epilepsiaEpilepsy and paroxysmal conditionsЭпилепсия и пароксизмальные состояния2077-83332311-4088IRBIS LLCepilepsia-259Research ArticleORIGINAL ARTICLESОРИГИНАЛЬНЫЕ СТАТЬИMULTIFOCAL EPILEPSY – VIEW OF MODERN NEUROPHYSIOLOGISTМУЛЬТИФОКАЛЬНАЯ ЭПИЛЕПСИЯ — ВЗГЛЯД СОВРЕМЕННОГО НЕЙРОФИЗИОЛОГАГенераловВ. О.GeneralovV. O.АвакянГ. Н.AvakyanG. N.СадыковТ. Р.SadykovT. R.КазаковаЮ. В.KazakovaYu. V.Центр внедрения передовых медицинских технологий «Планета Мед» (Москва)РоссияCenter of introduction of advanced medical technologies “Planeta Med” (Moscow)Russian FederationГБОУ ВПО Российский национальный исследовательский медицинский университет им. Н.И. Пирогова Минздравсоцразвития России (Москва)РоссияGBOU VPO Russian National Investigational Medical University” named after N.I. Pirogov, Ministry of Health and Social Development of the Russian Federation (Moscow)Russian Federation201203092016421320Copyright © Generalov V.O., Avakyan G.N., Sadykov T.R., Kazakova Y.V., 20162016Генералов В.О., Авакян Г.Н., Садыков Т.Р., Казакова Ю.В.Generalov V.O., Avakyan G.N., Sadykov T.R., Kazakova Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.epilepsia.su/jour/article/view/259

Data of own examinations and literature analysis regarding multifocal epilepsy are presented in the article. The analysis of etiology, clinical implications and prognostic factors of multifocal epilepsy of children and adults was done. It was discovered that the reasons of multifocal epilepsy in children are epileptic encephalopathies, genetic canalopathies and consequences of perinatal brain lesions. Formation of multifocal epilepsy in adults is associated with traumatic, ischemic and toxic factors, etc. Localization of epileptic sources is directly associated with zone of lesion: the source is located perifocally to zone of lesion in the structure or mediobasal temporal zones, that are more sensitive to diffusive effect of lesion (toxic and ischemic). More often localization of sources of epileptic activities in children is not associated with lesion character and zone. Multifocal epilepsy in children has very unfavorable prognosis, especially if caused by current pathological process (epileptic encephalopathy, neuroinfection). And on the contrary, multifocal epilepsy in adults is more successfully treated.

мультифокальная эпилепсияэпилептические энцефалопатиинелезиональная эпилепсиялезиональная эпилепсиявидео-энцефалографический мониторингmultifocal epilepsyepileptic encephalopathynonlesional epilepsylesional epilepsyvideoencephalographic monitoringReferencesАлиханов А.А., Петрухин А.С. Нейровизуализация при эпилепсии. М.: Леном. 2001; с. 238.Алиханов А.А., Петрухин А.С. Нейровизуализация при эпилепсии. М.: Леном. 2001; с. 238.Генералов В.О. Эпилепсия и структурные повреждения мозга. Автореферат дисс. д.м.н. - М. – 2010.Генералов В.О. Эпилепсия и структурные повреждения мозга. Автореферат дисс. д.м.н. - М. – 2010.Мишнякова Л.П. Клинико-нейрофизиологические исследования и методы нейровизуализации при эпилепсии в раннем и отдаленном периодах тяжелой черепно-мозговой травмы. Автореф. дисс. канд. мед. наук. М. 2008.Мишнякова Л.П. Клинико-нейрофизиологические исследования и методы нейровизуализации при эпилепсии в раннем и отдаленном периодах тяжелой черепно-мозговой травмы. Автореф. дисс. канд. мед. наук. М. 2008.Федин А.И. Генералов В.О. Мишнякова Л.П. Клиника эпилепсии в раннем и отдаленном периодах черепно-мозговой травмы. Вестник РГМУ. 2007; 6: 30-35.Федин А.И. Генералов В.О. Мишнякова Л.П. Клиника эпилепсии в раннем и отдаленном периодах черепно-мозговой травмы. Вестник РГМУ. 2007; 6: 30-35.Blume W.T. Clinical and electroencephalographic correlates of the multiple independent spike foci pattern in children. Ann Neurol. 1978; 4 (6): 541-7.Blume W.T. Clinical and electroencephalographic correlates of the multiple independent spike foci pattern in children. Ann Neurol. 1978; 4 (6): 541-7.Brouwer A.J., Groenendaal F., Koopman C. et al. Intracranial hemorrhage in full-term newborns: a hospital-based cohort study. Neuroradiology. 