PATHOMORPHOSIS OF FOCAL EPILEPSY AND ITS NEUROPHYSIOLOGICAL CORRELATES
https://doi.org/10.17749/2077-8333.2018.10.1.006-013
Abstract
The specific EEG patterns in patients with epilepsy enable the objective assessment of changes in the brain function and, in conjunction with clinical data, determine the efficacy of treatment. Characteristics of the EEG spectral power have additional diagnostic values as they reflect the severity and spatial distribution of epileptiform activity. The standard EEG analysis combined with further mathematical processing helps reveal the neurophysiological markers of resistance to anti-epileptic drugs.
The aim is to identify the neurophysiological correlates of drug-resistance.
Materials and methods. We examined 160 patients with epilepsy: 80 with drug-resistant epilepsy (DRE) and 80 with controlled epilepsy (CE). The subjects underwent a number of neurophysiological studies (EEG, EEG-video monitoring) including the spectral power analysis.
Results. We established a correlation between the paroxysmal activity localization and drug-resistance. The secondary bilateral synchronization syndrome of different degrees of severity was found in the DRE group 1.91 times more often than in the CE group; this syndrome is seen as an unfavorable factor aggravating the course of epilepsy in the DRE patients. Using the spectral analysis we also found that patients with DRE differed from those with CE by the types of paroxysmal activity in the frontal-occipital areas. There, the involvement of diencephalic and mesencephalic structures in the paroxysms were similar in the DRE group, while only diencephalic structures played a significant role in the paroxysmal activity in CE patients.
Conclusion. Neurophysiological factors correlating with resistance to antiepileptic drugs in patients with epilepsy were identified. The results can be used for the timely diagnosis of pathomorphism of epilepsy and the choice of therapy.
About the Authors
N. A. Sivakova
St. Petersburg V.M. Bekhterev Psychoneurological Research Institute
Russian Federation
Russian Federation
MD, PhD, Researcher at the Department of Psychiatric Diseases and Epilepsy,
3 Bekhtereva Str., Sankt-Peterburg 192019
E. A. Korsakova
St. Petersburg V.M. Bekhterev Psychoneurological Research Institute
Russian Federation
Russian Federation
MD, PhD, Senior Researcher at the Department of Clinical and Laboratory Diagnostics, Neurophysiology and Neuroimaging Research,
3 Bekhtereva Str., Sankt-Peterburg 192019
L. V. Lipatova
St. Petersburg V.M. Bekhterev Psychoneurological Research Institute
Russian Federation
Russian Federation
MD, PhD, Chief Researcher, Head of the Department of Psychiatric Diseases and Epilepsy,
3 Bekhtereva Str., Sankt-Peterburg 192019
References
1. Mukhin K.Yu., Petrukhin A.S., Mironov M.B. Epileptic syndromes. Diagnosis and therapy. Reference guide for physicians [Epilepticheskie sindromy. Diagnostika i terapiya. Spravochnoe rukovodstvo dlya vrachei (in Russian)]. Moscow. 2008. 223 s.
2. Zenkov L.R. Functional diagnostics of nervous diseases: a Manual for doctors [Funktsional’naya diagnostika nervnykh boleznei: Rukovodstvo dlya vrachei (in Russian)]. Moscow. 1991; 640 s.
3. Sivakova N.A. Optimization of diagnosis and treatment of patients with pharmacoresistant epilepsy and nonpsychotic mental disorders. PhD diss. [Optimizatsiya diagnostiki i lecheniya bol’nykh s farmakorezistentnoi epilepsiei i nepsikhoticheskimi psikhicheskimi rasstroistvami: diss. …kand. med. nauk (in Russian)]. SPb. 2015.
4. Alikhanov A.A., Generalov V.O., Demushkina A.A., Perepelova E.M. Visualization of epileptogenic brain lesions in children [Vizualizatsiya epileptogennykh porazhenii mozga u detei (in Russian)]. Moscow. 2009; 272 s.
5. Lipatova L.V. Clinical and neuroimmune disorders, their pathogenetic role and importance for the diagnosis and treatment of epilepsy complicated by encephalopathy. Dr. diss. [Klinikoneiroimmunnye narusheniya, ikh patogeneticheskaya rol’ i znachenie dlya diagnostiki i lecheniya epilepsii, oslozhnennoi entsefalopatiei. Dis. … dokt. med. nauk (in Russian)] SPb. 2009.
