Neurology, Neuropsychiatry, Psychosomatics

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Vol 5, No 1S (2013): Special issue "Epilepsy"


4-6 540

Stroke is one of the chief cause adults epilepsy. Screening study was performed. Risk factors of early and late after stroke epileptic seizures was studied. It were included 300 patient with different types of stroke, et the age of 41–94. Data of medical history and brain imaging were studied. Results of research were showed: risk of early seizures increase by patients with hemorrhagic stroke, with heart embolic type of ischemic stroke, with combination of cardiac fibrillation and arterial hypertension, with long-term stroke preceded neurometabolic therapy, with diabetus mellitus.

7-11 683

Epilepsy associated with malformations of the cerebral cortex is reported in the literature to account for up to 25% of the total cases of symptomatic epilepsies. It is characterized by the most severe course and often induces drug-resistance in seizures. A group of patients with resistant seizures is singled out among the total number of patients with symptomatic epilepsy caused by cerebral cortical dysgenesis. The most important risk factors for resistance are identified in dysplasias. The prognostically unfavorable clinical features of epilepsy are described. A diagnostic algorithm is proposed to identify risk groups and to prevent drug-resistant forms of epilepsy.

12-19 614

The paper describes a trial dealing with the effect of the formulation of an antiepileptic drug on therapy efficiency, safety, and compliance in epileptic patients. Switching from sustained-release valproates to Depakine®Chronosphere™ demonstrates how the values of efficiency, safety, and compliance vary with the taken dosage form, which ultimately affects quality-of-life indicators and may give rise to their improvement.

19-23 1076

A study was conducted to investigate electroclinical features in patients with epilepsy and autism and to determine the efficiency of antiepileptic therapy. A group of 113 patients aged 8 months to 10 years with autistic disorders was followed up. All the patients were divided into 6 groups, 3 of which consisted of those with the so-called epiautism. Epileptiform activity on awakening was found in 113 (63%) patients, of them 45% had benign epileptiform discharges of childhood (BEDCs) recorded as epileptiform activity also during sleep in all the patients with epiautism. The epiactivity index substantially increased in 94% of the patients during sleep as compared on awakening. Sleep EEG recording in a total of 113 patients revealed epileptiform activity in 71%, of them BEDCs were recorded in 73%, which was 26% greater than that on awakening. There was a rise in the presentation of multiregional activity during sleep. Epileptiform activity was more common in the central and temporal leads. Valproate used alone and in combination with other drugs was a major component of therapy in the children followed up. Levetiracetam, etosuximide, and other antiepileptic medications were also used. After therapy optimization, the majority of patients showed reduced activity on EEG; however, abnormalities remained in the higher psychic sphere.

23-28 1087

Objective: to study the incidence, anamnestic, clinical, electroencephalographic, and neuroimaging features of epileptic syndromes associated with epileptic spasms (ES) and the efficiency of antiepileptic therapy in patients with these conditions.
Patients and methods. The study covered 1261 patients with epileptic seizures in the history with their onset from the first day of life to 18 years.
Results. A history of ES was recorded in 112 patients, which accounted for 8.9% of cases among all the forms of epilepsy with its onset less than 18 years of age. ES was detected in 47.1% of the patients with seizure onset in the first year of life. There was a slight male preponderance: 59 (52.7%) versus 53 (47.3%). Epilepsy with ES onset occurred in the first 6 months of life in 57.9% of cases. The West syndrome was found in 58.9% of the patients with ES-associated epilepsy, which amounted to 5.2% of all forms of epilepsy developing at the age of less than 18 years; Ohtahara syndrome in 32.1% (2.9% of all forms of epilepsy), early myoclonic encephalopathy in 0.9% (0.08%) and symptomatic focal epilepsy with periodic spasms in 8.1% (0.7% of all forms of epilepsy). Antiepileptic therapy led to complete remission in 45.5% of ES-associated epilepsy cases. There was a 50% or more reduction in the rate of seizures in 35.7% of the patients treated with antiepileptic drugs. No effect was seen in 18.8% of cases.

29-32 690

Tics are the most common forms of hyperkinesis among children and adolescents, the etiology of which is not fully clear. A study has shown a high comorbidity of tic disorders and epilepsy, as evidenced by video-EEG monitoring. In patients with tics even in the absence of epileptic seizures, epileptiform activity is an adverse predictor and a determinant of the potential risk of comorbid epilepsy especially during neuroleptic therapy. Antiepileptic drugs are the drugs of choice to treat this category of patients.

33-38 531

The complex mechanism of epileptogenesis has not been adequately explored. Perinatal brain pathology is one of the most important triggers of epilepsy in children. The paper gives data on the course and transformation of epileptic seizures in children who have verified perinatal problems. A study of 66 children with perinatally induced epileptic seizures has provided evidence for the evolution of impairments in cerebral hemodynamics and neuroimaging phenomena in the examined contingent of patients.

38-44 871

Objective: to obtain additional Russian data on the efficacy of Depakine®ChronosphereTMas a first-line agent for monotherapy in the treatment of adult epilepsy.
Patients and methods. The short-term open-label prospective observational study that maximally approximated to routine clinical practice was conducted. The follow-up of patients lasted 2 months. The study included 494 patients over 18 years of age (mean age 30.2±14.1 years) with different types of epilepsy. Symptomatic focal epilepsies were noted in 52% of all cases, presumably symptomatic and idiopathic generalized epilepsies in 16.8 and 29.8%, respectively; unspecified ones in 1.4% of cases. The patients received Depakine Chronosphere in an average daily dose of 18.58±5.53 mg/kg. The efficacy of the drug was evaluated from the change in the number of seizures; moreover, subjective assessments of therapeutic effectiveness were made by a physician and a patient. The safety was estimated from patients' reports on adverse reactions during the follow-up.
Results. More than 90% of all the patients responded to Depakine Chronosphere positively (seizures ceased or decreased in number). Seizures completely disappeared in 64.6% of the patients. The drug was proven to be effective in different types of epilepsy (both partial and generalized ones). Depakine Chronosphere was well tolerated in this study. Adverse events were observed in 15.7% of the patients, but they gave grounds to discontinue the drug only in 0.8% of all cases. The physicians and patients unanimously assessed the efficiency of therapy as very good and good in over 90% of cases. The good efficacy and tolerance of the agent are supported by the data of an analysis using the global clinical rating scale: during the treatment, there was a marked improvement and no side effects in 61.1% and a marked improvement and mild side effects in 17%.
Conclusion. The study has indicated that Depakine Chronosphere monotherapy for adult epilepsy is effective and safe and a promising treatment.

45-51 800

Impaired cognitive function is a common problem in epileptic patients. The exact cause of cognitive impairment in case of epilepsy has not been explored fully, but there is no doubt that a role in this is played by three factors: the disease underlying epilepsy; epileptic seizures proper; and negative side effects of antiepileptic drugs. Their cognitive effects are one of the major problems affecting the tolerance of therapy. The review considers the effects of phenobarbital, phenytoin, carbamazepine, valproates, oxcarbazepine, topiramate, lamotrigine, and levetiracetam in terms of their action on the cognitive function of healthy volunteers and epileptic patients.

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