Посттравматическая эпилепсия: клинические, диагностические и терапевтические особенности

Согласно статистике на начало 2019 г. черепно-мозговые травмы (ЧМТ) являются наиболее распространенным видом травм и одной из главных причин инвалидизации в России. Ежегодно во всем в мире 200 человек из 10 тыс. получают серьезные травмы головного мозга. Тяжелая ЧМТ может приводить к длительной инвалидности. Посттравматическая эпилепсия (ПТЭ) является одним из наиболее драматичных последствий ЧМТ, частота которого по различным оценкам колеблется от 2% до 50% в зависимости от тяжести травмы. Исследование ПТЭ затруднительно ввиду того, что в ряде случаев может пройти более 10 лет после повреждения, прежде чем начнутся приступы, а у многих пациентов с ЧМТ в анамнезе эпилепсия не развивается вовсе.

В данном обзоре, включающем результаты наших исследований, а также исследований, проведенных российскими и зарубежными коллегами в течение последних лет (приоритетными являлись научные публикации за период 2017– 2021 гг.), осуществлен анализ и обобщение известных на сегодняшний день факторов риска, клинических и диагностических особенностей ПТЭ с целью повышения осведомленности врачей о современных методах лабораторной и инструментальной диагностики данного заболевания (включая электроэнцефалографию и рутинные/специальные методики нейровизуализации, с помощью которых возможна идентификация биомаркеров ПТЭ), а также данных о потенциальных разработке и внедрении в практику профилактических стратегий ведения пациентов. Доказано, что в настоящее время не существует четких алгоритмов превентивной диагностики и лечения ПТЭ, что зачастую приводит к недостаточной помощи пострадавшим.

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