Epilepsy and paroxysmal conditions

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Vol 15, No 2 (2023)


92-106 756

Background. One of the main goals of rehabilitation programs is to improve the quality of life (QoL) of patients with various chronic diseases, including epilepsy. However, the issues of rehabilitation of adult patients with drug-resistant epilepsy remain not fully resolved.

Objective: to evaluate an impact of the author-proposed EpiTapp® method on QoL of patients with drug-resistant structural focal epilepsy (SFE).

Material and methods. The study involved 60 patients with drug-resistant SFE: main group – 30 patients (median age

33.5 years) with drug-resistant SFE who along with antiepileptic therapy regularly used the wrist tapping EpiTapp® method as an element of emergency self-help upon appearance of the first signs of arising epileptic seizure; control group – 30 patients (median age 39.5 years) with drug-resistant SFE who used no EpiTapp® method, but continued to receive previously selected antiepileptic therapy. QoL was assessed by the questionnaire approach using author-translated Quality of Life in Epilepsy Inventory (QOLIE-31).

Results. While comparing QoL of two patient groups over a 6-month follow-up period, a significant (p<0.05) positive parameter dynamics was demonstrated only in main group but not in control group.

Conclusion. The author-based EpiTapp® technique improves QoL of patients with drug-resistant SFE and can be used as an additional method of rehabilitation.

107-114 227

Background. Drug support provided to the general population and medical institutions represents one of the most important directions in social policy of the Russian Federation.

Objective. To determine the awareness epileptologists and epilepsy patients about legal normative and regulatory aspects regarding preferential drug provision (PDP).

Material and methods. The study was conducted by using empirical data retrieved from questionnaire survey of epilepsy patients and epileptologists. We used an original questionnaire that consisted of questions about the PDP legal normative and regulatory aspects as well as organization of drug provision for patients with epilepsy.

Results. The study data revealed that half of the surveyed patients were unaware of the legal right to have a reduced drug coverage for patients with epilepsy without disability. The normative document designating the categories of diseases including epilepsy as well as the level of appropriate drug coverage for which citizens may qualif, was unknown to either patients or health care workers. Both groups named no the authorized body to which they should apply in case of refusal obtain a preferential vacation leave. The minimum number of correct answers was received to the questions about the maximum term of course prescriptions for reduced-price supply, the term of service for such prescriptions as well as the term for submission of notice on unwanted response to Federal Service for Surveillance in Healthcare (Roszdravnadzor). One-third of patients were unaware of the opportunity for electronic appeal to a state health care authority.

Conclusion. There is a need for educational activities among health care professionals and patient outreach to increase awareness of own legal rights and responsibilities of participants of PDP for epilepsy patients.

115-124 313

Background. Generalized seizures are often complicated by life-threatening health problems (such as airway obstruction, suppressed respiration and severe injuries) or observed as a manifestation of sudden cardiac arrest that determines a need for rapid recognition and management of the problem. Since immediate arrival of emergency medical service (EMS) specialists to a victim is impossible in most cases, first aid (FA) provision by immediate witnesses of seizures is of paramount importance for preventing death.

Objective: to analyze modern principles and approaches to FA provision for generalized seizures, to study existing organizational framework and to identify areas for improving the organization of FA provision for seizures, as well as to develop a draft domestic algorithm for distant consultation of untrained witnesses by emergency dispatchers on FA provision in generalized seizures.

Material and methods. The analysis was carried out for international and national guidelines on FA, domestic and foreign scientific publications corresponding to the study topic, as well as normative legal acts regulating FA provision in Russia, foreign sets of protocols for EMS dispatchers containing instructions on FA in seizures intended for remote (by telephone) provision to witnesses of the incidents.

Results. Based on the analysis of international and national guidelines on FA and existing dispatch protocols, taking into account the methodological recommendations approved by the Ministry of Health of Russia that determine general principles for receiving requests from the public by EMS dispatchers, the draft universal Russian-language algorithm for dispatcher interrogation and instruction of incident witnesses on FA provision for generalized seizures was developed. A need to modernize the domestic regulatory framework in terms of including seizures in the list of conditions for which FA should be provided, and officially approve the sequence and rules on FA provision for seizures was substantiated.

Conclusion. In Russia, the organization of FA provision for generalized seizures is not optimal and requires improvement. The effect of prompt involvement of untrained witnesses of seizures in the process of providing aid is expected to be ensured by introducing a practice of consulting incident witnesses on FA provision by emergency dispatchers over the telephone. The developed universal dispatch algorithm, after its discussion and testing, could act as one of the basic components of the domestic program for FA distance support.

