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Is it possible to predict the treatment efficacy in adult patients with focal epilepsy?

https://doi.org/10.17749/2077-8333.2019.11.4.312-320

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Abstract

The aim was to determine the factors impacting the treatment efficacy in patients with focal epilepsy.

Materials and methods. This was a prospective, comparative, observational study conducted in real clinical practice. We adhered to the following inclusion criteria: age over 18 years; history of two or more epileptic seizures with the focal onset; the presence of epileptic seizures at the time of the initial examination. The exclusion criteria were the history of nonepileptic seizures of any etiology and the inability to perform MRI and/or EEG. The primary and the follow-up examinations were separated by 3-12 months. Eighty three patients with focal epilepsy who met the inclusion criteria (37 men and 46 women aged 19 to 70 years) were examined. The examination included history taking, analysis of the seizure diary, clinical and neurological examination, routine EEG and/or EEG-video monitoring, brain MRI, laboratory tests. Therapy with antiepileptic drugs was maintained throughout the study period. All patients were followed-up for at least 1 year.

Results. Cessation of seizures was observed in 36.2% of patients and a >50% reduction in seizure frequency – in 32.5% of patients. The occurrence of side effects of antiepileptic drugs decreased from 56.6% to 26.5%.

Conclusion. The introduction into clinical practice of methods for assessing the factors impacting the treatment outcome in patients with focal epilepsy will allow for monitoring of the treatment efficacy and improve the patient quality of life.

The authors declare the absence of conflict of interest with respect to this publication. All authors contributed equally to this article.

About the Authors

K. V. Firsov
Moscow Regional Research and Clinical Institute (MONIKI)
Russian Federation
Konstantin V. Firsov – MD, PhD, Neurologist


M. G. Amirhanyan
Moscow Regional Research and Clinical Institute (MONIKI)
Russian Federation
Mhitar G. Amirhanyan – MD, Neurologist


A. S. Kotov
Moscow Regional Research and Clinical Institute (MONIKI)
Russian Federation
Aleksei S. Kotov – MD, PhD, Head of the Department of Neurology, Professor at the Department of Neurology


References

1. Fisher R. S., Cross J. H., French J. A., Higurashi N., Hirsch E., Jansen F. E., Lagae L., Moshé S. L., Peltola J., Roulet Perez E., Scheffer I. E., Zuberi, S. M. Operational classification of seizure types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017; https://doi.org/10.1111/epi.13670.

2. Scheffer I. E., Berkovic S., Capovilla G., Connolly M. B., French J., Guilhoto L., Hirsch E., Jain S., Mathern G. W., Moshé S. L., Nordli D. R., Perucca E., Tomson T., Wiebe S., Zhang Y.-H., Zuberi S. M. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017; https://doi.org/10.1111/epi.13709 1-3.

3. Avakyan G. N., Avakyan G. G. ILAE Classification of the epilepsies: the 2017 revision and update. Epilepsia i paroksizmalʹnye sostoania / Epilepsy and Paroxysmal Conditions. 2017; 9 (1): 6-25 (in Russ.). https://doi.org/10.17749/2077-8333.2017.9.1.006-025.

4. Kotov A. S. Compliance in patients with epilepsy. S.S. Korsakov Journal of Neurology and Psychiatry / Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova (in Russ.). 2010; 110 (11): 46-48.

5. Kotov A. S., Rudakova I. G., Belova Yu. A. Predictors of the effectiveness of treatment of symptomatic and cryptogenic partial epilepsy in adults. Almanac of clinical medicine. Al’manah klinicheskoj mediciny. 2006; XIII: 49-55 (in Russ.).

6. Kotov A. S. Predictors of pharmacoresistance of epilepsy in adults. Annals of clinical and experimental neurology. Annaly klinicheskoj i jeksperimental’noj nevrologii (in Russ.). 2012; 6 (1): 25-31.

7. Kotov A. S. Antiepileptic drugs and aggravation of seizures. Journal of neurology and psychiatry. S. S. Korsakov / Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova (in Russ.). 2014; 114 (11-2): 32-36.

8. Rudakova I. G., Kotov A. S., Belova Yu. a. the Use of generic drugs in the treatment of epilepsy on the example of Topiramate. Journal of neurology and psychiatry. S. S. Korsakov / Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova (in Russ.). 2011; 111 (3): 38-43.

9. Kotov A. S., Tolstova N. In. Provokers of seizures in adult patients with symptomatic and cryptogenic focal epilepsy. Clinical neurology / Klinicheskaja nevrologija (in Russ.). 2010; 1: 17-21.

10. Henning O., Alfstad K.A., Nakken K.O., Lossius M.I. A call for better information about epilepsy: The patients’ perspective-An online survey. Seizure. 2019 Apr 27; 69: 173-179. https://doi.org/10.1016/j.seizure.2019.04.015. [Epub ahead of print] PubMed PMID: 31054491.

11. Alshahrani A.M., Pathan A., Alruwais J.F., Alduhayshi A.M. Knowledge, attitude, and believes of epilepsy in local communities of Saudi Arabia. J Family Med Prim Care. 2019 Mar; 8 (3): 1065-1069. https://doi.org/10.4103/jfmpc.jfmpc_425_18. PubMed PMID: 31041252; PubMed Central PMCID: PMC6482760.

12. McKenney J.M., Slining J.M., Henderson H.R. et al. The effect of clinical pharmacy services on patients with essential hypertension. Circulation. 1973; 48: 1104-1111.

13. Urquhart J. Variable patient compliance in ambulatory trials – nuisance, threat, opportunity. J Antimicrob Chemother. 1993; 32: 643-649.


For citation:


Firsov K.V., Amirhanyan M.G., Kotov A.S. Is it possible to predict the treatment efficacy in adult patients with focal epilepsy? Epilepsy and paroxysmal conditions. 2019;11(4):312-320. (In Russ.) https://doi.org/10.17749/2077-8333.2019.11.4.312-320

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ISSN 2077-8333 (Print)
ISSN 2311-4088 (Online)