Resolved epilepsy: an updated insight
https://doi.org/10.17749/2077-8333.2019.11.1.21-26
Abstract
Classification of epilepsy is of great importance at the stages of rehabilitation when the disease is considered resolved. This is the time to address various aspects of etiology, pathogenesis, compensation and resolution of epilepsy and to decide upon further medical care. Materials and methods. Here we review clinical-neurophysiological, experimentalpsychological, and neuroimaging results of anti-epileptic treatment and its discontinuation in seizure-free patients. We also discuss the adoption of the new international classification of ILAE 2017 in the domestic epileptology and analyze clinical cases of 270 patients with epilepsy who were in control of seizures for up to 8 years. Results. The study revealed the clinical, neuropsychological and neurophysiological signs of epilepsy regression in patients with long-term control of seizures. In 85% of these patients, seizures were under control; in 45% of them, the issue of “resolution of epilepsy” was a matter of discussion. In this regard, we address the timing and indications for the discontinuation of antiepileptic drugs. Conclusion. The prolonged absence of seizures is due to an inhibition of epileptic activity at the neuronal level with a gradual restoration of the antiepileptic system during 3-5 years of seizure-free period; this mechanism is reflected in the new classification. The data obtained in the present study support the decision of the Russian League against Epilepsy to introduce the new classification of epilepsy proposed by ILAE in 2017. The new term “resolved epilepsy” has been adopted for use in patients previously referred to as “practically recovered”.
About the Authors
S. A. Gromov
St. Petersburg V. M. Bekhterev Psychoneurological Research Institute
Russian Federation
Russian Federation
MD, PhD, DSc, Chief Researcher at the Department of Psychiatry and Epilepsy
Scopus ID: 7103322270
3 Bekhtereva Str., Sankt-Peterburg 192019, Russia
N. A. Sivakova
St. Petersburg V. M. Bekhterev Psychoneurological Research Institute
Russian Federation
Russian Federation
MD, PhD, Researcher at the Department of Psychiatry and Epilepsy
Scopus ID: 57188641933 Researcher ID: S-9587-2018
3 Bekhtereva Str., Sankt-Peterburg 192019, Russia
References
1. Avakyan G. N. The main milestones in the development of the International and Russian Antiepileptic League. Epilepsiya i paroksizmal’nye sostoyaniya / Epilepsy and paroxysmal conditions. 2010; 2 (1): 13-24. (In Russ.)
2. Avakyan G. N., Blinov D. V., Lebedeva A. V., Burd S. G., Avakyan G. G. ILAE Classification of the epilepsies: the 2017 revision and update. Epilepsiya i paroksizmal’nye sostoyaniya / Epilepsy and paroxysmal conditions. 2017; 9 (1): 6-25. (In Russ.) https://doi.org/10.17749/2077-8333.2017.9.1.006-025.
3. Avakyan G. N. Questions modern epileptology. Epilepsiya i paroksizmal’nye sostoyaniya / Epilepsy and paroxysmal conditions. 2015; 7 (4): 16-21. (In Russ.) DOI: 10.17749/2077-8333.2015.7.4.016-021.
4. Avakyan G. N. The main milestones in the development of the International and Russian Antiepileptic League. Epilepsiya i paroksizmal’nye sostoyaniya / Epilepsy and paroxysmal conditions. 2010; 2 (1): 13-24. (In Russ.)
5. Gromov S. A. Controlled epilepsy: clinic, diagnosis, treatment. SPb. 2004; 302 s. (In Russ.)
6. Avakyan G. N. Questions modern epileptology. Epilepsiya i paroksizmal’nye sostoyaniya / Epilepsy and paroxysmal conditions. 2015; 7 (4): 16-21. (In Russ.) DOI: 10.17749/2077-8333.2015.7.4.016-021.
7. Broun T. R., Xolms G. L. Epilepsy. Clinical guideline. Moscow. 2006; 288 s. (In Russ.)
8. Gromov S. A. Controlled epilepsy: clinic, diagnosis, treatment. SPb. 2004; 302 s. (In Russ.)
9. Gromov S. Classification of epilepsy remission. Epilepsie-BlatterKily. 1997; 10: 72-73.
10. Broun T. R., Xolms G. L. Epilepsy. Clinical guideline. Moscow. 2006; 288 s. (In Russ.)
11. Gromov S. A., Sivakova N. A., Korsakova E. A., Kataeva M. F. Epilepsy: classification of remission of seizures and disease, their clinical and psychological and neurophysiological rationale, the questions of diagnostics and pharmacotherapy. V. M. Bekhterev review of psychiatry and medical psychology. 2017; (3): 34-40 (In Russ.).
