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Epilepsy and paroxysmal conditions

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"Epilepsy and paroxysmal conditions" is a scientific and practical peer-reviewed journal for medical professionals. Our aims and priorities include scientific and information support to the members of the "professional community" in their pursuit of new ideas in epilepsy research. The "Epilepsy and paroxysmal Conditions" journal is proud to contribute to the continuing medical education (CME) of recent medical graduates and other experts in neurology and related fields. 

"Epilepsy and paroxysmal conditions" was founded in 2008

The impact factor of this journal, as shown in the Russian Science Citation Index (RSCI) is among the highest for the periodicals on neurology and epileptology. According to RSCI, the biennial impact factor was 0.492 in 2013, 0.509 in 2014, and 0,511 in 2015.

The journal publishes scientific papers on clinical studies, as well as reviews on epilepsy and chronic pain syndromes.

Languages: Russian, English 

Periodicity: 4 issues per year (quarterly). 

The printed versions are distributed under the Creative Commons Attribution 4.0 License: full-text materials are freely available to the public in an open access repository.


Distribution of the printed version: Russia, the EurAsian Economic Community (EurAsEC) bcountries (Belarus, Kazakhstan, Kyrgyzstan, Tajikistan, Uzbekistan, Armenia, Moldova), Ukraine, Georgia.

The editorial board of "Epilepsy and paroxysmal conditions" includes full and corresponding members of the Russian Academy of Sciences, as well as distinguished neurologists from Russia, Switzerland, Denmark, Lithuania, Ukraine, Belarus, Moldova, Georgia, Kazakhstan, Uzbekistan and Tajikistan. 

The editorial board of this journal maintains the policy of full compliance with all principles of publishing ethics. Our ethical standards and codes conform to those of top international science publishers.

All submitted materials undergo a mandatory double-blind peer review.

Media Certificate of Registration: ПИ №FS77-34885 of December 29, 2008.
ISSN 2077-8333 (Print)
ISSN 2311-4088 (Online) 

By the decision of the Higher Attestation Commission (HAC), "Epilepsy and paroxysmal conditions" is included in the "List of top peer-reviewed scientific journals and publications" where scientists seeking academic degrees are required to publish their results.

The "Epilepsy and paroxysmal conditions" journal appears in the Russian Universal Scientific Electronic Library (RUNEB) elibrary.ru and is also present in the database of the Russian Science Citation Index (RSCI). Concise versions of major articles from this journal are published by the All-Russian Institute for Scientific and Technical Information (VINITI). The journal is also indexed by "Ulrich's periodicals Directory" – a global information system of periodicals and continued publications.

Current issue

Vol 13, No 3 (2021)

ORIGINAL ARTICLES 

192-199 185
Abstract

Objective: to evaluate the role of seizure severity and epileptiform activity index (IEA) assessment in newly-diagnosed idiopathic generalized epilepsy with generalized tonic-clonic awakening seizures (GTCS).
Material and methods. The study included 31 patients with newly-diagnosed generalized epilepsy with GTCS aged 14–52 years (mean age 25.06±9.3 years), which were divided into two groups depending on seizure severity: Group 1 (n=9, 29%) with <18 points, and Group 2 (n=22, 71%) with ≥18 points. Seizure severity was analysed by using National Hospital Seizure Severity Scale (NHS3). All patients underwent video-electroencephalography monitoring (8–24 hours) with IEA assessment at baseline and at 1, 3, 6 and 12 months after the beginning of treatment. Therapeutic efficacy was assessed using the criteria of seizure absence (medically induced remission), seizure rate decrease by >50% (responders), seizure rate decrease by <50% (insufficient efficacy), seizure rate increase and retention in treatment.
Results. Total EAI at baseline was significantly higher in patients from Group 2 (p=0.019). Despite markedly reduced EAI level in both groups, in Group 1 (less than 18 points by NHS3) EAI was significantly lower compared to Group 2 (≥18 points) at all subsequent visits: visit 2 (p=0.038), visit 3 (p=0.035), visit 4 (p=0.047), and visit 5 (p=0.022).
Conclusions. Assessing seizure severity may become an additional objective criterion while evaluating treatment efficacy.

