Epilepsy and paroxysmal conditions

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The incidence of epilepsy is highest in children and in elderly people (over 60 years of age). In about 75% of cases, the first seizures occur before the age of 16 with the maximal occurrence observed before the age of 10 [1]. The problems of diagnosis and treatment of epilepsy in patients of the “transitional” age – adolescents, as well as elderly people – need more attention because these two groups go through the most vulnerable periods of their lives, both psychologically and physiologically. These problems should be approached in the way specific for each age group. For example, there are difficulties in diagnosing a particular form of epilepsy in adolescents; therefore the diagnoses of “unspecified epilepsies” are made. In these cases, the use of wide spectrum antiepileptic agents is recommended. In elderly patients, we often see symptomatic forms of epilepsy in combination with a number of concomitant disorders. Given the age-related changes in pharmacokinetics of antiepileptic drugs, the treatment options for the elderly are quite limited. Here, the medical records of 420 patients (from 3 to 79 years old) diagnosed with various forms of epilepsy were studied. We were interested in patients with “unspecified” forms of epilepsy and the treatments they received. In 17% of cases, the form of epilepsy could not be identified. Levetiracetam and valproate were used most often; as a result of the therapeutic optimization, the volume of carbamazepine-based therapy declined. Among other agents, topiramate, zonisamide, lamotrigine and lacosamide were also in use. In 75% of the studied cases, the treatment with broad-spectrum drugs allowed to control seizures in patients with “unspecified” forms of epilepsy, which indicated the correct choice of therapy.

About the Authors

K. V. Voronkova
Russian National Research Medical University named after N. I. Pirogov, Health Ministry of Russian Federation
Russian Federation

MD, Professor of neurology, the Pirogov Russian National Research Medical University. Address: ul. Ostrovityanova, 1, Moscow, Russia, 117997 

N. A. Ermolenko
Voronezh’ Regional Children’s Clinical Hospital №1
Russian Federation

MD, Chief pediatric neurologist, the region of Voronezh, Head of the Department of neurology, Voronezh Regional Children’s Clinical Hospital №1. Address: ul. Burdenko, 1, Voronezh, Russia, 394024

D. I. Lebedeva
Tyumen State Medical University of the Ministry of Healthcare of the Russian Federation Regional Treatment and Rehabilitation Center
Russian Federation

PhD, Associate professor at the Department of outpatient and preventive medicine, the Tyumen State Medical University. Address: ul. Odesskaja, 54, Tyuman, Russia, 625023; Chief Physician at the Regional Treatment and Rehabilitation Center of Tyumen. Address: ul. Shchorsa, 11/2, Tyuman, Russia, 625048

A. S. Petrukhin
Russian National Research Medical University named after N. I. Pirogov, Health Ministry of Russian Federation
Russian Federation

MD, PhD, Professor of neurology, neurosurgery and medical genetics, the Pirogov Russian National Research Medical University. Address: ul. Ostrovityanova, 1, Moscow, Russia, 117997


1. Petrukhin A. S. Epileptology of childhood [Epileptologiya detskogo vozrasta (in Russian)]. Moscow. 2000; 622 s.

2. Aicardi J. Epilepsy in children. New York 1994; 555 p.

3. Smirnov V. M. Features of physiology in children [Osobennosti fiziologii u detei (in Russian)]. Moscow. 1993.

4. Obreimova N. I., Petrukhin A. S. Fundamentals of anatomy, physiology and hygiene of children and adolescents [Osnovy anatomii, fiziologii i gigieny detei i podrostkov (in Russian)]. Moscow. 2007; 384 s.

5. Voronkova K. V., Kholin A. A., Pylaeva O. A., Akhmedov T. M., Petrukhin A. S. Epilepsiya. (in Russian). 2010; 1: 3-8.

6. Panayiotopoulos C. P. A Clinical Guide to Epileptic Syndromes and their Treatment. Springer. 2010; 654 p.

7. Ermolenko N. A., Buchneva I. A., Ermakov A. Yu., Voronkova K. V., Zakharova E. I., Kalinkina T. A. Zhurnal nevrologii i psikhiatrii im S. S. Korsakova (in Russian). 2012; 6 (2): 12-17.

8. Genton P. et al. Valproic acid. Adverse effect in Antiepileptic Drugs. Fifth edition. Lippincott Williams & Wilkins. 2002; 837-851.

9. Morrell MJ, Montouris GD. Reproductive disturbances in patients with epilepsy. Cleve Clin J Med. 2004 Feb; 71 (2): 19-24.

10. Isojarvi J. I., Tapanainen J. S. Valproate, hyperandrogenism, and polycystic ovaries: a report of 3 cases. Arch Neurol. 2000 Jul; 5 7(7): 1064-8.

11. Voronkova K. V., Petrukhin A. S., Pylaeva O. A., Kholin A. S. Rational antiepileptic pharmacology. A guide for doctors [Ratsional’naya antiepilepticheskaya farmakologiya. Rukovodstvo dlya vrachei (in Russian)]. Moscow. 2008; 192 s.

12. Sauro K. M., Perucca E. Developing clinical practice guidelines for epilepsy: A report from the ILAE Epilepsy Guidelines Working Group. Epilepsia. 2015 Dec; 56 (12): 1859-69.

13. Malek N. et al. A review of medication adherence in people with epilepsy. Acta Neurol Scand. 2017; 135: 507-515.

14. Ermolenko N. A. Buchneva I. A. Epilepsiya. (in Russian). 2013; 2 (10): 3-8.

15. Kwan P., Brodie M. J. Effectiveness of first antiepileptic drug. Epilepsia. 2001; 42: 1255-60.

16. Benbadis S. R. The management of idiopathic generalized epilepsies. Acta Neurologica Scandinavica. 2005; 112: 63-67.

17. Vaz-Carneiro A. et al. Clinical comparability of the new antiepileptic drugs in refractory partial epilepsy: a systematic review and meta-analysis. Epilepsia. 2011; 52 (7): 1528-1167.

18. Hendry J. Seizure onset after age 60 years associated with increased risk of stroke. Lancet. 2004; 363: 1184-1186.

19. Karlov V. A. Epileptic status. Autoref .... MD. diss [Epilepticheskii status. Avtoref…. dokt. diss. (in Russian)]. Moscow. 1969.

20. Karlov V. A. Convulsive and non-convulsive status epilepticus [Sudorozhnyi i bessudorozhnyi epilepticheskii status (in Russian)]. Moscow. 2007; 81.

21. Benbadis Selim R. et al. Epilepsy and Seizures Treatment & Management. 2016.

22. Fedin A. I. (in Russian). 2015; 3 (18): 2-6.


For citations:

Voronkova K.V., Ermolenko N.A., Lebedeva D.I., Petrukhin A.S. TREATMENT OF EPILEPSY IN PATIENTS OF “VU LNERABLE” AGE: THE ADOLESCENTS AND THE ELDERLY. Epilepsy and paroxysmal conditions. 2017;9(3):32-38. (In Russ.)

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ISSN 2077-8333 (Print)
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