125-134 156

Background. Education regarding epilepsy is paramount because it is one of the measures to equip individuals with knowledge and skills for managing seizures, and reduce stigma and misconceptions towards this disease.

Objective: to determine the perceptions of life skills educational advisors regarding the inclusion of epilepsy lessons in life skills education.

Material and methods. The study employed an exploratory-descriptive design. It was conducted in Limpopo and Mpumalanga Provinces in South Africa. Eight life skills educational advisors were selected through snowballing sampling techniques, and data were collected using semi-structured interviews and analyzed using ATLAS.ti program.

Results. Four themes emerged which emphasize the need to include epilepsy in life skills education because the information regarding it is insufficient: life skills educational advisors’ knowledge of epilepsy, the benefits of including epilepsy in life skills education, content for such education, and methods of teaching. Some individuals consider epilepsy is a medical condition whereas others believe that it is a disease caused by witchcraft.

Conclusion. There is a need to include epilepsy in life skills education as it will improve people's awareness about the disease.


135–147 290

Due to elevated frequency of autoimmune epilepsy cases, the issues related to reliable clinical and laboratory-instrumental criteria for establishing the disease etiology become relevant. Differentiated assessment of autoantibody markers allows to choose the most effective tactics for managing patients. The article presents the criteria for assessing autoimmune epilepsy as well as diagnostic scales, features related to clinical picture and response to therapy based on the type of synthesized autoantibodies. Therapeutic lines and targets for immunomodulatory and antiepileptic drugs used in autoimmune epilepsy are detailed, the knowledge of which along with clinical and laboratory data collectively allow to determine effective and safe therapy algorithm.

148-159 1014

Post-stroke developing epileptic seizures represent a severe complication aggravating post-stroke condition. Epilepsy can exacerbate cognitive, psychopathological, somatic disorders resulting from cerebrovascular and comorbid diseases. Despite that post-stroke epilepsy (PSE) is a rather common type of acquired structural epilepsy, the issues related to diagnosis and management often raise difficulties for clinicians. Patients with severe strokes affecting brain, cortex, acute symptomatic seizures and intracerebral hemorrhage are at greater risk of developing PSE. Timely neurophysiological, neuroradiological research methods, assessed blood biomarkers as well as prognostic models provide information that complements PSE clinical risk factors. The management of post-stroke acute and long-term (late) symptomatic seizures differs markedly. At the same time, the choice of an optimal anticonvulsant drug should be based not only on its effectiveness, but also on related side effects, pharmacodynamics as well as an impact on concomitant diseases. Drug interactions, especially between anticonvulsants and anticoagulants or antiplatelet agents also affect a choice of treatment, which should be taken into consideration for management of PSE patients.

160-170 1013

The review considers pharmacological characteristics of new antiepileptic drugs (AEDs) of the third generation such as eslicarbazepine, lacosamide, retigabine, perampanel, everolimus, brivaracetam, zonisamide. The data on the mechanisms of action, pharmacokinetics, drug interactions, indications for use and side effects are presented. The drugs are recognized as superior in safety and efficacy to previously known AEDs of the first and second generations. The majority of new AEDs is used to control focal seizures, as well as in specific epileptic syndromes (Lennox–Gastaut syndrome, Dravet syndrome), and tuberous sclerosis. The drugs differ in the mechanism of action, pharmacokinetic properties, effectiveness and profile of side effects, which account for an opportunity to apply a personalized approach to patient treatment. Properly selected therapy allows to achieve good control over epileptic seizures as well as lower a risk of disease-related complications. While prescribing AEDs, it is necessary to take into account their pharmacokinetic and pharmacodynamic features.


171–192 310

The purpose of this article is to familiarize medical specialists involved in registration and analysis of electroencephalographic (EEG) studies using methods of mathematical processing and analysis for recorded EEG data. Understanding the principles of how quantitative EEG analysis tools work should help medical personnel to properly use their capabilities and ultimately improve quality of medical care. Here, we discuss basic and innovative mathematical tools for EEG processing and analysis.


193-201 251

This paper represents a unique study carried out by a team of physicians having diverse medical experience (practitioners, residents, students), who relying on own viewpoints positions came to a common understanding and began to consider epilepsy not only as a severe, chronic, and widespread brain disease, but also as a part of human culture reflected in many literary works. Our study was aimed at searching and analyzing available sources that describe a course of epilepsy and its impact on life of famous people as well as its role in society. Literary images created in diverse centuries and eras by writers who personally suffered from epilepsy (F.M. Dostoevsky, Edgar Allan Poe, Wilkie Collins, and many others) turned out to be so colorful and convincing that they sometimes anticipated appearance of the first descriptions in professional medical literature, and even lay down in their basis.

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