6. Fedin A. I., Alikhanov A.A., Generalov V.O. Al’manakh Klinicheskoi meditsiny (in Russian). M. 2006; XIII: 159-169.
7. Gromov S.A., Sivakova N.A., Korsakova N.A., Kataeva M. F. Voprosy diagnostiki i farmakoterapii. Zh. Obozrenie psikhiatrii i meditsinskoi psikhologii (in Russian). 2017; 3: 24-40.
8. Karlov V.A. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova (in Russian). 2008; 108 (1): 75-81.
9. Korsakova E.A., Khorshev S.K., Foteev V.B. Method of diagnosis of various stages of epileptogenesis. RF patent for the invention № 2297791. Priority from 14.12.2004. [Sposob diagnostiki razlichnykh stadii epileptogeneza. Patent RF na izobretenie № 2297791. Prioritet ot 14.12.2004 (in Russian)]. 2007; 9 s.
10. Slezin V.B., Korsakova E.A., Khorshev S.K., Foteev V.B. Method of fractal analysis of EEG for diagnosis of different stages of epileptogenesis: guidelines. Psychoneurological research Institute of V.M. Bekhterev [Metod fraktal’nogo analiza EEG dlya diagnostiki raznykh stadii epileptogeneza: metodicheskie rekomendatsii. NIPNI im. V.M. Bekhtereva (in Russian)]. SPb. 2009.
11. Lipatova L.V., Korsakova E.A., Civakova N.A. The spectral characteristics of the EEG in patients with symptomatic temporal lobe epilepsy. Abstracts of the X all-Russian Congress of neurologists [Spektral’nye kharakteristiki EEG u bol’nykh simptomaticheskoi visochnoi epilepsiei. Tezisy dokladov X Vserossiiskii s”ezda nevrologov (in Russian)]. Nizhnii Novgorod. 17-21 iyunya 2012 g.; 286-287.
12. Zenkov L.R. Clinical electroencephalography with elements of epileptology [Klinicheskaya elektroentsefalografiya s elementami epileptologii (in Russian)]. Moscow. 2004; 368 s.
13. Tuckel K., Jasper H. The ECG in Parasagittal lesions. Electroencephalogram. Clin. Neurophysiol. 1952; 4: 481-494.
14. Fedin A. I., Generalov V.O., Amcheslavskaya E.V., Mishnyakova L.P., Sadykov T.R. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova (in Russian)]. 2008; 108 (2): 13-18.
15. Blume W. T., Pillay N. Electrographic and clinical correlates of secondary bilateral synchrony. J. Epilepsia. 1985; 26 (6): 636-641.
16. Rougier A., Claverie B., Pedespan J.M., Marchal C., Loiseau P. Callosotomy for intractable epilepsy: overall outcome. J. Neurosurg. Sci. 1997; 41 (1): 51-57.
17. Tinuper P., Cerullo A., Marini C., Avoni P., Rosati A., Riva R., Lugaresi E. Epileptic drop attacks in partial epilepsy: clinical features, evolution, and prognosis. J. Neurol. Neurosurg. Psychiatry. 1998; 64 (2): 231-237.
18. Belousova E.D., Ermakov A. Yu., Gorchkhanova Z.K., Kovalenko G. I. Farmateka. 2006; Special issue «Psikhiatriya/Nevrologiya» (in Russian): 2-6.
19. Gobbi G., Tassinari C., Roger J., Bureau M., Dravet C., Salas-Puig X. Particularites electro-encephalographiques des epilepsies partielles symptomatiques severes de l’enfant. Neurophysiologie Clinique/Clinical Neurophysiology. 1989; 19 (3): 209-218.
20. Tinuper P., Cerullo A., Riva R., Marini C., Provini F., Plazzi G., Lugaresi E. Clinical and EEG features of partial epilepsy with secondary bilateral synchrony. Journal of Epilepsy. 1995; 8 (3): 210-214.
21. Beaumanoir A., Mira L. Secondary bilateral synchrony: significant EEG pattern in frontal lobe seizures. Frontal Lobe Seizures and Epilepsies in Children. Ed. by. A. Beaumanoir, F. Andermann, P. Chauvel, L. Mira, B. Zifkin. France, Montrouge. 2003; 195-205.
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For citations:
Sivakova N.A., Korsakova E.A., Lipatova L.V. PATHOMORPHOSIS OF FOCAL EPILEPSY AND ITS NEUROPHYSIOLOGICAL CORRELATES. Epilepsy and paroxysmal conditions. 2018;10(1):6-13. (In Russ.) https://doi.org/10.17749/2077-8333.2018.10.1.006-013
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