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Epilepsy and paroxysmal conditions

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Vol 9, No 4 (2017)
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EDITORIAL ARTICLES

SCIENTIFIC EVENTS

76-85 178
Abstract

In the international literature, the nature of epileptogenesis is largely viewed through the relations between the epileptic focus and the nervous system. The Russian national neurophysiological and clinical science proposed the concept of pro- and anti-epileptic systems. The results of 50-year experimental and clinical studies fully confirmed this theory; some of the results are presented in this report. Among other aspects, for the first time, we explain why the avalanche of antiepileptic drugs in the pharmaceutical market cannot prevent the development of epileptic seizures resulted from the epileptic forms of brain damage.

NEWS

ORIGINAL ARTICLES

6-11 191
Abstract

Aim – to study chronic somatic comorbidity as a possible predictor of epilepsy in children after a single seizure.

Materials and methods. Based on the follow-up results, 279 cases were studied and compared: the study group – epilepsy – included 166 children with two or more seizures developed at least 24 hours after the first seizure; the control group – 113 children with a single seizure that remained isolated for the subsequent three years.

Results. We found that at the time of the first (single) attack, the background of chronic ocular morbidity (myopia, hypermetropia, optic nerve atrophy, retinal dystrophy) was significantly more common among children in the control group as compared with the confirmed epilepsy group where cardiovascular disorders prevailed. Other concomitant diseases had no statistically significant correlations with the occurrence of epilepsy after a single seizure.

Conclusion. Diagnosis of somatic comorbidity in children with a single seizure may be a prognostic factor of subsequent epilepsy.

86-95 178
Abstract

The aim of the study is the assessment of possibility of using «Bioscope» device to detect the direction of changes in the integrative state of organism of rats under the influence of analeptic and convulsive agent of corazole, and known anticonvulsant medicaments the Phenobarbital, luminal, and diazepam. Materials and methods. Six series of experiments were performed with a 90-minute recording of integrative state of animals in the norm, after injection of corazol (50 mg/kg, subcutaneously), after injection of luminal (40 mg/kg, intraperitoneally) and diazepam (2 mg/kg, intraperitoneally), as well as after combined injection of luminal and corazole, diazepam and corazole. To record and analyze the signals of Bioscope device, a comprehensive software package was developed in the LabView software environment. Results. Signals of «Bioscope» device are changed differently after injection of corazole, luminal or diazepam. At the same time, among all used indicators, the spectral distribution of BB-intervals of «Bioscope» signals turned out to be the most sensitive to different experimental conditions. After injection of corazole, a pronounced peak in the frequency range of 0.3 osc/min is formed in the spectral distribution of inter-peak BB-intervals, which, perhaps, reflects the epileptiform state of the animal’s organism. After combined injection of luminal and corazole, as well as diazepam and corazole, the spectral distribution of inter-peak BB-intervals approaches the control type, which indicates the effectiveness of used anticonvulsants medicaments. Conclusion. The conducted research revealed the expediency of using the «Bioscope» device complex for rapid assessment of the type and dose of anticonvulsant medicaments for inerruption of epileptiform states of the organism.

12-21 193
Abstract

Aim. To predict the course of epilepsy using a set of physiological parameters.

Materials and methods. We examined 72 healthy individuals (control group) and 163 patients with epilepsy by monitoring the EEG, the evoked potentials, and the parameters of the motor and vegetative systems. Based on the cluster approach, the patients were subdivided into subgroups according to their clinical and psychological characteristics, as well as the quality of life. These subgroups were quantitatively described using the logit regression models and the artificial neural networks technology.

Results. We were able to discern between the subgroups of patients with a favorable and unfavorable course of the disease. The patients with an unfavorable course of epilepsy had an increased latency of cognitive evoked potentials, a decreased activation of the associative and the motor cerebral mechanisms, as well as a prevalence of the sympathetic activity. We have found reasonably good correlations between the patients’ clinical characteristics and the physiological parameters based on the logit regression analysis and artificial neural networks models.

Conclusion. The clinical and psychosocial heterogeneity of patients with epilepsy is associated with the prevalence of symptomatic forms in the group with an unfavorable course of the disease. The crucial role in dividing the patients into clinical groups is played by the manifestations of nonspecific modulating brain structures.
96-102 221
Abstract

The aim was to study the seasonal birth rates of epileptic patients.

Materials and methods. Case reports of 6934 patients with epilepsy in three districts of Moscow and one medical center were analyzed. The distribution of patients according to the forms of epilepsy was conducted in agreement with the ILAE classification (2017): genetic generalized – 1475 (21.27%); structural focal – 3972 (57.28%) and unspecified – 1487 (21.45%).

