Epilepsy and paroxysmal conditions

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Vol 9, No 2 (2017)
View or download the full issue PDF (Russian)




67-73 600

In this review we discuss clinical significance of using evoked potentials in children with epilepsy and related disorders. This approach has been commonly adapted for practice in pediatric epileptology. In most cases, it serves a neuromonitoring tool to assess the effectiveness of a therapy program and / or its side-effects. In addition, the method of evoked potentials is helpful in testing the central inhibition and excitation balance in different forms of epilepsy. In this respect, we also take a look at the impact of epileptic activity on the function and development of brain regions. The method of evoked potentials may be used for localization of epileptic lesions in children suffering from focal epilepsy. Given the variety of existing modalities of evoked potentials, their safety, painlessness and neuromonitoring qualities, we recommend to expand the use of these techniques in pediatric patients with paroxysmal disorders.

74-90 12721

West syndrome is an epileptic syndrome, characterized by a triad of symptoms: infantile spasms, hypsarrhythmia on interictal EEG, and a regression or delay of psycho-motoric development. According to the current concept, two of these three criteria suffice for the diagnosis. The incidence of this syndrome is 1 per 2000 newborns. This article reviews recent publications on the etiology, pathogenesis, clinical course, diagnosis, and treatment options in West syndrome. The text is supplemented with illustrations of ictal EEG at infantile spasms and variants of hypsarrhythmia. Today, in addition to classical hypsarrhythmia, five versions of modified hypsarrhythmia are proposed: synchronized version, asymmetric version, version with stable focus of spikes or acute waves, version with rhythmic flattening episodes, version with high-amplitude and asynchronous slow activity. The hormonal therapy is recommended to begin the treatment; if not effective, vigabatrin is to be used as the second choice medication.



6-19 638

We have conducted an experiment with valproic acid drugs (used as an example), where we have identified the determinant and dominant structures of the epileptic system. The main determinant structure is hypothalamus; it is responsible for secondary generalized seizures formation. The next strusctures in the hierarchy are contralateral and ipsilateral hippocampus, contralateral cortex. Collateral subordination of the structures and the transformation of the epileptic pathological system has been revealed. We demonstrated the advantages of the Depakin Chronosphere microgranules and effectiveness of the drug for treating children, adolescents, adults and elderly patients with epilepsy. The results of experimental studies with Nano-Phenazepam substantiate its further development as an antiepileptic drug for the treatment of secondary generalized seizures and prevention of status epilepticus. To optimize the surgical treatment of pharmacoresistant epilepsies, it is necessary to use minimally invasive functional neurosurgical techniques and/or their combination in each individual patient.


41-49 829

Temporal epilepsy is one of the most common forms of epilepsy. This form of epilepsy is diagnosed in about 25% of all epileptic patients; around 30-40% of temporal epilepsy cases are drug-resistant. Since 1945-1955, both preoperative diagnosis and surgical treatment of temporal epilepsy have been consistently improving. Indications for surgery include drug-resistance, disease progression and a decline in patient’s quality of life. Surgical treatment of temporal epilepsy results in remission or essential decrease in the seizure incidence in 60 to 85% of patients. In this report, a female patient (35 years old) diagnosed with temporal epilepsy at the age of 2, is described in terms of preoperative diagnostic procedures and subsequent surgical treatment.

50-56 2364

The report addresses the causes and diagnostic problems of cryptogenic focal frontal epilepsy. A clinical case of a patient with cryptogenic focal frontal epilepsy is presented. In this patient, epileptic seizures have long been considered as psychogenic non-epileptic paroxysms.


57-66 786

Objective of the research is to evaluate the anticonvulsant effect of the new original compound GIZH-298 (4-benzoylpyridine oxime derivative) versus valproic acid (VPA) in a model of epilepsy in rats with cobalt-induced lesions.

Materials and methods. Modeling of epileptic status was performed using the technique of creating a chronic epileptogenic focus caused by the application of cobalt to the sensorimotor zone of the rat cortex, followed by intraperitoneal administration of homolecysteine thiolactone. Compounds GIZH-298 and VPA were introduced against the background of development of electrographic status with behavioral convulsive seizure manifestations.

Results. The study revealed that GIZH-298 at a dose of 60 mg/kg (i. p.) in 50 minutes after injection reduces the number of high-amplitude generalized discharges caused by homocysteine thiolactone in the ipsilateral and contralateral cortex (46-fold decrease), in the hippocampus and hypothalamus (28-fold decrease); eliminates (in 100% of the animals) the generalized tonic-clonic seizures that arise in the advanced stage of status epilepticus. VPA at a dose of 100 mg/kg (i. p.) in 3 hours after injection significantly suppresses the EpA in all evaluated structures with the maximum value in the hypothalamus (28-fold decrease), and after 5 hours in the ipsilateral and contralateral (33-fold decrease). At the same time, VPA eliminates generalized motility of status epilepticus only in 71% of the animals and protects from death 86% of the rats.

Conclusion. The compound GIZH-298 significantly earlier (for 2 hours) than the VPA (100 mg/kg) and at a lower dose (60 mg/kg) fully eliminates electrographic (in all evaluated brain structures with the greatest efficiency in the contralateral cortex and the hypothalamus) and behavioral manifestations of unfolded status epilepticus and prevents deaths in 100%.

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