Background. Pharmacotherapy of secondary metabolic syndrome (MetS) induced by antiepileptic drugs (AEDs) remains unresolved issue in epileptology. The mechanisms of development and incidence of metabolic disorders (changes in eating behavior, weight gain, lipid and carbohydrate metabolism disturbances, etc.) in patients with epilepsy taking AEDs long-term remain poorly understood. AED-induced MetS (AED-MetS) impairs quality of life and reduces life expectancy in patients with epilepsy, increasing the risk of cardiovascular disease, type 2 diabetes mellitus, and abdominal obesity.

Objective: To investigate incidence of metabolic disorders induced by long-term use of AEDs of various generations in monotherapy and polytherapy regimens in adult patients with epilepsy.

Material and Methods. A pilot, single-center, open-label, observational, clinical, cross-sectional, comparative study was conducted in patients with epilepsy taking valproic acid (VPA), lamotrigine (LTG), and levetiracetam (LEV). The total sample consisted of 60 participants, including 45 patients with epilepsy (study group) and 15 clinically healthy volunteers (control group). Patients in main group were divided into subgroups based on the prescribed AED. The mean age of the participants was 37.5±12.6 years. The scope of the research included a clinical somatic and neurological examination, anthropometry (height, weight, waist and hip circumferencеs), a pharmacological history, as well as clinical and biochemical blood tests (serum biomarker analysis, AED-MetS).

Results. It was found that AED-MetS anthropometric biomarkers peaked for body mass index (p=0.015), waist circumference (p=0.048), and hip circumference (p=0.024), which were significantly higher in the VPA subgroup compared to control group. In contrast, no such changes were observed in LTG and LEV subgroups when compared to control group (p>0.05). Abdominal fat distribution was significantly more common in VPA subgroup compared to newer-generation AEDs (LTG and LEV) and control group. C-reactive protein with significantly higher level in VPA subgroup (p=0.02) was most sensitive laboratory biomarker for AED-MetS, confirming the role for AED-induced systemic inflammation in developing metabolic disorders.

Conclusion. The prevalence of the examined AED-induced metabolic disorders was higher in patients receiving VPA vs. LTG and LEV. However, AED-MetS laboratory (biochemical) biomarkers excepting C-reactive protein, had no clinical significance. Thus, it may account for a need to search for new specific and sensitive AED-MetS biomarkers to be introduced in real-world clinical practice.

Background. Recently, patients with comorbid conditions such as epilepsy and dissociative (psychogenic non-epileptic) seizures have been increasingly identified in clinical practice. No generally accepted diagnostic algorithms for confirming such conditions are currently available. However, it is known that patients with epilepsy and comorbid pathology have certain personality characteristics, for identifying which an experimental psychological examination is conducted, which uses multidimensional personality questionnaires. Among them, the Minnesota Multiphasic Personality Inventory (MMPI) is most widespread, adapted by L.N. Sobchik (2007) as a standardized multifactorial personality study.

Objective: To examine the personality pattern in patients with epilepsy and comorbid dissociative disorders.

Material and methods. The study included 54 patients with epilepsy, 27 of them with comorbid dissociative disorders (ED group) in the form of psychogenic non-epileptic seizures, and 27 respondents with exclusively epileptic seizures (E group). All study participants underwent clinical and psychological examinations using MMPI.

Results. Patients in ED vs. E group had a higher level of hypochondria score points (74.96 vs 65.23 points; p=0.012). According to the results of the assessment by the scale of anxiety and depression, the average score in ED group was lower than in E group (64.26 vs 75.77 points; p=0.001). According to the hysteria scale, patients in ED group had a higher average score compared with E group (73.26 vs 64.08 points; p=0.014).

Conclusion. Patients with epilepsy and comorbid dissociative disorders have higher levels of hypochondria, hysteria, as well as low levels of anxiety and depression, compared with patients without conversion disorders. The results obtained correspond to the “conversion five” and characterize the personality pattern observed in such patients.

Background. Due to the high prevalence of autism spectrum disorders (ASD) and the dependence of prognosis on intervention time, the development of factor models for autistic symptoms in preschool childhood is an urgent area of research. Comparing autism symptoms multifactorial models obtained using structural equation modeling for preschoolers with autism of different age groups is valuable because it provides information that cannot be covered by studying a single age group.

Objective: To compare the factor patterns for ASD symptoms in children aged 3–4 and 5–7 years to identify autism development trajectories.

Material and methods. Since autism symptoms pattern changes as children develop, comparing factor models allows to identify age-related indicators and use more accurate diagnostic criteria adapted to each age group for improving sensitivity and specificity of early autism diagnosis and optimize corrective interventions. Within the years 2023–2024, 7-factor and 8-factor models for autism symptoms, respectively, were obtained in 3–4-year-old (n=294) and 5–6-year-old (n=374) ASD children. The data in both studies were collected by specialists who worked with the patients on a regular basis by filling out the online questionnaires.