200-210 137
Abstract

Objective: to prove the therapeutic equivalence and similar safety profile of “Sibazon, rectal solution” (international nonproprietary name: diazepam) and “Sibazon, solution for intravenous and intramuscular administration” in children with primary generalized and bilateral tonic, clonic and tonic-clonic seizures.
Material and methods. An open-label, randomized clinical trial on efficacy and safety was conducted in 20 patients suffering from epilepsy with generalized seizures aged 1 to 17 years. Clinical blood and urine tests, biochemical blood analysis were used for diagnostics (glucose, total protein, albumin, total bilirubin, cholesterol, aspartate aminotransferase, alanine aminotransferase, creatine phosphokinase, alkaline phosphatase, creatinine, urea, creatinine clearance), as well as data on electrocardiographic (ECG) and electroencephalographic (EEG) studies. The patients were divided into two groups: in Group 1 (n=8), a rectal solution was used, in Group 2 (n=12) – a solution for intravenous and intramuscular administration.
Results. The number of cases in which seizures were completed within 10 minutes after using the drug without resuming within subsequent 60 minutes, in Group 1 was 7 (87.5%), and in Group 2 – 9 (75.0%) (Fisher exact test (FET): p=0.617). Repeated primary generalized or bilateral tonic/clonic/tonic-clonic seizures within 24 hours after drug administration, in Group 1 were absent in 5 (62.5%) patients, in Group 2 – in 6 (50%) (FET: p=0.670); within 48 hours after drug administration – in 5 (62.5%) and 7 (58.3%) children, respectively (FET: p=1.00). Physical examination revealed no pathology in all patients at the final visit. While comparing ECG and EEG data at the final visit, no inter-group differences were found by the number of children with deviations from the norm. The results of laboratory studies confirmed that using the studied drugs had no negative effect on the main indicators of clinical and biochemical blood tests as well as clinical urine analysis.
Conclusion. The effectiveness of the rectal form of Sibazon in relieving pediatric generalized epileptic seizures is comparable to that of Sibazon for intramuscular administration. The drug rectal form, due to easy-to-use administration, is preferable for outpatient practice. “Sibazon, rectal solution” is safe and has good tolerability.

211-225 132
Abstract

Objective: to study teratogenic effect – the long-term pregnant mother-taken antiepileptic drugs (AEDs) related consequences on paired child mental, social and intellectual development.
Material and methods. There were enrolled 80 subjects: 40 children aged 3–9 years and paired mothers suffering from epilepsy for 3 to 35 years. Thirteen and 27 patients had generalized and focal epilepsy, respectively. Seven mothers were in prolonged remission without taking AEDs, 23 were on monotherapy and 10 were on polytherapy. Child research methods: T. Achenbach's clinical CBCL (The Child Behavior Checklist) scales (for children aged under 5 and 6–18 years), a questionnaire for detecting attention deficit hyperactivity disorder and other behavioral disorders modified by N.N. Zavadenko, Wechsler Intelligence Scale for Children (WISC), Luria batteries of neuropsychological tests adapted by J.M. Glozman (for children aged 3–6 and 7–12 years).
Results. Neuropsychological study and assessment of intelligence revealed problems in the development of praxis, speech, gnostic functions and memory, as well as disproportion in the development of verbal and non-verbal structures of intelligence. The most common behavioral disorders in children were impulsivity, distraction, difficulties in controlling and organizing movements. The most affected spheres were praxis (motor awkwardness, fine motor disorders of the hands) and speech.
Conclusion. The proposed hypothesis that the teratogenic effect of taking AEDs may result in unevenness or delay in developing mental functions in a child was confirmed.