12. Gromov S. Classification of epilepsy remission. Epilepsie-BlatterKily. 1997; 10: 72-73.
13. Gromov S. A. Kissin M. Ya., Yakunina O. N., Eroshina E. S. Epilepsy, personality changes, treatment. SPb. 2006; 320 s. (In Russ.).
14. Gromov S. A., Sivakova N. A., Korsakova E. A., Kataeva M. F. Epilepsy: classification of remission of seizures and disease, their clinical and psychological and neurophysiological rationale, the questions of diagnostics and pharmacotherapy. V. M. Bekhterev review of psychiatry and medical psychology. 2017; (3): 34-40 (In Russ.).
15. Kazakovcev B. A. Mental disorders in epilepsy. Moscow. 1999; 419 s. (In Russ.).
16. Gromov S. A. Kissin M. Ya., Yakunina O. N., Eroshina E. S. Epilepsy, personality changes, treatment. SPb. 2006; 320 s. (In Russ.).
17. Gromov S. A. Controlled epilepsy: stages of epiactivity compensation and recovery issues. Epileptology in the system of neuroscience. Proceedings of the conference. Under the editorship of prof. G. Neznanov, prof. V. A. Mikhailov. SPb. 2015; 5-9. (In Russ.).
18. Kazakovcev B. A. Mental disorders in epilepsy. Moscow. 1999; 419 s. (In Russ.).
19. Zenkov L. R. Electroencephalography for epilepsy. Epilepsy. Under the editorship of N. G. Neznanov. SPb. 2010; 105-123. (In Russ.).
20. Gromov S. A. Controlled epilepsy: stages of epiactivity compensation and recovery issues. Epileptology in the system of neuroscience. Proceedings of the conference. Under the editorship of prof. G. Neznanov, prof. V. A. Mikhailov. SPb. 2015; 5-9. (In Russ.).
21. Karlov V. A. Pathophysiology of epilepsy. Epilepsy. Under the editorship of N. G. Neznanov. SPb. 2010; 105-123. (In Russ.).
22. Zenkov L. R. Electroencephalography for epilepsy. Epilepsy. Under the editorship of N. G. Neznanov. SPb. 2010; 105-123. (In Russ.).
23. Karlov V. A. Pharmacoresistance and tolerance. Epilepsy in children and adult women and men. A guide for doctors. Moscow. 2010; 667-676. (In Russ.).
24. Karlov V. A. Pathophysiology of epilepsy. Epilepsy. Under the editorship of N. G. Neznanov. SPb. 2010; 105-123. (In Russ.).
25. Karlov V. A. Paroxysmal brain: clinical and neurophysiological aspects. Epilepsiya i paroksizmal’nye sostoyaniya / Epilepsy and paroxysmal conditions. 2015; 7 (4): 13-15. (In Russ.).
26. Karlov V. A. Pharmacoresistance and tolerance. Epilepsy in children and adult women and men. A guide for doctors. Moscow. 2010; 667-676. (In Russ.).
27. Kryzhanovskij G. N. Determinant structures in the pathology of the nervous system. Moscow. 1997; 282 s. (In Russ.).
28. Karlov V. A. Paroxysmal brain: clinical and neurophysiological aspects. Epilepsiya i paroksizmal’nye sostoyaniya / Epilepsy and paroxysmal conditions. 2015; 7 (4): 13-15. (In Russ.).
29. Novikov A. E. Evolution in Clinical Epileptology. Ivanovo. 2006; 388 s. (In Russ.).
30. Kryzhanovskij G. N. Determinant structures in the pathology of the nervous system. Moscow. 1997; 282 s. (In Russ.).
31. Wolf P. Epileptic seizures and syndromes. London. 1994; 678 p.
32. Novikov A. E. Evolution in Clinical Epileptology. Ivanovo. 2006; 388 s. (In Russ.).
33. Gromov S. A., Lipatova L. V., Yakunina O. N., Sivakova N. A. The features of nonpsychotic mental disorders in patients with epilepsy in the initial period of the disease. V. M. Bekhterev review of psychiatry and medical psychology. 2018; (3): 22-31. (In Russ.) https://doi.org/10.31363/2313-7053-2018-3-22-31.
34. Wolf P. Epileptic seizures and syndromes. London. 1994; 678 p.
35. Gromov S. A., Lipatova L. V., Yakunina O. N., Sivakova N. A. The features of nonpsychotic mental disorders in patients with epilepsy in the initial period of the disease. V. M. Bekhterev review of psychiatry and medical psychology. 2018; (3): 22-31. (In Russ.) https://doi.org/10.31363/2313-7053-2018-3-22-31.
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Gromov S.A., Sivakova N.A. Resolved epilepsy: an updated insight. Epilepsy and paroxysmal conditions. 2019;11(1):21-26. (In Russ.) https://doi.org/10.17749/2077-8333.2019.11.1.21-26
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