Epilepsy and paroxysmal conditions

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Vol 4, No 4 (2012)


6-10 411
Current work is dedicated to analysis of treatment with generic topiramate in mono- as well as in polytherapy in patients with different forms of epilepsy. Forclinical assessmentsHospital Anxiety and Depression Scale (HADS), quality of life questionnaire for patients with epilepsy (QOLIE-10) and efficacy primary assessment based on decrease in frequency of seizures and adverse events before and after switching to generic topiramate were used. As a result of focus investigation switch to Topsaver was associated with maintenance of stable therapeutic effect in more, than 80% of cases. No negative dynamics in changes of HADS and QOLIE-10 points were observed.
12-17 442
The main goal of our study was to gain knowledge on blood supply changes during an attack in patients with migraine without aura using contrast-enhanced perfusion-weighted MRI (PWI). Standard MRI, and PWI were performed twice: during an attack (in all three cases) and in between attacks (in two cases). Three females with long history of migraine without aura were observed. Cerebral blood volume (CBV), mean transit time of the contrast bolus (MTT), and cerebral blood flow (CBF) were calculated using Functool package. All three cases produced similar local MR perfusion changes that included reduced CBV and decreased CBF without any change in MTT. Cerebral blood supply decrease observed during migraine attack is reversible and absent during headache-free interval. Transient perfusion abnormalities occurring during recurrent attacks and confirmed by PWI may serve as one of the mechanisms causing the small subcortical white matter lesions.
18-25 776
Study is dedicated to investigation of clinical, electroencephalographic features and chronologic peculiarities of epileptic seizures, associated with focal epilepsy in children with structural changes of brain and benign epileptiformic patterns on EEG. We observed 61 patients at age of 3-22 years old (medium age 11,64 years±4,54). Our study demonstrated the prevalence of secondary generalized seizures (40,9% of cases), focal clonic seizures (37,7% of cases), seizures, coming from occipital cortex. Epileptic seizures were observed at night time (85,3% of cases). In 65,6% of cases seizures were associated only with dream (periods of asleeping, dream and awakening) and were not occuring in wakefulness. In 19,7% of patients seizures occurred in dream as well as in wakefulness. Most often (in 54,1% of patieпts) rare seizures, occurring several time in an year (31,2% of cases), or in single cases in whole period of disease (22,9%).
26-31 756
Authors of the current article have made clinic- electroencephalographic and neurovisualisative analysis of group of 85 patients with different forms of focal epilepsies with indications to epileptic aura. It was established that in 6% of cases clinical manifestations of aura didn’t match the criteria described in classification of epileptic aura by Cleveland Clinic Foundation, Ohio, USA. These stereotypic feelings, occurring before epileptic seizure of another character or isolated and described by patients as «unexplainable feeling, prompting the upcoming the seizure» was proposed to name as undifferentiated aura. As a result of detailed analysis of group patients with undifferentiated aura was established, that in most of the cases there was link between clinical manifestation of epilepsy, including auras, and temporal region of brain cortex. Authors demonstrate these standing points with clinical case of patient with focal epilepsy and undifferentiated auras. The article contains proposal for optimization of focal epilepsy with undifferentiated auras diagnostics.
32-39 662
The article represents the results of investigation of spike wave complex componen lateralization in patient with prefrontal epilepsy. Meaning of absolutely dominance of left hemispheric localization spike and postspike wave was shown. The problem of hemispheric asymmetry is discussed.
40-48 445
Focused observational study on efficacy, tolerability and quality of life in adult patients with different forms of epilepsy taking combined therapy with lamotrigine (Sazar). 32 patients (19 men and 13 women), 23-79 years old with focal forms (cryptogenic and symptomatic) epilepsy with different disease duration and presence of of different type and etiology seizures were enrolled into the study. Patients having been taken various antiepileptic drugs in monotherapy with different efficacy degree were observed. Patients sample included 20 patients, receiving valproic acid in various dosages and 12 patients, receiving topiramate. Sazar was added as a second drug with initial dosage of 25 mg daily. Results of focused observation allow us to make conclusion of possible expedience of Sazar indication, especially in patients in whom therapy with valproic acid is less effective.
49-54 448
Clinical, anamnestic and immunological features, type of interrelation between organic and neurophysiologic brain disorders as well as peculiarities of pharmacotherapy were investigated in 166 patients suffering from epilepsy (E) combined with organic encephalopathy (OE). The morbid state in E and OE patients was found to be manifested by syndrome complexes, with each of them dominating at a certain stage. E intencity was noticed to depend on the type of cerebral structural-morphological disorders. The evaluation criteria of the severity degree (diagnostic algorithm to assessment of condition) of E progressing in interconnection with OE were developed. Specificity of topographic interrelations of morphological and neurophysiological brain defects were found to influence epileptogenesis level. The conclusion is that maladaptive influence of OE on mechanisms of cerebral homeostasis compensation in E results in lowering of OE responsiveness to pharmacologic treatment and requires more intensive therapy.

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