226-236 143
Abstract

Objective: to study the electrophysiological parameters of brain bioelectric activity and features of the autonomous nervous system assessing heart rate variability, sympathetic skin response, clinical and physiological tests depending on the lateralization of migraine pain syndrome in the right or left brain hemisphere in patients with epileptic electroencephalogram (EEG) signs and migraine.
Material and methods. Thirty six patients with aura-free episodic migraine at risk of developing epilepsy and 9 age-matched healthy subjects were examined. All participants underwent EEG, clinical and physiological tests, assessment of heart rate variability and sympathetic skin response.
Results. Patients with right-hemisphere migraine headache had signs of activated sympathetic nervous system at baseline level and during exercise, lower baseline EEG epileptiform activity and in provocative tests. In contrast to the subjects of this group, patients of other group featured with a more stable migraine pain syndrome in the left hemisphere tended to dominate with functional activity of the parasympathetic system such as increased trophotropic support during exercise, as well as greater magnitude of baseline epileptiform bioelectric activity and during load tests.
Conclusion. Values of heart rate variability in combination with objective results of clinical and physiological assessment of the autonomous nervous system and electrophysiological parameters of brain bioelectric activity are reliable prognostic indicators for varying functional conditions in patients with episodic migraine.

CLINICAL CASES 

237-248 114
Abstract

The International Classification of Functioning, Disability and Health (ICF) is a globally recognized classification for health components and health-related factors, which has been recommended by the World Health Organization for use in medical rehabilitation. In the practice of a rehabilitation doctor dealing with patients suffering from juvenile myoclonic epilepsy (JME), the ICF is used to establish a rehabilitation diagnosis and formulate the goal of rehabilitation, as well as to implement its basic principles. It provides better insight into a range of difficulties patients with JME might face at the level of personal health and in everyday life.

249-253 108
Abstract

Lennox–Gastaut syndrome (LGS) is an epileptic encephalopathy characterized by delayed mental development and intractable multiple seizure types, predominantly tonic. Drop attacks are the commonest and the most disabling type of seizures. Resective surgery is often not possible in LGS as the electroencephalogram (EEG) abnormalities are usually multifocal and generalized, and magnetic resonance image is often either normal or multilesional. We report a case of LGS with bilateral parieto-occipital gliosis where EEG before and after callosotomy demonstrated synchronized bilateral interictal epileptiform discharges and ictal discharges becoming desynchronized and running down. This phenomenon emphasizes the role of the corpus callosum in secondary bilateral synchrony.

SCIENTIFIC SURVEYS 

254-263 152
Abstract

In 2019, some restrictions for use of valproic acid in women with reproductive potential by regulatory authorities and the original drug manufacturer based on the results of studies in real clinical practice were introduced. During 2019–2021, there were a further clinical data accumulation and labeling changes. The review presents a critical analysis of the changes in prescribing information and product label. There is a long lead time from the moment when safety data become known to the moment when changes are made to the medicinal product label and patient brochures. Some of the changes, including the need for high doses of folic acid to prevent neural tube defects, are debatable. Repealing the provision for mandatory archiving of informed consent forms for valproic acid use in girls and women raises legal risks. Improvements in pregnancy prevention programs and further research on the safety of valproic acid in real-world clinical settings are needed.

264-273 237
Abstract

Objective: to analyze available publications assessing efficacy of the Mozart effect in patients with epilepsy.
Material and methods. A search for scientific publications has been performed in PubMed, Scopus and eLibrary databases by retrieving inquiries "Mozart effect" and "epilepsy" in paper title, resume and keywords. As a result, 18 studies matching inclusion and exclusion criteria were selected. The data obtained were systematized into four categories: 1) whether a single listening of Mozart’s Sonata for Two Pianos in D major, K.448 affect interictal epileptiform activity (IEA) immediately during an event; 2) whether a repeated (course) of listening K.448 affect IEA; 3) is there a delayed effect on IEA after a single or repeated listening of K.448; 4) how does the Mozart effect act on rate of epileptic seizures during ongoing therapy course of listening K.448 or afterwards.
Results. It was found that therapy with Mozart’s sonata K.448 may lower IEA index during a single listening of this musical composition and shortly afterwards. A lowered IEA index during a course listening of K.448 lasting for some time afterwards may be observed as well. Moreover, a repeated listening of K.448 may reduce rate of epileptic seizures within entire music course.
Conclusion. The analysis revealed that there are currently some reasons to consider the Mozart effect as a means of neurostimulation impacting on rate of epileptic seizures and IEA.

