The International League Against Epilepsy (ILAE) has developed and approved the Operational classification of seizure types 2017 and the Classification of the Epilepsies 2017 . According to the ILAE 2017 Operational classification of seizure types,   seizures  can be initially divided into focal or generalized; and the seizure onset  is of crucial importance in this case. Focal seizures are optionally subdivided into focal aware seizures and focal impaired awareness seizures. Several new types  of generalized-onset  seizures  were implemented. Specific motor and non-motor  classifiers may be added. Unknown onset seizures are placed separately.  Three levels of diagnostics are specified in the 2017 ILAE Classification of the Epilepsies: seizure type (defined in accordance with the 2017 ILAE Operational classification of seizure types), epilepsy  type  (focal, generalized,  combined  generalized  and focal, unknown),  and epilepsy  syndrome.  An etiologic diagnosis should be considered  at each step along the diagnostic pathway. A patient ’s epilepsy may be classified into more than one etiological category. The term “benign” is replaced by the terms “self-limited” and “pharmacoresponsive” to be used where appropriate. The term “developmental and epileptic encephalopathy” can be applied in whole or in part where appropriate. The 2017 Operational classification of seizure types and the 2017 ILAE Classification of the Epilepsies can be helpful both in routine clinical practice and scientific research that will assist  in improving epilepsy care and quality of life of patients with epilepsies.

Objective: to estimate the role of MR – tomography in epilepsy diagnostics. We have analyzed the main protocol used for examination of patients with epileptic seizures in anamnesis, as well as a number of modern techniques,  which help to get additional information about both structural and functional changes in the brain. We have described several types of pathological changes detected by us during examination of the patients from this group.

Pharmacotherapy of epilepsy requires deep knowledge  of anti-epileptic drugs (AEDs), including the following issues: spectrum of therapeutic efficacy and therapeutic strength, adverse effects (especially severe and life-threatening adverse reactions); specific features of pharmacokinetics,  pharmacodynamics, and drug interactions; titration rate, the need for laboratory tests  during treatment,  pharmacoeconomic components.  The main properties  of antiepileptic drugs  are defined by their mechanisms of action. Today, particular attention is paid to the drugs with broad spectrum  activity, which give an ability to use them in patients with so-called undifferentiated epilepsies. In this article, the authors describe their own experience in optimization of antiepileptic therapy in a group of 141 patients with various forms of epilepsy. This new optimized  strategy implies inclusion of modern  broad spectrum  AEDs in treatment  schemes along with the reduction  in use  of narrow spectrum  drugs.  Moreover, polytherapy  was  used  in most  of the cases  after treatment regimen correction. All the measures  allowed to achieve remission  in about half of the patients with epilepsy earlier considered as incurable.

Antiepileptic drugs are frequently associated with a risk of adverse effects,  which have an impact on the tolerability and success of treatment. Patients who develop intolerable adverse effects have to discontinue treatment early after initiation or to switch to another antiepileptic drug. A long-term management  strategy for the patients with such a long-lasting chronic disease  as epilepsy should include both effective  seizure control and early detection  of adverse drug events, ensuring prognosis, prevention and minimizing side effects,  which is quite important. All these measures  are expected to improve adherence to treatment, quality of patients’ life and control of epilepsy.