Results. When comparing two autism factor models, it was found that the identified factor pattern, which includes three groups of symptoms for young children, was dramatically changed in older children. With age, the relationship between specific symptoms and the underlying factors has significantly increased and become more complex. For younger children, the identified 7-factor pattern consists of three unrelated groups of symptoms: communication problems (including factors such as emotional dysregulation, speech understanding, echolalia, alienation), persistence on sameness with sensory disintegration and hyperactivity/disinhibition. For older children, the 8-factor pattern has developed into three other groups of relatively independent but related symptoms: the verbal group (including factors of speech understanding and empathy), praxis disorders (including factors such as hyperactivity, emotional dysregulation, motor disorders) and sensory disintegration (including factors such as persistence on sameness, sensory disintegration and echolalia).

Conclusion. Speech and motor development are two lead symptoms that deserve special attention from specialists. By understanding how the pattern of ASD symptoms and factor load change throughout preschool age, researchers can improve existing diagnostic tools to increase their accuracy and effectiveness in detecting autism at different ages and develop targeted intervention strategies.

The article systematizes data on rare levetiracetam-related adverse events that go beyond the approved data provided in package insert. The key factor in selecting an antiepileptic drug is the risk-benefit ratio, which is largely determined by the knowledge of all potential adverse effects. This review aims to increase awareness of adverse reactions to levetiracetam in patients with epilepsy. Further research is needed to explore the pathogenetic mechanisms and identify risk factors of adverse effects for better understanding of the drug safety profile.

A substantial amount of progress has been made in the field of neurohumoral transmission, which has led to the disclosure of precise details regarding the communication mechanisms that occur within the neurological system. This review article gives an extensive analysis of neurohumoral transmission, focusing on the evolving concept of co-transmission and its implications for understanding psychiatric disorders in adolescents. It first provides details on classical neurotransmitters: acetylcholine, serotonin, dopamine, glutamate, and gamma-aminobutyric acid and their role in neuronal communication. Recent research findings have shown that many neurons have the ability to simultaneously release one or more than one neurotransmitter, a phenomenon termed as co-transmission and seem to add complexity to how signals are processed through the nervous system. This phenomenon raises important implications in adolescent psychiatric disorders such as depression, anxiety, schizophrenia, attention deficit hyperactivity disorder, and autism spectrum disorder, which inevitably worsen during this stage of critical development. Recent findings suggest that diminished neurotransmitter co-transmission in certain regions, such as the prefrontal cortex, might be associated with some of these impaired cognitive and emotional regulatory processes. Understanding these complex mechanisms might provide insights into the development of effective treatments targeting several neurotransmitter systems simultaneously-especially during adolescence, when the brain is particularly sensitive to chemical interactions. This review integrates recent findings into a discussion on their implications for treatment strategies, and it hints at new pharmacological interventions directed at modulating co-transmission pathways that can enhance mental health outcomes in adolescents.

This literature review focuses on studying reflex epilepsy: a group of epileptic syndromes characterized by seizures triggered by specific external stimuli. Current scientific publications assessing the mechanisms underlying formation, clinical manifestations, and approaches to treat various subtypes of reflex epilepsy were analyzed. The domestic and foreign publications containing up-to-date information on reflex (stimulus-sensitive) epilepsy and its subtypes were investigated. The literature search was conducted in the PubMed/MEDLINE, Cochrane Library, eLibrary and CyberLeninka databases. The main types of reflex epilepsy, including photosensitive, praxis-induced, musicogenic, bathing epilepsy, etc, were detailed. Of special attention were clinical features and therapeutic approaches. Shedding light on reflex epilepsies is crucial for increasing effectiveness of medical care and improving patients’quality of life.

Mesial temporal lobe epilepsy (MTLE) is a severe form of focal epilepsy, often therapy-resistant, resulting from a long-term epileptogenesis. This clinical lecture examines the key early provoking factors of MTLE development: prolonged febrile seizures in childhood, neuroinfections, perinatal hypoxia, and traumatic brain injuries. The universal pathophysiological mechanisms triggered by these factors are analyzed in detail: excitotoxicity, neuroinflammation, blood-brain barrier disruption, aberrant neurogenesis, synaptic reorganization, and the central role of mammalian target of rapamycin (mTOR) signaling pathway hyperactivation. MTLE pathogenesis is explained from the perspective of the “dual/multiple hit” model, according to which the cumulative impact of several injuries leads to the depletion of the hippocampal compensatory capabilities and the formation of hippocampal sclerosis. The importance of comprehensive diagnosis, including detailed history collection, magnetic resonance imaging according to epileptology protocol, and the search for biomarkers is emphasized. Treatment prospects are related to shifting focus towards predictive and preventive therapy targeting key molecular pathways (pro-inflammatory cytokines, mTOR signaling), paving the way for personalized disease management.

Modern telecommunication solutions have been gradually penetrating the medical field. For example, in the field of electroencephalography (EEG), cloud-based databases remotely accessing to examination data have recently become widespread. Given the shortage of qualified specialists, especially in small Russian cities, the ability to remotely interpret EEG examinations opens up new opportunities for providing highly qualified medical care to the population. Telemedicine technologies are gradually moving beyond simple teleconsultations. Wearable medical devices for home use are emerging, taking many diagnostic methods, including video-EEG monitoring, to a new level, increasing the availability of diagnostic methods, and developing screening methods, thereby improving the overall accessibility and quality of medical care. This article provides an overview of modern capabilities for cloud storage and remote access to EEG examination data.