274-285 121
Abstract

Respiratory system pathology is the most common clinical disorder associated with COVID-19. However, there are also lesions of the immune, cardiovascular, genitourinary, endocrine systems, and digestive tract. In addition, there are numerous reports on infection-related neurological manifestations, which can be divided into 3 groups: central nervous system manifestations (headache and dizziness, stroke, encephalopathy, encephalitis, acute myelitis), lesions of the peripheral nervous system (anosmia, Guillain–Barre syndrome), secondary lesions in the skeletal muscles. Brain damage that occurs during novel coronavirus infection and determines some of the above-mentioned manifestations often account for the development of structural epilepsies. Only a few scarce review articles on neuroimaging features in patients with COVID-19 have been found in Russian research publications.
The objective of the review was to collect, analyze and summarize the results of brain magnetic resonance imaging (MRI), currently accumulated worldwide in patients with COVID-19. We present the most common diagnoses based on brain MRI in patients with COVID-19 established by foreign researchers from March 2020 to March 2021, as well as initial attempts to interpret the pathophysiological mechanisms of the changes observed in the brain substance.

286-304 143
Abstract

There is a number of unsolved issues in management of epilepsy associated with primary and metastatic brain tumors (BTs). In particular, no consensus approaches to treatment of patients with epilepsy associated with BTs have been proposed regarding use of current anti-epileptic drugs (AEDs). The review presents the relevant data on epidemiology, features of clinically manifested epilepsy at varying stages of BTs, aspects of drug-drug interaction between AEDs and anti-tumor agents, AED-related effects on cognitive functions as well as quality of life in patients with epilepsy associated with BTs. Levetiracetam and valproic acid comprise the first-line drugs for treating seizures in patients with BTs. It is unreasonable to use AEDs acting as hepatic microsomal enzyme inducers for therapy of epileptic seizures in BTs, because it may decrease efficacy of chemotherapy agents and glucocorticoids along with elevated rate of side effects. Perampanel acting as a selective noncompetitive AMPA receptor antagonist, may be one of the drugs of choice for the adjunctive therapy of epileptic seizures associated with BTs.

EVENTS 

 
306-310 147
Abstract

On June 26, 2021, a meeting of the experts of the Russian League Against Epilepsy (RLAE) was held, dedicated to the effectiveness, safety and assessing the results of drug therapy in patients with epilepsy. Having considered the history of the issue and guided by domestic and foreign experience, the participants discussed the problems associated with the use of various antiepileptic drugs for different forms of epilepsy in patients of different sex and age. Special attention was paid to psychiatric comorbidity in patients with epilepsy, increasing their compliance with treatment and quality of life. The article presents the Resolution of RLAE experts meeting adopted as a result of the discussion.

OBITUARIES 

Events

2021-09-16

XX Российский Конгресс «Инновационные технологии в педиатрии и детской хирургии

Уважаемые коллеги!

21 - 23 октября 2021 года, в конференц-залах гостиницы «Космос», г. Москва, пройдет очередной, XX Российский Конгресс «Инновационные технологии в педиатрии и детской хирургии» с международным участием.

Научная программа, XX Российского Конгресса «Инновационные технологии в педиатрии и детской хирургии» с международным участием, будет включать результаты последних научных достижений в диагностике, лечении и профилактике наиболее распространенных болезней детского возраста.

В рамках Конгресса пройдет более 15 сателлитных мероприятий, на которых будут рассмотрены актуальные вопросы в области педиатрии, неонатологии, пульмонологии, гастроэнтерологии и нутрициологии, кардиологии, неврологии, аллергологии и клинической иммунологии, нефрологии, отоларингологии, стоматологии и других областях диагностики и лечения заболеваний детского возраста.

Особое внимание будет уделено наследственным болезням у детей и новым генетическим технологиям. Важной проблемой, которая будет обсуждена на Конгрессе – это отдаленные медико-биологические последствия влияния малых доз ионизирующей радиации на детское население.

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В рамках Конгресса будет проведен Конкурс молодых ученых по специальностям педиатрия и стоматология с вручением дипломов. Молодым ученым будут вручены именные премии В.А. Таболина (по специальности педиатрия) и И.М. Коварского (по специальности стоматология).

На Конгрессе будет работать XX Международная выставка «Современные диагностические, лекарственные и нутрициологические технологии в педиатрии и детской хирургии», в которой примут участие ведущие российские и зарубежные компании, действующие на фармацевтическом рынке, в области медицинской техники и детского питания.

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