Epilepsia and paroxyzmal conditions

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Vol 7, No 4 (2015)



16-21 123
Recent epidemiological studies in 16 regions of the Russian Federation showed that seizures in patients with epilepsy missing only 14.93% of patients. Less than 5% of patients receiving "new" anti-epileptic drugs (AEDs). In many cases, drugs are administered in doses lower than therapeutic. Hence the need to optimize the treatment, research new technologies and AEDs to treat drug-resistant epilepsy. 

22-28 189
Pharmacogenetics allows to determine the cause of the ineffectiveness of drug therapy for certain groups of people who do not respond to treatment or exhibiting an inadequate response to a standard dose of the drug. Pharmacogenetic test can predict the speed and features of a metabolism of antiepileptic drugs in patients with epilepsy, depending on the activity involved in their metabolism enzyme systems and conveyors, that allows to individualize drug therapy in epileptological practice, to avoid side effects. 
29-34 124

Objective. Influence of a solar eclipse known as "Russian", phases of the moon (full moons-new moons) on the maintenance of urinary 6 Sulfatoximelatonine (SOM) in patients with focal epilepsy and healthy is studied.

Materials and Methods. 20 patients with focal epilepsy are examined: 10 during the periods of full moons and new moons – the 1st group; 10 patients with focal epilepsy (the 2nd group) and 12 healthy (the 3rd group) in the period of a solar eclipse. Concentration of the main metabolite of melatonin – a 6-Sulfatoksimelatonin (6-COM) was studied in evening and night time by an immunofermental method by means of Buhlmann 6-Sulfatoxymelatonin ELISA test system (Switzerland).

Results. The night urinary excretion 6-СОМ was higher during the new moon compared to full moon 10006.5+1272 and 6421.8 +2421.7 ng, respectively. Received reliable effect of solar Eclipse on excretion night 6 SOM. During the Eclipse, compared to the next day, evening 6 SOM excretion was lower in healthy – 1.46, patients with epilepsy – in 2.47 times. Changes in morning excretion of 6 SOM were the opposite in nature: increased in the period of the Eclipse compared to the next day in healthy (28%) and epilepsy patients (27%).

 Conclusion. Obtained data open perspective correction of disorders melatonin status to eliminate the negative influence of the planetary geomagnetic factors. 

40-49 109
The article provides basic information on the chemical structure, mechanism of action, pharmacokinetics, indications, contraindications, and the prospects of clinical application of new antiepileptic drugs: eslikarbazepin, zonisamide, perampanel and rufinamid. Each newest AEDs has a unique mechanism, improved pharmacokinetics and tolerability, thereby significantly expanding the possibilities of rational therapy of epilepsy.
50-57 186

Every neurologist or epileptologist faces a problem of changing antiepileptic treatment. The goal of the therapy is producing seizure freedom. Many patients fail a first drug due to lack of efficacy or failure to tolerate an initial medication. While monotherapy is preferable in epilepsy treatment we need an alteration in therapy. The preferred method for converting between the first and the second therapy is transitional polytherapy, a process involving initiation of a new antiepileptic drug (AED) and adjuncting it toward a target dose while maintaining or reducing the dose of the baseline medication. This articale reviews practical consensus recommendations from an expert panel for successful monotherapy to monotherapy AED conversions are then summarized. Transitional polytherapy is most successful when clinicians appropriately manage the titration strategy and consider pharmacokinetic factors germane to the baseline and new adjunctive medication. 

59-65 121
The review presents data on new antiepileptic drugs (AEDs), which have been applied in medical practice in recent years. New AEDs have different spectrum of pharmacological effects and mechanism of action. The authors presented the classification of AEDs for their ability to influence the processes of excitation and inhibition in the central nervous system. This article contains information about AEDs, blocking or modifying the ionic conductivity of the voltagedependent Na+ and Ca++-channels; AEDs, blocking glutamate receptors; AEDs, activating the ionic conductivity of K+ channels; AEDs, enhancing the braking effect of GABA
66-71 108

The frequency of detection of stroke in children has increased over the last 25 years (from 1.3 to 13/100 000). The children identified more than 100 risk factors for stroke, but more than a third of cases the cause is not identified. We have analyzed the incidence of epilepsy in children with stroke and risk factors to evaluate the possibility of occurrence of epileptic seizures. It handled 280 case histories of children who had a stroke in the period from 2013 to August 2015 (excluding children with perinatal stroke and bleeding with severe brain injuries) treated at the Morozov Children'sClinicalHospital. All children held in the dynamics of EEG, psychological testing, repeat MRI. The diagnosis of epilepsy had 24 children (8.6%) of the treated patient records. Ischemic stroke was diagnosed in 62%, hemorrhagic – 38%. In HS, prevailed children aged up to 3 years, with ischemic from 6 to 14 years. The most common attacks made their debut from 12 to 24 months after a stroke, some earlier occurrence of attacks observed in hemorrhagic stroke, from 1 month to 12 months (77%). Only 3/24 (12.5%) children seizures were observed in the acute phase stroke. In 71% was a combination of several types of attacks. Two of the children diagnosed with idiopathic forms epilepsy – childhood absence and juvenile myoclonic. Evaluation of the outcome of stroke scale PSOM-SNE and pathopsychological evaluation by the Achenbach revealed more severe neuropsychological problems in children with stroke with epileptic seizures than those without epilepsy. 


77-82 151

The purposes of researches were: studying concrete nosological forms of an epilepsy and no-epilepsy paroxysmes at children; the analysis of therapeutic efficiency of the basic groups against epileptic preparations. Materials and Methods. results of the analysis and an expert estimation of 1314 medical records are presented. The statistical analysis of the social status, perinatal and the genetic anamnesis, EEG-data and computer tomographic. Results of researches and approaches to appointment antiepilepsys preparations are presented at various forms of an epilepsy and others paroxysmes at children. 

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