Epilepsia and paroxysmal conditions

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Vol 4, No 2 (2012)


6-12 107
In this paper we are discussing the issues of diagnosis, classification, features of preoperative evaluation and surgical treatment of focal cortical dysplasia in children. Particular attention is paid to the complexities of visualization of FCD, as well as the reasons of frequent poor postoperative outcomes in epilepsy associated with FCD.
13-20 293
Data of own examinations and literature analysis regarding multifocal epilepsy are presented in the article. The analysis of etiology, clinical implications and prognostic factors of multifocal epilepsy of children and adults was done. It was discovered that the reasons of multifocal epilepsy in children are epileptic encephalopathies, genetic canalopathies and consequences of perinatal brain lesions. Formation of multifocal epilepsy in adults is associated with traumatic, ischemic and toxic factors, etc. Localization of epileptic sources is directly associated with zone of lesion: the source is located perifocally to zone of lesion in the structure or mediobasal temporal zones, that are more sensitive to diffusive effect of lesion (toxic and ischemic). More often localization of sources of epileptic activities in children is not associated with lesion character and zone. Multifocal epilepsy in children has very unfavorable prognosis, especially if caused by current pathological process (epileptic encephalopathy, neuroinfection). And on the contrary, multifocal epilepsy in adults is more successfully treated.
21-27 96
Mitochondrial diseases (MD) represent a large clinically heterogeneous group of disorders that arise as a result of dysfunction of the mitochondrial respiratory chain. The article discusses clinical features of the MD, accompanying by epilepsy. Two case reports are presented of MELAS syndrome and Alpers-Huttenlocher syndrome. The genetic background of MD is discussed as well as methods for establishing the diagnosis of MD and peculiarities of antiepileptic therapy
28-33 111
Nonconvulsive epileptic seizures make the most part of all attacks which are registered in patients with mostly a focal epilepsy, the status of nonconvulsive seizures (NCSE) represents the most difficultdiagnostics problem for neurologist, epileptologist or reanimatologist. However, the given problem is insufficiently studied till now, not numerous data on diagnostics and treatment of NCSE are presented in literature.According to literature more than 30 % of patients of emergency care departments with infringement of consciousness of unknown reason are patients with NCSE.»New» antiepileptic drugs for intravenous introduction (valproates, levetiracetam,lacosamid) may give us new opportunitiesand perspectives in treatment of patients with serial nonconvulsive seizuresand NCSE.
34-39 88
Results of own investigations and literature review on clinical symptomatology of temporal epilepsy seizures are represented in the article. Analysis of 63 seizures in 32 patients showed that often during temporal epilepsy initial implications of seizures like aura, oral alimentary and hand automatisms, discontinuation of activities are present. High prognostic value for determination of epileptiform site lateralization in temporal epilepsy has combination of following clinical symptoms: automatism of hand at side of epileptogenic site and dystonic hand placement at the opposite side. Although, none of the clinical symptom alone can reflect epileptogenic site localization with absolute accuracy.
40-47 86
There was carried out the therapeutic drug monitoring of antiepileptic drug carbamazepine by use of a bayesian mathematical modeling method in 47 patients with a focal epilepsy. The database of patients pharmacokinetic characteristics concerning carbamazepine was created. According the results of carbamazepine monitoring anticonvulsant dosage regimen was corrected
48-54 96
use of Depakine Chronosphere in Russian clinical practice for first line monotherapy for treatment of adult patients with epilepsy Study objective: to get additional Russian data on Depakine Chronosphere efficacy as a first line monotherapy for treatment of adult patients with epilepsy. Methods: the study was short-term open-label, observational, prospective by its design and was conducted very close to the real clinical practice. Duration of the observation was 2 months. 494 patients older than 18 years (mean 30,2±14,1 years) with different forms of epilepsy were enrolled into the study. Symptomatic focal epilepsy forms were diagnosed in 52% of cases, presumably symptomatic – in 16,8% cases, idiopathic generalized epilepsy – in 29,8%, unspecified – in 1,4%. Patients received Depakine Chronosphere in mean day dosage of 18,58 ± 5,53 mg/kg. Drug efficacy was assessed on the basis of changes in number of seizures. Besides of this, subjective assessment of treatment efficacy was performed by physician and patient. Safety was assessed on the basis of adverse events reports by patients during the observation period. Results: more than 90% of all patients had positive effect on treatment with Depakine Chronosphere (epileptic seizures were stopped and their number reduced). Epileptic seizures were completely stopped in 64,4% of patients. The drug was effective in different forms of epilepsy (in partial and as well as in generalized). Depakine Chronosphere showed good tolerability. Adverse events were observed in 15,7% of patients, but only 0,8% of them led to therapy discontinuation . Physicians and patients assessed treatment efficacy as very good and good in more, than 90% of cases. Good efficacy and tolerability of therapy were confirmed by scale of common clinical assessment – 61,1% of patients had significant improvement and absence of the side effects, 17% of patients had significant improvement and nonsignificant side effects. Conclusion: the study demonstrates efficacy and tolerability of Depakine Chronosphere as monotherapy of epilepsy in adults and it can be considered as a first line therapy.


56-66 68
Results of Depakine Chronosphere use in Moscow city out-patient clinics are demonstrated in the article. 48 patients with focal forms of epilepsy (cryptogenic and symptomatic) were examined: 32 men and 16 women in age of 16 - 59 years with different duration of disease and different types of seizures. Depakine Chronosphere was indicated to patients who were already taking antiepileptic drugs in monotherapy with efficacy of 50% and more, and also to patients with drug remission, but with side effects, requiring changes of current indications. Results of the observation demonstrated high efficacy of Depakine Chronosphere in adult patients with different forms of focal epilepsy in monotherapy and also its use possibility in case of noneffective or poor tolerability of other valproates and carbamazepine.
67-71 134
Data on carbamazepine prolonged dosage forms use for treatment of epilepsy are presented in current review. Expediency of carbamazepine prolonged forms use in patients with different epilepsy forms and types of seizures is demonstrated. Besides its efficacy for stopping epileptic seizures prolonged dosage form of carbamazepine has stable plasma concentration, that is associated with better tolerability profile.

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