;54(2):350-4.

22. Зейналова СР. Особенности диагностики эпилепсии в современных условиях. Военно-медицинский журнал. 2003;(10):68-70. [Zeinalova SR. Features of diagnostics of epilepsy in modern conditions. Voenno-meditsinskii zhurnal. 2003;(10):68-70. (In Russ.)].

23. Burneo JG, Jette N, Theodore W, et al. Disparities in epilepsy: report of a systematic review by the North American Commission of the International League Against Epilepsy. Epilepsia. 2009 Oct;50(10):2285-95. doi: 10.1111/j.1528-1167.2009.02282.x. Epub 2009 Sep 3.

24. Hauser WA, Annegers JE, Kurland LT. Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota. Epilepsia. 1993 MayJun;34(3):453-68.

25. Jallon PM. Epilepsy in adults and elderly subjects. Epidemiological aspects, therapeutic strategies. Praxis (Bern 1994). 1994 Oct 4;83(40):1126-31.

26. Shorvon SD. The causes of epilepsy: changing concepts of etiology of epilepsy over the past 150 years. Epilepsia. 2011 Jun;52(6):1033-44. doi: 10.1111/j.1528-1167.2011.03051.x. Epub 2011 Apr 11.

27. Tallis R, Easter D, Craig I. Multicentre trial of valproate and phenytoin in the patients with newly diagnosed epilepsy. Age and Aging. 1994;(23):2-5.

28. Генералов ВО, Садыков ТР, Казакова ЮВ, Амчеславская ЕВ. Варианты генерализации эпилептических приступов при мезиальной височной эпилепсии у взрослых. Эпилепсия и пароксизмальные состояния. 2011;(3):6-14. [Generalov VO, Sadykov TR, Kazakova YuV, Amcheslavskaya EV. Variants of generalization of epileptic seizures in mesial temporal lobe epilepsy in adults. Epilepsiya i paroksizmal'nye sostoyaniya. 2011;(3):6-14. (In Russ.)].

29. Camilo O, Goldstein LB. Seizures and epilepsy after ischemic stroke. Stroke. 2004 Jul;35(7):1769-75. Epub 2004 May 27.

30. Карлов ВА. Развивающийся, инволюционирующий мозг, цереброваскулярные заболевания и эпилепсия. Журнал неврологии и психиатрии им. С.С. Корсакова. 2009;3:4-7. [Karlov VA. Evolving, involutionary brain, cerebrovascular diseases and epilepsy. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2009;3:4-7. (In Russ.)].

31. Barolin GS, Sherzer E. Epileptische Anfalle bei Apoplektikern. Wein Nervenh. 1962;(20):35-4714.

32. Giroud M, Gras P, Fayolle H, et al. Early seizures after acute stroke: a study of 1640 cases. Epilepsia. 1994 Sep-Oct;35(5):959-64.

33. Kilpatrick CJ, Davis SM, Tress BM, et al. Epileptic seizures in acute stroke. Arch Neurol. 1990 Feb;47(2):157-60.

34. Lami C, Domigo V, Semah F, et al. Early and late seizures after cryptogenic ischemic stroke in young adults. Neurology. 2003 Feb 11;60(3):400-4.

35. Lancman M, Golimstok A, Norscini J, Granillo R. Risk factors for developing seizures after a stroke. Epilepsia. 1993 Jan-Feb;34(1):141-3.

36. So EL. Symposium on the prognostic significance of interictal epileptiform discharges. J Clin Neurophysiol. 2010 Aug;27(4):227-8. doi: 10.1097/WNP.0b013e3181eaa60e.

37. Velioglu SK, Ozmenoglu M, Boz C, Alioglu Z. Status epilepticus after stroke. Stroke. 2001 May;32(5):1169-72.

38. Alberti A, Paciaroni M, Caso V, et al. Early seizures in patients with acute stroke: Frequency, predictive factors, and effect onclinical outcome. Vasc Health Risk Manag. 2008;4(3):715-20.

39. Gupta SR, Naheedy MH, Elias D, Rubino FA. Postinfarction seizures. A clinical study. Stroke. 1988 Dec;19(12):1477-81.

40. Reith J, Jorgensen HS, Nakayama H, et al.Seizures in acute stroke: predictors and prognostic significance. The Copenhagen Stroke Study. Stroke. 1997 Aug;28(8):1585-9.

41. Reuck J, Van Maele G. Acute ischemic stroke treatment and the occurrence of seizures. Clin Neurol Neurosurg. 2010 May;112(4):328-31. doi: 10.1016/j.clineuro.2010.01.004. Epub 2010 Feb 4.


For citation:


Khasanova D.R., Danilova T.V., Latypova Z.K. Some clinical and diagnostic features of patients with new-onset epilepsy in the presence of chronic cerebrovascular disease. Neurology, Neuropsychiatry, Psychosomatics. 2015;7(3):28-34. (In Russ.) https://doi.org/10.14412/2074-2711-2015-3-28-34

Views: 448


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)