2010; 52 (6): 567-76.Brouwer A.J., Groenendaal F., Koopman C. et al. Intracranial hemorrhage in full-term newborns: a hospital-based cohort study. Neuroradiology. 2010; 52 (6): 567-76.Chepurnov S.A., Chernov Y.V., Chepurnona N.E et al. New synaptic contacts in a mirror epileptic focus of the rabbit amygdale. Nauchnye Doki Vyss Shkoly Biol Nauki. 1977; 11: 78-85.Chepurnov S.A., Chernov Y.V., Chepurnona N.E et al. New synaptic contacts in a mirror epileptic focus of the rabbit amygdale. Nauchnye Doki Vyss Shkoly Biol Nauki. 1977; 11: 78-85.Croucher M.J., Bradford H.F. NMDA receptor blockade inhibits glutamate-induced kindling of the rat mygdale. Brain Res. 1990; 506: 349-352.Croucher M.J., Bradford H.F. NMDA receptor blockade inhibits glutamate-induced kindling of the rat mygdale. Brain Res. 1990; 506: 349-352.Di Rocco C., Battaglia D., Pietrini D. et al. Hemimegalencephaly: clinical implications and surgical treatment. Childs Nerv Syst. 2006 Aug.; 22 (8): 852-66.Di Rocco C., Battaglia D., Pietrini D. et al. Hemimegalencephaly: clinical implications and surgical treatment. Childs Nerv Syst. 2006 Aug.; 22 (8): 852-66.Diaz-Arrastia R., Agostini M.A., Frol A.B. et al. Neurophysiologic and neuroradiologic features of intractable epilepsy after traumatic brain injury in adults. Arch Neurol. 2000; 57: 1611-1616.Diaz-Arrastia R., Agostini M.A., Frol A.B. et al. Neurophysiologic and neuroradiologic features of intractable epilepsy after traumatic brain injury in adults. Arch Neurol. 2000; 57: 1611-1616.Dragic S., Pavlovic V. Penicillin epilepsy in rats. Acta Medica Medianae. 2004; 43 (4): 19-23.Dragic S., Pavlovic V. Penicillin epilepsy in rats. Acta Medica Medianae. 2004; 43 (4): 19-23.Evans L.T., Morse R., Roberts D.W. Epilepsy surgery in tuberous sclerosis: a review. Neurosurg Focus. 2012 Mar.; 32 (3): p. 5.Evans L.T., Morse R., Roberts D.W. Epilepsy surgery in tuberous sclerosis: a review. Neurosurg Focus. 2012 Mar.; 32 (3): p. 5.Frey L.C. Epidemiology of posttraumatic epilepsy: a critical review. Epilepsia. 2003; 44: 10-17.Frey L.C. Epidemiology of posttraumatic epilepsy: a critical review. Epilepsia. 2003; 44: 10-17.Jiruška P, Prokš J, Otáhal J. et al. Motor correlates of models of secondary bilateral synchrony and multiple epileptic foci. Seizure. 2007; 16 (7): 627-635.Jiruška P, Prokš J, Otáhal J. et al. Motor correlates of models of secondary bilateral synchrony and multiple epileptic foci. Seizure. 2007; 16 (7): 627-635.Kabuto H., Yokoi I., Habu H. et al. Reduction in nitric oxide synthase activity with development of an epileptogenic focus induced by ferric chloride in the rat brain. Epilepsy Res. 1996; 25: 65–68.Kabuto H., Yokoi I., Habu H. et al. Reduction in nitric oxide synthase activity with development of an epileptogenic focus induced by ferric chloride in the rat brain. Epilepsy Res. 1996; 25: 65–68.Kawasaki M., Hernandez-Fustes O.J., Machado S. et al. Epilepsy and cerebral tumor. Rev Neurol. 1999 Jun.; 28 (11): 1047-1049.Kawasaki M., Hernandez-Fustes O.J., Machado S. et al. Epilepsy and cerebral tumor. Rev Neurol. 1999 Jun.; 28 (11): 1047-1049.Kroczka S., Skowronek-Bała B., Zajac A. Causes of symptomatic epilepsy in two first years of life children hospitalized in 2006- 2007 years. Przegl Lek. 2008; 65 (11): 745-50.Kroczka S., Skowronek-Bała B., Zajac A. Causes of symptomatic epilepsy in two first years of life children hospitalized in 2006- 2007 years. Przegl Lek. 2008; 65 (11): 745-50.Liigant A., Haldre S., Oun A. et al. Seizure disorders in patients with brain tumors. Eur. Neurol. 2001; 45 (1): P.46-51.Liigant A., Haldre S., Oun A. et al. Seizure disorders in patients with brain tumors. Eur. Neurol. 2001; 45 (1): P.46-51.Lüders H., Comair Y.G. Epilepsy surgery. Lippincott Williams & Wilkins. 2001; p.1060. 20. Martinez-Garcia F.A., Villaverde R., Salmeron P., Morales A., Molto J.M., Fernandez-Barreiro A. Late onset epileptic crisis and cerebrovascular disease. Neurol. 