A comparison was made between the efficacy of anti-epileptic (AE) outpatient treatment which was initially prescribed by neurologist, and that after therapy correction by qualified epileptologist. The prospective study enrolled 310 subjects (69.03% of females and 30.97% of males) with different types of seizures. The mean age of patients was 29.8 ± 8.7 years, duration of disease was 13.01 ± 6.7 years, and the mean age at the onset of disease was 16.8 ± 8.5 years. After treatment correction by epileptologist the share of “new generation” AE drugs has gone up significantly, and the size of administration of basic AE drugs also increased, with increased share of dosage forms with active substance controlled release. The prolonged forms of valproic acid started to be used 1.75-fold more often (from 20.6% to 36.13%), and carbamazepine by 2-fold more often (from 7.09% to 14.19%). In a year after treatment correction the medicinal remission was attained in 51.2% of patients (n = 159), and seizures became rarer (>50% - <100%) in 42.58% of patients (n = 132). Treatment appeared to be inefficient in only 6.1% of patients (n = 19). The annual frequency of seizures before and after optimization was 255.6 ± 999.6 and 19.4 ± 75.9, respectively. The inefficiency in diagnosis and treatment of epilepsy was revealed at the district polyclinic neurologist level, which indicates the requirement for close interaction between neurologists from different medical facilities.

The purpose of examination was revealing diagnostic efficiency of video-EEG monitoring for children with paroxysms. 259 children are included in examination in the age from 1 month till 18 years, from which 103 (39,8 %) girls and 156 (60,2 %) boys. All children are guided by neurologists to Centre of diagnostic and treatment of an epilepsy and nonepileptic paroxysmal disorders for refinement of the diagnosis, character paroxysmal derangement of consciousness, refinement of the shape of epilepsy, selection of adequate treatment. 80,69 % of children have acted with the diagnosis «epilepsy», 19,31 % of children – with the diagnosis nonepileptic paroxysms. Effects of complex diagnostic study in view of given video-EEG of monitoring have allowed to install an epilepsy of preferentially symptomatic character for 163 patients, and for 66 (40,49 %) patients install the partial form, for 16 (9,82 %) patients – generalized. For 68 (41,72%) patients there was a cryptogenic partial epilepsy, for 3 (1,84 %) patients – syndrome Landau-Kleffner and for 10 (6,14 %) patients – an idiopathic epilepsy. With the improved diagnosis nonepileptic paroxysms there were 96 patients. From them 44 (45,83 %) patients – with disturbance of a sleep (parasomnias), 21 (21,88 %) – with neurosolike states. Other nonepileptic paroxysms are installed for 26 (27,08 %) children, syndrome of a deficit of attention and hyperactivity – for 1 (1,05 %) the child.

Recent studies have proven the functioning of neuro-endocrine and immune systems as a united integrative functional system. This article presents the results of author’s own investigations of clinical neuro-immune disorders in epileptic patients, and the assessment of their role in disease pathogenesis and formation of treatment-resistant forms. A justification of highlyefficient use of immune modulators for treatment of nervous system diseases is presented.

Epilepsy negatively affects patient’s quality of life leading to patient’s stigmatization, i.e., isolation of an individual based on one’s negative qualities, for instance, one or the other disease, which entails negative consequences for a subject suffering from the disease. This article presents results of author’s own studies on quality of life and stigmatization aspects of epileptic patients using the WHO questionnaire and up-to-date methods of information analysis. Administration of such modern medications as carbamazepine, valproic acid, lamotrigine and topiramate allows control of quality of life and stigmatization during rehabilitation of epileptic patients.

Modern methods of instrumental diagnosis allow the rise of quality, swiftness and accuracy of diagnosis to a new higher level. This article highlights the abilities of proton magnetic resonance spectroscopy (1H-MRS), positron emission tomography (PET) and single-photon emission computed tomography (SPECT) as functional methods of neurovisualization in epileptology.

Post-traumatic epilepsy (PTE) is a serious problem. Selection of adequate medicinal treatment and disease prognosis are particularly difficult. This review of foreign literature presents recent studies’ data on PTE diagnostic and therapeutic aspects.