 Results. The minimal seasonal rate of birth of epileptic patients, regardless of the form of the disease, was in the autumn. The maximal rate of birth occurred in July: 18.4% more epileptic patients were born in summer than in autumn.

Conclusion. Considering the children born after pregnancy of normal duration, the autumn (October) is the least favorable season for conception as far as the chances of epilepsy in these children are concerned.

22-30 174
Abstract

Aim. To assess the quality of life and mental adjustment of mothers of children with epilepsy; to further specify the areas of psychological rehabilitation.

Materials and methods. One hundred and twenty women who had children with epilepsy were studied. Clinical assessment of their mental state and their psychological condition were performed using the following instruments: the WHOQOL-BREF, the Stigmatization-of-Patients-with-Epilpesy questionnaire (Wasserman LI, Mikhailov VA), the State-Trait Anxiety Inventory (STAI), the Zung Anxiety Rating Scale (Z-CDS), the Level-of-SocialFrustration questionnaire (Wasserman LI), the Coping Strategy Indicator (Amirkhan D), and the Value Survey (Rokeach M).

Results. We found symptoms of anxiety in 51 women (42.5%) and symptoms of neurotic disorders in 34 women (28.3%); among the latter, neurasthenia was diagnosed in 8 women and prolonged depression – in 26 women. The symptoms were accompanied by dissatisfaction with their quality of life, social frustration, maladjustment, high selfstigma due to the child’s disease, hyper-social attitudes and preference for choosing irrational coping strategies in difficult situations.

Conclusion. The results indicate the ways of psychological rehabilitation (i.e. psychological education and prevention) of such mothers to improve their mental adjustment and stress resistance.

SCIENTIFIC SURVEYS

31-34 183
Abstract
The currently accepted approaches to clinical and para-clinical diagnosis of hereditary forms of epilepsy are reviewed. The optimal methods for laboratory confirmation of epilepsy are: in the case of suspected chromosome pathology – the chromosomal microarray analysis; in the case of a disease with a suspected nuclear DNA mutation – the epilepsyassociated gene panel exome sequencing of nuclear DNA; and in the case of a disease suspected for a mitochondrial mutation – the mitochondrial DNA sequencing.
35-40 157
Abstract

The inheritance of epilepsy is an important problem of current neuroscience. The present report reviews the factors that impact the development of a specific disease in children born to parents with epilepsy. Due to the increasing number of patients with autism spectrum disorders it is important to continue the research into the possible relations between these diseases in children.

41-49 254
Abstract

Diagnosis of epilepsy remains a challenging task facing physicians of various specialties. When epilepsy is suspected, neuroimaging is one of the major diagnostic tests able to localize the epileptic site and identify the underlying pathology; this information is indispensable in making the diagnosis and predicting the prognosis of the disease. Magnetic resonance imaging (MRI) is the most common modality widely used due to its high sensitivity and specificity in detecting of subtle abnormalities in the brain structure. In addition to the structural pulse sequences, the epilepsy-specific MRIprotocol incorporates a number of recently introduced techniques for the assessment of local functional abnormalities. In this report, the epilepsy-specific protocol that includes the updated pulse sequences technique was used in patients suspected of having temporal lobe epilepsy. Using this technique, characteristic changes in the structure and function of local brain segments in temporal epilepsy were demonstrated.

50-63 365
Abstract

Epileptic seizures affect the heart function and can provoke heart rhythm abnormalities and conduction disorders. Dysfunctions of the supra-segmental vegetative structures are thought to play a significant role in the development of arrhythmic syndrome in epilepsy. The asymmetric influence of the left and right cerebral hemispheres on the heart rate, the impact of antiepileptic drugs and other factors on the heart rhythm are still under discussion. The role of heart rhythm abnormalities in the pathogenesis of sudden unexplained death in epilepsy is also reviewed here. We analyze the pathogenesis of cardiac arrhythmias in epilepsy, the occurrence and risk factors, the types of disorders, the role of antiepileptic therapy and the significance of cardiac arrhythmias for the development of sudden death in patients with epilepsy (SUDEP).

64-71 274
Abstract

The majority of epilepsy cases have their onset in childhood. Compared to their peers, many more children with epilepsy suffer from severe neurodevelopmental disorders, including intellectual disability and autism spectrum disorders. In the present report, the incidence of intellectual disability and autism spectrum disorders among children with epilepsy is reviewed. Four types of connection between epilepsy and autism are discussed: these two conditions are independent as they have different etiologies and may co-occur just by chance; epilepsy and autism are associated because both originate from the same genetic defect or from an early CNS damage; autism is caused by the epileptic process, which interferes with the developing brain networks involved in communication and social behavior. Studies demonstrating positive effects of levetiracetam on the behavioral and cognitive functions (memory, attention) in epileptic children are cited.



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