epilepsiaEpilepsy and paroxysmal conditionsЭпилепсия и пароксизмальные состояния2077-83332311-4088IRBIS LLCepilepsia-45Research ArticleCLINICAL CASESКЛИНИЧЕСКИЕ СЛУЧАИSEIZURES AS THE DEBUT SYMPTOMS OF ACUTE PAEDIATRIC STROKEСУДОРОЖНЫЕ СОСТОЯНИЯ КАК ПРОЯВЛЕНИЕ ДЕБЮТА ОСТРЫХ НАРУШЕНИЙ МОЗГОВОГО КРОВООБРАЩЕНИЯ У ДЕТЕЙШалькевичЛ. В.ShalkevichL. V.ЛьвоваО. А.LvovaO. A.ДроньА. Н.DronA. N.Белорусская медицинская академия последипломного образования, МинскРоссияBelarusian Medical Academy of Postgraduate Education, MinskRussian FederationУральский государственный медицинский университет, ЕкатеринбургРоссияUral State Medical University, EkaterinburgRussian FederationТюменская государственная медицинская академия, ТюменьРоссияTyumen State Medical Academy, TyumenRussian Federation201402062016633037Copyright © Shalkevich L.V., Lvova O.A., Dron A.N., 20162016Шалькевич Л.В., Львова О.А., Дронь А.Н.Shalkevich L.V., Lvova O.A., Dron A.N.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/45

Abstract: the data about seizures as the clinical manifestation of acute stroke in childhood is generalized. Authors propose the following diagnostic criteria to determine seizures as the symptom of stroke vs epilepsy debut: stable neurological signs (more than 24 hours) during the postictal period; neuroimaging data, confirming the focus of stroke; congenital heart malformations or diseases; procoagulant or hemorrhagic predisposition confirmed due to laboratory data in children or in family history; hyperhomocysteinemia; thrombophilic genes polymorphisms (more than 3) in children or in family. Clinical case of 6 y.o. boy demonstrates the time lag before seizures debut and stroke verification as the reason for those seizures.

В статье рассматриваются дебют острых нарушений мозгового кровообращения у детей в виде судорожного синдрома. Предложены следующие критерии, позволяющие определить сосудистый генез впервые развившихся судорог: наличие стойких (более 24 ч) неврологических нарушений в постиктальном периоде; данные нейровизуализации, подтверждающие наличие очага острых нарушений мозгового кровообращения (ОНМК), наличие кардиальной патологии; результаты лабораторных методов исследования, свидетельствующие о прокоагулянтной настроенности или геморрагической предрасположенности, гемоконцентрация, гипергомоцистеинемия и пр.; носительство у ребенка и/или в семье комбинаций однонуклеотидных замен (более трех) в генах тромбофильного спектра; анамнестические данные, подтверждающие наличие протромботической или гемофильной настроенности в семье (наличие родственников с тромботическими/геморрагическими событиями, дебютировавшими в нетипичном возрасте – моложе 55 лет). На клиническом примере разбирается предложенная авторами схема дифференциальной диагностики дебюта эпилепсии и начала ОНМК с судорожного синдрома.

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The authors declare that there are no conflicts of interest present.