1998 Oct.; 27 (158): 671- 675.Lüders H., Comair Y.G. Epilepsy surgery. Lippincott Williams & Wilkins. 2001; p.1060. 20. Martinez-Garcia F.A., Villaverde R., Salmeron P., Morales A., Molto J.M., Fernandez-Barreiro A. Late onset epileptic crisis and cerebrovascular disease. Neurol. 1998 Oct.; 27 (158): 671- 675.Mutani R., Bergamini L., Fariello R. et al. Bilateral synchrony of epileptic discharge associated with chronic asymmetrical cortical foci. Electroencephalography and Clinical Neurophysiology. 1973 January; 34 (1): 53-59.Mutani R., Bergamini L., Fariello R. et al. Bilateral synchrony of epileptic discharge associated with chronic asymmetrical cortical foci. Electroencephalography and Clinical Neurophysiology. 1973 January; 34 (1): 53-59.Noachtar S, Rémi J. Epilepsy surgery. Nervenarzt. 2012 Feb.; 83 (2): 209-12.Noachtar S, Rémi J. Epilepsy surgery. Nervenarzt. 2012 Feb.; 83 (2): 209-12.Panayiotopoulos C.P. A clinical guide to epileptic syndromes and their treatment. Springer. 2007; p. 620.Panayiotopoulos C.P. A clinical guide to epileptic syndromes and their treatment. Springer. 2007; p. 620.Singh R., Pathak D.N. Lipid peroxidation and glutathione peroxidase, glutathione reductase, superoxide dismutase, catalase, and glucose-6-phosphate dehydrogenase activities in FeC13-induced epileptogenic foci in the rat brain. Epilepsia. 1990; 31: 15–26.Singh R., Pathak D.N. Lipid peroxidation and glutathione peroxidase, glutathione reductase, superoxide dismutase, catalase, and glucose-6-phosphate dehydrogenase activities in FeC13-induced epileptogenic foci in the rat brain. Epilepsia. 1990; 31: 15–26.Sun D.A., Sombati S., DeLorenzo R.J. Glutamate Injury–Induced Epileptogenesis in Hippocampal. Neurons Stroke. 2001: 32: 2344.Sun D.A., Sombati S., DeLorenzo R.J. Glutamate Injury–Induced Epileptogenesis in Hippocampal. Neurons Stroke. 2001: 32: 2344.Ueda Y., Willmore L.J. Sequential changes in glutamate transporter protein levels during Fe(3+)-induced epileptogenesis. Epilepsy Res. 2000; 39: 201-209.Ueda Y., Willmore L.J. Sequential changes in glutamate transporter protein levels during Fe(3+)-induced epileptogenesis. Epilepsy Res. 2000; 39: 201-209.Vale F.L., Pollock G., Benbadis S.R. Failed epilepsy surgery for mesial temporal lobe sclerosis: a review of the pathophysiology. Neurosurg Focus. 2012 Mar.; 32 (3): E9.Vale F.L., Pollock G., Benbadis S.R. Failed epilepsy surgery for mesial temporal lobe sclerosis: a review of the pathophysiology. Neurosurg Focus. 2012 Mar.; 32 (3): E9.Van Bogaert P. Epilepsy and perinatal anoxia-ischemia. Rev Med Brux. 1999 Jun.; 20 (3): 172.Van Bogaert P. Epilepsy and perinatal anoxia-ischemia. Rev Med Brux. 1999 Jun.; 20 (3): 172.Veatch L.M., Gonzalez L.P. Chronic ethanol retards kindling of hippocampal area CA3. Neuroreport. 1997; 8 (8): 1903-1906.Veatch L.M., Gonzalez L.P. Chronic ethanol retards kindling of hippocampal area CA3. Neuroreport. 1997; 8 (8): 1903-1906.Wiebe S. Epilepsy. Outcome patterns in epilepsy surgery--the long-term view. Nat Rev Neurol. 2012; 8 (3): 123-4.Wiebe S. Epilepsy. Outcome patterns in epilepsy surgery--the long-term view. Nat Rev Neurol. 2012; 8 (3): 123-4.Wilder B.J., Morrell F. Analysis of single cell activity in the mirror focus of the frog. Electroencephalogr Clin Neurophysiol. 1967 Jul.; 23 (1): 84.Wilder B.J., Morrell F. Analysis of single cell activity in the mirror focus of the frog. Electroencephalogr Clin Neurophysiol. 1967 Jul.; 23 (1): 84.Yates J.R., Maclean C., Higgins J.N. et al. The tuberous sclerosis 2000 study: presentation, initial assessments and implications for diagnosis and management. Arch Dis Child. 2011 Nov.; 96 (11): 1020-5.Yates J.R., Maclean C., Higgins J.N. et al. The tuberous sclerosis 2000 study: presentation, initial assessments and implications for diagnosis and management. Arch Dis Child. 2011 Nov.; 96 (11): 1020-5.

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