Факторы эволюции генетических генерализованных эпилепсий

В статье проанализированы литературные данные, касающиеся клиники, генетических детерминант, прогноза и эволюции генетических генерализованных эпилепсий и характерных для них электроэнцефалографических коррелятов с целью определения негативных прогностических факторов. Приведены результаты исследований детской абсансной эпилепсии, юношеской миоклонической эпилепсии и эпилепсии с изолированными генерализованными тонико-клоническими приступами. Выявлены факторы, способствующие как более тяжелому течению и исходам данных форм заболевания, так и указывающие на ожидаемо более благоприятное развитие: такие как возраст дебюта, вид инициальной терапии, сроки до начала инициальной терапии и сроки до ответа на нее, когнитивный статус, комбинация приступов, патологические изменения электроэнцефалограммы, наличие неврологического дефицита. Проведенный анализ показал, что к факторам, достоверно ухудшающим прогноз, относятся наличие более одного типа приступов, отсроченный ответ на стартовую терапию, политерапия и сопутствующие когнитивные нарушения.

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